Myomectomy is a surgical procedure used to remove uterine fibroids. Uterine fibroids, also known as myomas, are non-cancerous growths in or around the uterus. They can range from the size of a seed to bulky masses that can distort the shape of the uterus. Uterine fibroids can be associated with endometriosis.
Types of uterine fibroids
Uterine fibroids are classified by shape and location.
- Intramural fibroids are located in the thick wall of the uterus (myometrium).
- Subserosal fibroids are located outside the wall of the uterus.
- Submucosal fibroids are located beneath the lining of the uterus (under the endometrium).
- Intracavity fibroids are located within the uterine cavity.
- Cervical fibroids are located in the cervix, the neck of the uterus.
- Pedunculated fibroids are located on a stalk that grows into the uterus or outside the uterine wall. This type of fibroid is usually easier to remove than other types.
Types of myomectomy
There are several types of myomectomy, based on the size of the fibroids and where they are located.
This type of myomectomy is used for multiple or deeply rooted fibroids. A single large incision is made in the abdomen, usually a horizontal cut along the bikini line. The uterus is sometimes cut with a laser, which closes or cauterizes the blood vessels, reducing bleeding. The fibroids are removed and the uterus, abdominal wall, and skin are closed with sutures. This surgery generally requires one to three days’ stay in a hospital.
This type of myomectomy can be used to remove subserosal fibroids. The surgeon makes a number of small incisions, which allow different instruments access to the uterus. Among these is the laparoscope, a telescope-like device that allows visualization of the abdominal cavity. The fibroids are removed, and the small incisions are sutured or sewn closed. This surgery generally requires a day’s stay in the hospital.
This type of myomectomy can be used to remove cervical or intracavity fibroids. The fibroids are removed via the dilated cervix, so no abdominal incisions are needed. The instrument used is called a resectoscope, which is a tube with a fitted light and a wire loop. The instrument is inserted through the cervix, and the wire loop placed around the fibroid. Electrical current is passed through the loop to cut the fibroid loose. It is then removed through the vagina. This is usually an outpatient procedure and most patients can go home at the end of the day.
Like any surgical procedure, myomectomy has its risks. These include blood loss, blood clots, pain, and infection. Surgery in or near the uterus may also damage the uterus and prevent future pregnancies. Fibroids sometimes grow back.
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