Myomectomy is the surgical removal of fibroids without removing the uterus.
This can be performed through the abdominal wall, stomach or if the fibroids are small by laparoscope (a small tube inserted near the belly button) or hysteroscope (a small tube is inserted through the vagina).
Myomectomy is normally only offered to women wishing to have children because most women will subsequently need to have a hysterectomy.
Myomectomy is a longer operation than hysterectomy, help often involving more bleeding.
There is considerable pain after the operation normally lasting from 3 to 10 days.
The operation is associated with heavy bleeding requiring blood transfusions. A high fever occurs in a large proportion (32%) of patients.
Normal hospital stay is 6 days to 2 weeks.
Myomectomy is very invasive surgery. There is danger of a hernia (protrusion of a portion of organ or tissue) if there is any lifting or stretching of the abdomen. For this reason women must not even lift a kettle or drive a car for at least 6 weeks.
Return to work is normally between 2 to 3 months, depending on the nature of the work.
Most women will need considerable care at home for at least 6 weeks, because they will not be able to lift or stretch or drive. This means another member of the family will need to look after them.
The most serious side effects arise because myomectomy is such an invasive procedure. Urinary tract infections (from the bladder to the kidneys) occur in 3.3% to 25% of women and wound infections in 25%.
Deep vein thrombosis (DVT) occurs in approximately 15-18% of patients having gynae surgery. This is a serious complication where a blood clot occurs usually in the leg due to the surgery and subsequent inactivity. This blood clot can move to the heart and lungs causing a potentially fatal pulmonary embolism.
The overall surgical complication rate is 1.8-25%.
Although myomectomy is effective at removing the fibroids in the short-term most re-grow and require further treatment.
Adhesions, where surgically damaged tissues grow together and can cause severe pain occur in 55-100% of women.
If a pregnancy occurs, the baby will normally be delivered by Caesarean section.
Fertility is maintained and if fibroids were the cause of infertility or miscarriage the success rate for pregnancies is high.
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Our Survey and Guidelines
Thanks to all who took part in our survey about the information and choices for their fibroid treatment. Please click here for the Patient Information and Choice Survey report and here for our report on access to UFE treatment with The Medical Technology Group and All Party Parliamentary Group on Improving Patient Access to Medical Technologies.
You MUST be offered an alternative to hysterectomy. Download the quick reference guide to the NICE guidelines.
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