Fibroids

What are the types of fibroids?

Intramural fibroids
These are the most common types of fibroid, intramural fibroids grow in the muscle wall of the uterus. These growths can become very large and stretch the uterus.

Subserosal fibroids

These fibroids grow on the outside of the uterus. Large subserosal fibroids can cause pelvic pain, urinary frequency and constipation.

Pedunculated fibroids
These are a type of subserosal fibroid on the outside of the uterus. They have a slender stalk that supports them.

Submucosal fibroids
These fibroids grow into the uterine cavity and distort the uterine lining or endometrium.

What conditions can be treated by myomectomy?

A myomectomy removes uterine fibroids and relieves their symptoms. A myomectomy treats the following symptoms of uterine fibroids:

  • Anaemia

  • Pelvic pain and pressure that cannot be managed with medication

  • Menorrhagia

  • Abnormal uterine bleeding

  • Infertility and recurring miscarriage

In contrast to hysterectomy, a myomectomy leaves the uterus intact, making it a popular choice among patients who still want to get pregnant.

Fibroids and myomectomy

What is a myomectomy – uterine fibroid removal surgery?

Uterine fibroids – or myomas are benign smooth muscle tumours in the uterus.

Fibroids can be removed with a myomectomy. This surgery treats fibroid symptoms and improves fertility outcomes leaving the uterus intact.

Myomectomy can be performed open or laparoscopically.

How are myomectomy surgeries performed?

A myomectomy can be performed in one of three ways. The method chosen by your surgeon will depend on the number, size and location of the fibroids. Surgery is performed under general anaesthesia.

Abdominal myomectomy

This is the most invasive type of surgery. A large incision is made in the abdominal wall, and allows a clear view of the pelvic organs and allows safe removal of the fibroids. It is the best choice of procedure for removing large fibroids, multiple fibroids and fibroids that are deeply embedded in the uterine wall.

Laparoscopic myomectomy

This is a less invasive option. Laparoscpy is performed through several small incisions in the abdomen. Laparoscopy is typically used when there are only one or two fibroids to be removed, and if they are less than 5 cm diameter.

Hysteroscopic myomectomy

Hysteroscopic surgery is performed through the vagina and cervix. The cervix dilated and operative hysteroscopy is performed for the removal of submucosal fibroids that grow into the uterine cavity.A benign ovarian cyst can be removed while leaving the ovary intact. However if the cyst is cancerous, an oophorectomy- removal of one or both ovaries may be required.

Pregnancy after myomectomy

Patients who have a myomectomy in order to improve their chances of having a baby are advised to wait a minimum of 6 months before conceiving, if intramural fibroids were removed. This is to allow adequate healing of the uterine scars.

If you get pregnant following a myomectomy, there’s a slightly increased risk of complications involving the placenta such as placenta accreta. A caesarean section may be recommended depending on the size and location of the surgical site.

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