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Myomectomy

Myomectomy

The Department of Obs and Gynae at Vimhans Nayati Super Speciality Hospital is one of the best in the country, offering leading-edge treatment options for patients suffering from a wide range of uterine fibroids, aka leiomyomas.

Fibroids or leiomyomas are non-cancerous elements in the uterus, usually develop during childbearing years, but can appear at any age. The leading cause of fibroids' development in the uterus is a genetic mutation of uterine muscle tissues. The genetic mutation is either inherited or runs within the family. It occurs due to more female sex hormones, progesterone, and estrogen in a female's body, leading to the risk of developing fibroids.

The surgeon's main goal during myomectomy surgery is to take out the fibroids to reconstruct the uterus. Women who go for surgery find relief against prolonged or heavy menstrual bleeding, spotting bleeding between periods, pain, or feeling of heaviness in the pelvic region, persistent pain during intercourse.

Unlike a hysterectomy, which removes the entire uterus, myomectomy removes only the fibroids and leaves your uterus. The reasons you may choose a myomectomy instead of a hysterectomy include:

  • Plan to bear children in the future.
  • Uterine fibroids might interfere with fertility.
  • Don't want to discard your uterus.

Major indication of myomectomy

Though myomectomy is a surgical process to remove excess uterine fibroids from a female's body, the symptoms may be troublesome and may include the following:

  • Heavy bleeding that may lead to anemia or low hemoglobin.
  • Pelvic pain or discomfort due to pressure on the adjacent organs.
  • Challenging to become pregnant.
  • Urinary symptoms due to pressure on the bladder.
  • The complication in pregnancy.

How to prepare for the procedure?

Before the surgery procedure, doctors ask you to fast or stop eating and drinking. Follow the doctor's recommendation before the specific hours of surgery. In case of any medication, ask the doctor if there is a change in routine, medicines, vitamins, etc.

Depending on the procedure, the patient receives any one of the following anesthesia.

  • General anesthesia- It is given to a patient that will allow you to sleep fully during the surgery.
  • Monitored anesthesia care- In this type of anesthesia, you don't feel or remember anything during surgery.
  • You have to stay in the hospital for a day or two, depending on the procedure.
  • The gynecologist will do a physical test and routine.
  • Pregnancy test in case of sudden pregnancy.
  • Blood pressure and ECG to the fitness of the heart and other body parts.
  • A blood test to check the hemoglobin level.
  • Urine test and x-rays.
  • Ultrasound to get an image of uterus and fibroids.
  • MRI gives an exact size and location of fibroids.

What are the steps involved?

In large fibroids, two or three injections are given at a range of three months gap before myomectomy that helps shrink the fibroids and reduces the risk of excess bleeding.

  • The steps include the day before and in the morning of surgery:
  • The patient requires to get admission to the hospital before the date of surgery.
  • Overnight fasting helps to administer intravenous fluids.
  • The patient will have a regular bath in the morning and wear the hospital clothes.
  • The patient will be shifted to the operation room before two hours of surgery.

Women who have multiple uterine fibroids and have chronic vaginal bleeding and severe pelvic pain due to fibroids should go for Myomectomy surgery.

What to expect after the procedure?

After the procedure, you will be required to stay in the hospital for a few days.

  • Immediate relief from the symptoms of fibroids.
  • The recovery after myomectomy surgery takes 4-6 weeks.
  • It would help if you avoided heavy or weight lifting activities in your daily life for a few days.
  • Doctors also ask to avoid intercourse and use a tampon till full recovery.
  • It is good to wait for three to four months after surgery before attempting for any conception.
  • There is an improvement in your fertility, and you have better chances of pregnancy.

Benefits of Myomectomy surgery

  • Relief from pain and heavy bleeding.
  • Relief from backache, leg pains, constipation, urinary urgency after surgery.
  • Improved fertility.
  • Issue related childbearing gets solved.

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