Tag: myomectomy

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Fibroids

Risks and Side Effects of a Myomectomy

There are several ways to remove fibroids. A myomectomy is a surgical procedure to remove uterine fibroids while keeping the uterus intact.

When fibroids are causing troublesome symptoms, and pain, and interfere with your normal activities, it is important to be aware that there are many treatment options available to relieve this burden. These treatment options can result in a decrease in symptoms, and in the case of a hysterectomy or a myomectomy, remove the fibroids completely.

Unlike a hysterectomy, which removes the fibroids by removing the entire uterus that contains them, a myomectomy is a surgical procedure to remove uterine fibroids, while keeping the uterus intact. Though it is actually more invasive than a hysterectomy, a myomectomy is an alternative to a hysterectomy for women that plan to bear children, or whose fibroids may be the cause of fertility issues.

As with all major surgeries, a myomectomy procedure does come with its own set of side effects and risks.

Some of which are:


Blood Loss:

Many women who undergo a myomectomy report an improvement in fibroid symptoms such as pelvis pressure and heavy bleeding. However, a myomectomy is still major surgery, and though it has a relatively low complication rate, the procedure still comes with its own unique set of challenges and risks.

One of the biggest risks involved in a myomectomy is the risk of excessive blood loss.

Many women with fibroids already have low blood counts and even anemia due to the fibroid symptoms of abnormally heavy menstrual bleeding. This, therefore, puts them at a much higher risk of problems due to blood loss.


Scar Tissue:

Due to the incisions that are done inside the uterus in order to remove fibroids, there is a risk of developing bands of scar tissue after surgery.


Pregnancy and Childbirth Complications:

Women of childbearing years may opt to have a myomectomy, especially over the option of a hysterectomy. However, a myomectomy can cause an increase in some risks during the delivery of a child. Though this is rare, it does happen and may result in a cesarean delivery to avoid rupturing the uterus during labor.


Increased Chance of a Hysterectomy:

Depending on the size, number, and location of fibroids, sometimes the surgeon may have to remove the uterus completely. Though this rarely happens, if the bleeding during a myomectomy becomes uncontrollable or there are additional abnormalities found in the uterus, sometimes the uterus needs to be removed as well.


Spread of Cancer:

During a myomectomy surgery, there is a very rare chance of a cancerous tumor being mistaken for a fibroid. As a result of trying to remove an unknown to be cancerous fibroid, there is the risk that it could lead to the spread of cancer.


Other potential risks and complications of a myomectomy are:

  • Hemorrhage
  • Injury to the uterus
  • Damage to the nearby organs of the urinary system
  • Infection
  • Blood clots
  • Eventual re-growth of fibroids

Though these risks and complications may be rare, they do happen. Therefore it’s important to be aware of them before deciding on any treatment plan.

In the end, you may find that both a hysterectomy and a myomectomy come with too many side effects and risks, and you may wish to learn more about a much less invasive procedure to remove fibroids, such as Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional.

In our next article, we will look at some of the things that can be done to help prevent possible surgical complications before choosing to have a myomectomy to remove uterine fibroids.

Categories
Fibroids

Removing Fibroids Permanently

A hysterectomy is still the only definitive treatment option for removing fibroids permanently. A myomectomy is a uterine-sparing treatment.

Even with all of the treatment options available to women with uterine fibroids, a hysterectomy is still a preferred treatment method, due to the fact that it is currently the only definitive treatment option for removing fibroids permanently. However, since the procedure removes the uterus and cervix, a hysterectomy is not an option for women that would like to have children.

Though medication can help relieve the symptoms of fibroids, and most likely will not interfere with fertility, it does so as a temporary fix and is not a solution to the fibroid problem.

The only way to successfully remove fibroids is through a non-invasive surgery such as Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional. Or through a major surgery such as a hysterectomy, as well as a uterine sparing surgical procedure called a myomectomy.

A myomectomy is a surgical procedure that removes uterine fibroids while keeping the uterus intact, thereby preserving fertility.

A myomectomy is usually offered as a treatment recommendation for women who wish to have children after the fibroids are removed, or who wish to keep their uterus for other reasons. The procedure can also help regulate abnormal uterine bleeding caused by fibroids, as well as other fibroid-related symptoms.

Remove the fibroids, and remove the symptoms.

Depending on the number of fibroids, their location, and their size, a surgeon will perform a myomectomy operation with one of three approaches.

The first approach is a standard open surgery, while the second and third options are less invasive.

Let’s take a look at what those operations are.

Laparotomy: 

A laparotomic myomectomy is performed as open surgery, by way of an abdominal incision. Though effective, due to its invasiveness, a laparoscopic myomectomy has a higher risk for blood loss and scarring, which can be problematic.

A laparotomic myomectomy is usually necessary when there are several very large fibroids that are located in a difficult area of the uterus to reach using other surgical methods. It is also oftentimes the best approach to removing intramural fibroids.

–     Intramural fibroids are located primarily within the width of the uterus. There are several types of intramural fibroids: anterior intramural fibroids, which are located in the front of the uterus, posterior intramural fibroids, which are located in the back of the uterus, and a fundal intramural fibroid, located in the upper part of the uterus.

Because intramural fibroids grow toward the outside of the uterus, if they are too large, they can cause fertility issues and pregnancy complications.

Hysteroscopy:

During a hysteroscopic myomectomy, fibroids are removed using a surgical instrument called a hysteroscopic resectoscope.

This hysteroscopic resectoscope enters the uterine cavity through the vaginal canal, and it is usually the preferred method for removing submucosal fibroids.

–     Submucosal fibroids are located near the outer layer of the uterus, however, they grow toward the internal layer of the uterus, called the mucosa, causing them to protrude into the uterine cavity. These fibroids tend to be symptomatic even at smaller sizes, and can even impact fertility. However, when caught early, these fibroids can be removed, thus preventing fibroid-related issues during pregnancy

Laparoscopy:

A laparoscopy is similar to a hysteroscopy, only it is less invasive and typically an option for women who have a small number of subserosal fibroids.

–     Subserosal fibroids are located near the outer layer of the uterus, known as the serosa. This particular type of fibroid grows toward the outside of the uterus. When they are small, they are unlikely to cause symptoms and usually do not require treatment. However, they should be monitored in case they become larger and therefore symptomatic.

Both the hysteroscopy and the laparoscopy have a much faster recovery time than a laparotomy, as they are less invasive than open surgery.

As with any surgery, a myomectomy does come with its risks.

Every reproductive organ is a very serious surgery, and none of the methods of a myomectomy are immune to their own set of risks, side effects, and complications.

In our next article, we will take a look at some of the risks of a myomectomy and provide more information on each procedure.