A myomectomy is a procedure used to remove uterine fibroids. There are a variety of surgical procedures available to perform the removal including hysteroscopy, laparoscopy, and laparotomy. Hysteroscopy accesses the uterus through the vagina and uses a lighted camera mounted on the end of a thin tube and other specially designed instruments. Laparoscopy is a minimally invasive procedure where the uterus is accessed through a few small incisions in the abdomen and performed with special, long thin instruments. Laparotomy uses a larger incision in the abdomen to reach the uterus and is used when the fibroids are very large, numerous, or deeply embedded in the uterine walls.
Most of the time, a myomectomy is an outpatient procedure and the patient returns home on the same day. Following the more invasive laparotomy option, the patient will stay in the hospital for between 1-4 days. For the minimally invasive procedures, recovery typically takes 1-2 weeks while the laparotomy takes between 4-6 weeks. Patients will experience some discomfort in the abdomen and are advised to avoid strenuous activity and any lifting for the first week or two following the procedure. Following the procedure, most women experience reduced vaginal bleeding and significantly less pelvic pain. Women who are trying to conceive should attempt to get pregnant as soon as possible following the procedure to reduce the risk of more fibroids growing and preventing pregnancy.
In addition to the removal of fibroids, myomectomy is also used to treat anemia which has not been successfully treated with medication. The procedure can also be used to relieve pelvic pain and pressure that has not been successfully treated through other means. Also, in cases where deeply embedded fibroids have damaged the uterine wall, causing infertility or repeated miscarriage, myomectomy is performed to improve the chances of a successful pregnancy via in vitro fertilization.
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