Let's learn simply about Myomectomy, the surgery to remove uterine fibroids.

A problem that many women have is the growth of these tumors in the uterus. Some people also call these fibroids. Because of this, you may also suffer from things like heavy bleeding during menstruation and unbearable stomach pain. This can be a great stress for someone who is hoping to have a child. So, the best solution to remove these tumors, but without damaging the uterus and preserving the ability to have a child in the future, is a 'myomectomy' surgery. Let's talk about this in detail, very simply, today.

Simply put, what is this Myomectomy surgery?

Myomectomy is a surgical procedure to remove uterine fibroids, or leiomyomas as some call them, from your uterus. These tumors are made up of connective tissue and muscle cells. They can grow inside or outside the uterus. The good news is that these tumors are not cancerous (benign) . They can occur as one or more fibroids of varying sizes.

In a myomectomy, the doctor removes only the fibroids and preserves the tissues of your uterus without damaging them. This means that you still have the ability to conceive a child in the future. This is the biggest advantage of this surgery.

In what cases is a myomectomy necessary?

If your fibroids are causing the following symptoms, your doctor may recommend this surgery:

• Persistent pelvic pain.
• Bleeding irregularly, or between periods.
• Heavy menstrual bleeding.
• A feeling of not being able to completely empty the bladder.

Especially, if you are hoping to have a child in the future and want to preserve your fertility, myomectomy surgery is a very good option for you.

Let's know the exact difference between Myomectomy and Hysterectomy surgeries.

Many people do not have a clear understanding of these two surgeries. Let's look at the main differences between these two surgeries in a table like this. This will help you get a better idea.

What to expect before surgery?

Your doctor will give you detailed instructions on what you need to do before surgery. For example, how long you should stop eating and drinking before surgery, or whether you should stop taking certain medications.

Discuss everything in advance, including how long you will stay in the hospital after surgery, and what to be careful of after you go home. Ask your doctor any questions you may have before surgery.

On the day of surgery, the following may happen:

• An IV line will be placed in a vein in your arm. This is where you will be given fluids and medications during the surgery. It will also give you anesthesia to numb your pain.
• During the surgery, you will be connected to monitors to measure your heart rate and other vital signs.
• A catheter may be inserted to drain urine during the surgery.

Are there types of myomectomy surgery?

Yes, there are three main types of myomectomy surgery. The type of surgery that is best for you will depend on several factors, including the size of your fibroids, how many of them you have, and where they are located in your uterus.

1. Open Myomectomy

This is also called an Abdominal Myomectomy. This involves making an incision in your abdomen. This incision can be vertical or horizontal. This method is best for people with very large fibroids . This is because the surgeon can see all of your pelvic organs clearly. Since this is a major surgery, the recovery time is a little longer.

• You will have to stay in the hospital for a few days.
• It can take about six weeks to fully recover and resume normal activities.

2. Minimally Invasive Laparoscopic or Robotic Myomectomy

This is the most common method used today. These surgeries require less recovery time and are less uncomfortable.

• Laparoscopic or Robotic Myomectomy: This involves inserting a small camera through your vagina, making a few small incisions in your abdomen, and inserting surgical instruments through them to remove the fibroids. The fibroids are then removed through the vagina or through those small incisions. Some doctors use a robot (Robotic Myomectomy) to perform this surgery.
• Single port myomectomy: In this procedure, all instruments are inserted through a single incision near the anus, which leaves no scars on the abdomen.

3. Hysteroscopic Myomectomy (surgery without any incisions)

This method does not require any incisions . If the fibroids are located deep inside the uterus, the doctor can insert a special camera through the vagina into the uterus and remove the fibroids. Compared to other methods, this is a very quick procedure.

What are the possible risks after surgery?

As with any surgery, there are some risks involved. However, these are very rare. Your medical team will do their best to prevent them.

• Excessive bleeding
• Infection
• Blood clots
• Damage to surrounding organs
• Allergy to anesthesia
• Increased risk of having to undergo a cesarean section when having a baby in the future.

How is the recovery time after surgery?

The recovery time depends directly on the type of surgery you had. There may be some pain for the first few days. The doctor will give you painkillers for that. Also, you will be advised to move around a bit after the surgery to prevent blood clots.

• Open Myomectomy (surgery that involves cutting the abdomen): It can take about six weeks to fully heal and resume normal activities.
• Laparoscopic Myomectomy (surgery done through a small incision): You may be able to go home the same day. It takes about two to four weeks to recover from home.
• Hysteroscopic Myomectomy (surgery performed without incisions): You can fully recover in a few days.

Expect these things after surgery

• There may be a small amount of blood or discharge from the vagina for a few weeks.
• Do not lift more than 2-4 kilos during the first week. This period may be longer if you have had abdominal surgery.
• Avoid sexual intercourse for six weeks. It is not advisable to insert anything into the vagina during the healing period.
• Start your daily routine gradually. Don't suddenly start doing everything the way you did before.

What are the symptoms that require immediate medical attention?

• Excessive bleeding.
• Flu symptoms such as fever, chills, and shivering.
• Severe pain that cannot be controlled even with medication.
• Chest pain or difficulty breathing.
• Legs become red, swollen, and painful (this could be a sign of a blood clot).