FAQs on Myomectomy in Los Angeles
Uterine fibroids are benign tumors of the reproductive tract. A myomectomy is a surgical procedure used to remove uterine fibroids while keeping the uterus protected. This procedure can help young women who wish to preserve fertility by avoiding a hysterectomy.
What are fibroids?
These growths are composed of muscle cells similar to the cells that form the uterus. Fibroids vary in size from the diameter of a pen to the size of a large cantaloupe. Uterine fibroids often do not cause any symptoms. However, they can produce frequent, heavy menstrual periods and create pelvic pressure. A fibroid uterus is the main reason for hysterectomy in the United States, accounting for 30% of these procedures.
What can I expect before the procedure?
Because general anesthesia is used, do not eat or drink after midnight the day of surgery. Leave valuables at home, and arrange to have someone drive you home. Discuss all medications you are taking with the doctor beforehand. Certain blood-thinning drugs have to be held for several days. When you arrive at the medical facility, a nurse discusses the pros and cons of the myomectomy and asks you to sign a consent form. After you change into a gown, the nurse places an intravenous catheter in your arm.
What happens during the myomectomy procedure?
After you are positioned on the procedure table, a mild sedative is given and anesthesia. After the lower abdomen is cleaned with an antiseptic solution, a small incision is made over the area. The myomectomy is done by laparoscopic means, where a small, thin, flexible tube is inserted into the uterus. This device has electronic eyes (sensitive video camera), which allows the surgeon to see inside the reproductive tract. A bright light at the end of the scope shines over the surgical area, and this is broadcast onto a TV monitor. This highly visible operative field allows the surgeon to locate and dissect the fibroids for removal.
What can I expect following the myomectomy?
After the incisions are closed with sutures and a bandage is applied, you are monitored for around 30-40 minutes. Expect to experience some soreness of the lower abdomen. You must rest for the remainder of the day, and gradually return to activities as tolerated. Do not soak in a tub or pool until the incisions have healed, but bathing is permitted.
Do fibroids cause infertility?
Fibroids are not a common cause for infertility, but if they obstruct the uterine opening or fallopian tube area, they can block entrance of the sperm and passage of the egg. For infertility to occur, both fallopian tubes must be blocked.
What is myoma coagulation?
Also called myolysis, myoma coagulation is shrinkage of a fibroid without actual removal. The procedure is done similar to the myomectomy, but a laser or electrical needle is passed into the fibroid to destroy the tissue and the blood vessels supplying it. Once the tissue is destroyed, it will gradually be absorbed into the uterus.
What are the different approaches to the myomectomy?
The open myomectomy is a major surgery, and the doctor must make a large bikini cut incision to remove the fibroids. This procedure requires extensive recovery, and is only done when other methods cannot be performed. The laparoscopic myomectomy is the most common procedure, and it is done using four small incisions. The hysteroscopic myomectomy is done for submucosal fibroids. The scope is passed through the cervix, and no incisions are made.
What complications are associated with the myomectomy procedure?
The risks associated with the myomectomy include prolonged bleeding, infection, organ trauma, and nerve injury. Most women report soreness of the pelvic region following the procedure, and cramping is expected.