Myomectomy
A myomectomy is a hysterectomy alternative treatment that involves the removal of myomas. There are several approaches and techniques for dealing with leiomyomas, (myomas) also known as uterine fibroids.
A common method for surgical treatment of leiomyomas is laparotomy or minilaparotomy with excision of the tumor(s). The incision is similar to that of a Cesarean section, though usually much smaller.
Incisions are made on the uterus where the fibroids are located. The normal muscle is separated from the uterine fibroids. using gentle traction and an electrosurgical device.
Care must be taken to minimize bleeding because the normal uterine muscle is highly vascularized and will bleed easily when disrupted.
Surgeons attempt to remove as many of the uterine fibroids. as possible through the anterior aspect of the uterus (side closest to the bladder). This is done to reduce the risk of the fallopian tubes and intestines scarring from the incision and interfering with fertility.
This risk is increased with incisions made to the posterior side of the uterus, but can be minimized with careful surgical technique. The incisions are also closed in such a manner as to reduce the risk of adhesion (scar tissue) formation.
The Division of Reproductive Endocrinology and Infertility at Duke University in Durham, NC has extensive experience with myomectomy procedures, as well as expertise in the field of adhesion formation.
After Surgery
Following surgery, the patient will experience some uterine pain as the uterine tissue undergoes remodeling and healing. After this process, the uterus can take on a normal appearance and function.
Depending on the amount of normal muscle that is disrupted by the surgery or displaced by the fibroid, the physician may recommend that labor be avoided in favor of a Cesarean section. This is the result of scare tissue that may form as the muscle heals. This scar is prone to rupture during labor.
Not all myomectomies require subsequent Cesarean section for delivery, so be certain you understand your situation after the surgery.
The majority of myomectomies can be performed in our outpatient surgical center under the extended observation program. This allows patients to maintain nursing care overnight without actually being admitted to the hospital. The recovery period at home is often quite brief.
If you would like to meet with one of our physician to discuss your options please feel free to call us at 919-572-HOPE (4673). If you have had previous testing such as ultrasounds, laparoscopy, or previous surgeries, these reports may be helpful. Please request a copy of these documents.
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