Myomectomy is a method of removing a uterine fibroid. Uterine fibroids, or uterine fibroids, are common noncancerous tumors in the uterus that usually occur at reproductive age but can occur at any age. The goal of myomectomy is to remove the fibroids or thyroid glands that cause the symptoms and then to rebuild the uterus. Unlike a hysterectomy in which the entire uterus is removed, in myomectomy only the fibroids are removed and the rest of the uterus remains intact. In women who have a myomectomy, symptoms such as heavy menstrual bleeding and pelvic pressure improve. In fact, myomectomy, sometimes called fibroidectomy, is a type of gynecological surgery in which leiomyomas of the uterine tissue, known as fibroids, are removed. It refers to the removal of a non-cancerous mass of muscle tissue that has grown abnormally. In this surgery, the goal is to rebuild the uterine tissue and relieve the symptoms, not to remove all of the uterine tissue that occurs in a hysterectomy.
Method of performing myomectomy
-Laparatomy: A laparotomy means making a large incision in the abdominal wall and inserting it into the abdominal cavity for possible diagnosis, diagnosis, and treatment. Diagnostic laparotomy is performed if the surgeon is unable to make a definitive diagnosis of the patient's condition by other methods. One or more incisions are made in the uterine muscle to remove the fibroid. Recovery after laparotomy takes about 6 to 8 weeks.
-Laparoscopy: The surgeon examines the uterus and removes the fibroids through a laparoscopic myomectomy. Studies show that this method reduces mortality and heals faster than laparotomy myomectomy. However, laparoscopic myomectomy is not used to treat very large fibroids.
-Hysteroscopy: Fibroids that protrude into the uterus and endometrium lead to infertility and miscarriage. In this case, the myoma can be removed hysteroscopically.
-Endometrial embolization (burning of the lining of the uterus): The lining of the uterus is removed, destroyed, or burned in a controlled manner to control severe bleeding. This may be done with lasers, wire loops, boiling water, electric current, microwaves, freezing, or other methods. Did. This rarely causes complications, but in some cases there is a risk of complications.
-Myolysis: Usually with the help of a laparoscope, a needle is inserted into the fibroid and then the fibroid is removed using electric current or freezing. Another similar procedure, called cryomyelosis, is used to freeze fibroids.
-Fibroma embolization (UFE) or uterine artery embolization (UAE): A very narrow tube is inserted into the blood vessels that feed the uterine fibroids and then thin plastic or jelly particles are injected into the artery to block it. This causes blood flow to the fibroid tissue to stop and the fibroid to shrink over time. Complications of this method include premature menopause but are rare.
-Laparoscopic hysterectomy: The surgeon inserts instruments into the abdomen through small incisions in the abdomen and removes the uterus. The surgeon may leave the ovaries and cervix intact so that your body will continue to produce female hormones.
Postoperative complications of uterine fibroids or myomectomy:
The possible risks after surgery are as follows:
- Bleeding, uterine infection, fallopian tubes, and pelvic infection.
- Removal of fibroids from the uterine muscle may cause scar tissue.
- In rare cases, a scar from a uterine incision may cause infertility.
- In rare cases, damage to the bladder or intestines, such as intestinal obstruction, may occur.
- In rare cases, a hysterectomy may be needed during a myomectomy. Hysterectomy is usually performed when the fibroid is removed to cause severe bleeding.
- Myomectomy surgery can increase the risk of uterine wall rupture in subsequent pregnancies. Therefore, cesarean section should be used in women who undergo this surgery to prevent the risk of uterine rupture.
Prevention of possible complications of myomectomy(uterine fibroid surgery):
* Taking iron and vitamin supplements: If you have iron deficiency anemia due to heavy periods, your doctor may suggest iron and vitamin supplements to boost your blood cell count before surgery.
* Hormone therapy: Another strategy to correct anemia or anemia is hormone therapy before surgery. Your doctor may prescribe gonadotropin-releasing hormone or GnRH agonists, birth control pills, or other hormonal medications to reduce or stop menstrual blood flow. The GnRH agonist stops the production of estrogen and progesterone, stops menstruation, and builds up hemoglobin and iron stores.
* Treatment to shrink uterine fibroids or fibroids: Hormone therapies such as the GnRH agonist can shrink fibroids and cause less damage to the uterus. can be used.
Pregnancy after myomectomy
How fibroids affect your fertility depends on the choice of fibroid surgery. You can no longer get pregnant after a hysterectomy, but you can still get pregnant after a myomectomy.