MYOMECTOMY

A myomectomy is a surgery done to remove uterine fibroids while retaining the uterus, done in a women during child bearing age.

SYMPTOMS - uterine fibroids can cause.

•     Heavy periods
•     Painful periods
•     Infertility
•     Pelvic pressure
•     Increase in abdominal girth

AIM - the aim of a myomectomy is to remove the fibroids, and hence relive the symptoms and improve the chances of fertility.

TECHNIQUES OF MYOMECTOMY
1. Laparoscopic myomectomy - The surgery is performed through a few small incisions made on the abdomen. The fibroid is cut into pieces (morcellation) and removed through a small incision. Sometimes the fibroid is put into a bag (endo bag) and in-bag morcellation is done.

2.HYSTEROSCOPIC MYOMECTOMY - A fibroid that protrudes into the uterine cavity is called a submucosal fibroid. This is removed (resected) through a hysteroscope inserted through the vagina and cervix.

3.ABDOMINAL MYOMECTOMY - A large open cut is made in the abdomen.

WHAT TO EXPECT

    1.You will need to come in the morning of the surgery on an empty stomach.

   2. You will be prepared for general anaesthesia.

    3.Depending on the procedure you can go home late evening (hysteroscopic myomectomy) or stay overnight (laparoscopic myomectomy)

   4. As we perform only minimally invasive surgery here at Rashmi Hospital you will have.

•     Less pain
•     Shorter hospital stay
•     Quicker recovery
•     A much smaller scar; as compared to an open procedure.

FERTILITY AND LAPAROSCOPIC MYOMECTOMY
Women who have undergone a laparoscopic myomectomy have a good chance of improved fertility. Results are better in younger women with only 1 fibroid.

We advise waiting 6 months before planning a pregnancy, this gives time for the uterus to heal.

PREGNANCY RISKS AFTER A MYOMECTOMY
As the uterus has been operated upon, the scar on the uterus makes that area weak, which can rupture during labor. A cesarean section may be advised around 38 weeks of pregnancy.

WILL THE FIBROIDS COME BACK
Yes, they can come back especially in

•     Older women
•     Women who do not plan a pregnancy fast
•     Women who have had multiple fibroids

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HYSTEROSCOPY

Hysteroscopy is a surgical procedure where a small telescope (the size of a pencil) is used to inspect the inside of the uterus. A camera is attached to the end of the telescope and the image is viewed on a video monitor. Surgery is carried out while looking at the monitor.

DIAGNOSTIC HYSTEROSCOPY  is performed with a smaller instrument. It can be combined with a D & C (Dilatation and curettage) or an endometrial sampling.

OPERATIVE HYSTEROSCOPY.
When a problem is diagnosed during a diagnostic hysteroscopy it can be cleared or operated upon at the same time.

The operative hysteroscope is larger and has parts which allows the physician to insert operating tools like scissors, cautery or a laser.

PROBLEMS THAT CAN BE TREATED

•     Uterine polyps.
•     Uterine septum.
•     Adhesions (a scar tissue) in the uterus.
•     Same types of tubal block.
•     Uterine fibroids.
•     An old IUCD that is ‘lost’.

ROLE OF SIMULTANEOUS LAPAROSCOPY and HYSTEROSCOPY.

The surgeon may advise a simultaneous laparoscopy

•     In infertility patients to check the potency of the fallopian tubes
•     When a bicornuate (double) uterus is suspected.
•     While doing tubal cannulation in patients with blocked tubes.
•     To aid in the prevention of uterine perforation if excessive hysteroscopy surgery is performed.

WHAT TO EXPECT.

•     You will come in the morning of surgery on an empty stomach.
•     You should be able to go home in the evening.
•     In general, you will be able to return to normal activity within 1-2 days.
•     Complications are infrequent, may be same mild cramping. 

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MYTHS OF A HYSTERECTOMY

1.I will put on weight and have an early menopause.

Mood changes, dry skin etc are a sign of menopause. Menopause occurs when both the ovaries are removed and the production of the hormones stop. In a hysterectomy only the uterus is removed. Here in Rashmi Hospital, we retain the ovaries even in post menopausal women.

2.Along recovery period with bed rest.

At Rashmi Hospital all women who undergo a laparoscopic hysterectomy are home the next day and back to work or all normal activities within a week to 10 days.

3.A hysterectomy is very painful.

As we perform only laparoscopic hysterectomy, the cuts are very small and not painful. You can walk by evening and eat normal food too.

4.I will have a huge ugly scar.

No, a laparoscopic hysterectomy is done through a few small incisions (a cuts) which heal very well.

5.Sex is not enjoyable.

On the contrary some women enjoy sex more because.

•     The fear of pregnancy is no longer there.
•     Any condition like a deep fibroid which was causing painful intercourse is eliminated.

6.I will have back pain.

This is again a sign of menopause when women do not take calcium. Since your ovaries are left intact you will not experience back pain.

WHAT HAPPENS TO ME AFTER A HYSTERECTOMY.

You will be relieved of your symptoms like heavy periods, painful periods etc.

The only change that you will see in your body is

•     You will no longer have your periods.
•     You will not be able to have a baby.

 

Visit Us        : rashminursinghome.com
Reviewed By : Dr Deepak Rao
Mail Us        : rashmihospital123@gmail.com
Book Your Appointment Here : rashminursinghome.com/book-appointment.html