Prof. Dr. Ali EKİZ

Prof. Dr. Ali EKİZ

Gynecology and Perinatology (Risky Pregnancy) Specialist

With over 15 years of professional experience, dozens of national and international research articles, and most importantly, his smiling face, Gynecology and Perinatology Specialist Prof. Dr. Ali EKİZ is with you.

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What to Know About Myomectomy?

What to Know About Myomectomy?

Surgeries performed to remove uterine fibroids, also known as leiomyoma (myoma, myoma), are called Myomectomy. Uterine fibroids increase with age in women. Also known as non-malignant growths. Uterine fibroids usually develop during the childbearing years and can occur at any age. That’s why many women research myomectomy. In this article, we have compiled information that will answer the questions you have about myomectomy.

What kind of complaints do myomas cause?

Myomas cause complaints through various mechanisms.

Myomas growing into the uterus can cause bleeding and restriction.

  Myomas growing outside the uterus press on nearby organs, causing pressure complaints. For example, it can cause constipation by putting pressure on the intestines, and it can cause frequent urination by putting pressure on the bladder. Fast-growing fibroids can cause pain. Myomas that reach large sizes can be felt even by the patient himself.

What is myomectomy (myomectomy)?

Myomectomy is a surgical procedure that realigns the uterus by removing fibroids that are causing symptoms. The difference from hysterectomy, in which the entire uterus is removed, is that myomectomy only removes the fibroids. For this reason, the remaining parts of the uterus are left untouched and thus fertility is preserved. Women who undergo myomectomy surgery see improvements in a variety of fibroid symptoms, from heavy menstrual bleeding to reduced pelvic pressure.

Why is myomectomy performed?

As explained above, fibroids can cause a wide variety of complaints. These symptoms are prevented by myomectomy. Myomectomy is done for various reasons:

• Having a desire for children

• Not wanting to have the uterus removed, but also because fibroids cause serious complaints.

• Having pain that is resistant to painkillers

• Severe bleeding that cannot be corrected by other treatments

• Pain during intercourse (dyspareunia)

What are the risks of myomectomy procedure during pregnancy?

The likelihood of complications following myomectomy surgery is very low. However, myomectomy is used as a last resort during pregnancy.

Possible risks when getting pregnant after myomectomy surgery: There is a risk of rupture in the uterus. For this reason, women who have undergone myoma surgery prefer cesarean section as the method of delivery in the next pregnancy. The reason for this is that the doctor performing the surgery had to make a deep incision in the uterine wall. Therefore, although it is a very rare complication, cesarean delivery may be recommended to prevent uterine rupture.

How is Myomectomy Done?

How to perform myomectomy; It may vary depending on the size, number and location of myomas. There are three different surgical methods for myomectomy, and your doctor will choose the most appropriate method for you. We can list myomectomy methods as follows:

• Abdominal myomectomy

• Laparoscopic myomectomy

• Hysteroscopic myomectomy

What is Abdominal Myomectomy?

Abdominal myomectomy is also known as laparotomy. In this procedure, an open abdominal incision is made, as in a cesarean section, to access the uterus and remove the fibroids. If possible, a horizontal incision can be made in the area known as the bikini line. In larger uteruses, vertical incisions are needed.

What is Laparoscopic Myomectomy?

Laparoscopic myomectomy, a minimally invasive surgical procedure, accesses and removes fibroids through several small abdominal incisions. Moreover, the hospital stay and recovery process is faster after laparoscopic myomectomy. The rate of blood loss, postoperative complications and adhesion formation is also lower.

In the laparoscopic myomectomy procedure, a narrow tube equipped with a camera is inserted into the abdomen. The surgery is performed with the help of instruments inserted through other small incisions on the abdominal walls.

In some cases, fibroids are broken into pieces. This situation is called morcellation. By performing morcellation, myomas are removed through a small incision in the abdominal wall. In some cases, myomas can be removed without breaking them into pieces. For this, a larger incision may be made in the abdomen. In rare cases, fibroids can be removed through an incision in the vagina. This procedure is called colpotomy.

What is Hysteposcopic Myomectomy?

Hysteroscopic myomectomy may be recommended to treat fibroids that protrude significantly into the inner wall of the uterus (endometrium) and are small in size. These small myomas are called submucosal myomas. With hysteroscopic myomectomy, instruments are inserted into the uterus through the vagina and cervix. Using these tools, myomas can be accessed and removed.

We can list the processes of hysteroscopic myomectomy as follows:

• A small, lighted instrument is inserted into the uterus through the vagina and cervix.

• A clear liquid is filled into the uterus to expand the uterine cavity and facilitate examination of the uterine wall. This is usually a sterile salt solution.

• Pieces are removed from myomas using electricity or a knife. This process continues until the myoma is completely removed. In some cases, it is not possible to remove large myomas with a single surgery. In such a case, a second surgery is needed.

What are the things to consider after myomectomy?

A pain reliever may be prescribed by the doctor when you are discharged from the hospital. In addition, information is given about how the person should take care of himself and what restrictions should be made in diet and various other activities. Depending on the type of surgery performed, some vaginal spotting or light bleeding may occur for a few days to 6 weeks.

What are the results of myomectomy procedure?

After myomectomy, most women: There is relief from various uncomfortable symptoms such as excessive menstrual bleeding, pelvic pain and pressure. Additionally, women who have a laparoscopic myomectomy can become pregnant within a year after surgery. After a myomectomy, you must not become pregnant for a certain period of time to allow the uterus to heal. This period usually varies between 3 and 6 months.

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