A myomectomy is a surgical procedure performed to remove uterine fibroids, which are noncancerous growths of the uterus that often appear during childbearing years. Fibroids can cause various symptoms, such as pelvic pain, heavy menstrual bleeding, and pressure on the bladder or rectum.
During myomectomy, the surgeon removes fibroids, leaving the uterus intact. This procedure is usually considered for women who want to preserve their fertility or who want to preserve their uterus for other reasons. Myomectomy can be performed with various techniques, including Abdominal myomectomy, Laparoscopic myomectomy, and Hysteroscopic myomectomy.
The choice of technique depends on factors such as the size, number, and location of the fibroids, as well as the patient's overall health and preferences.
The exact cause of uterine fibroids is not fully understood, but various factors may contribute to their development. These factors are genetic predisposition, hormones, race and ethnicity, age and hormonal changes, lifestyle and environmental factors.
It is important to note that although these factors contribute to fibroid development, the interaction between them is not fully understood. Additionally, many women with risk factors do not develop fibroids, and the presence of fibroids does not always cause symptoms or complications. The relationship between genetics, hormones, and environmental factors in myoma development is an active area of research.
Fibroids may or may not cause some symptoms. The severity and nature of symptoms can vary greatly between women. Common symptoms of fibroids include:
It is important to remember that some women with fibroids may not experience any visible symptoms, and the presence of fibroids may only be discovered during a routine pelvic exam or imaging study for another reason. The size, number, and location of fibroids can affect the type and severity of symptoms.
If you suspect you have uterine fibroids or are experiencing symptoms, it is recommended that you consult a healthcare professional. Diagnosis typically includes a pelvic exam, imaging studies (such as ultrasound or MRI),and sometimes additional tests to rule out other conditions.
Fibroids, uterine fibroids, can be classified based on their location within the uterus. The main types of fibroids include:
These are the most common type and develop within the muscular wall of the uterus (myometrium). Intramural fibroids can cause the uterus to become enlarged, and they may lead to heavy menstrual bleeding, pelvic pain, and a feeling of fullness or pressure.
Submucosal fibroids grow just beneath the inner lining of the uterus (endometrium) and can protrude into the uterine cavity. They are associated with heavy menstrual bleeding, prolonged periods, and may contribute to fertility issues or recurrent pregnancy loss.
Subserosal fibroids develop on the outer wall of the uterus and can grow outward, potentially pressing on surrounding organs such as the bladder or rectum. These fibroids may cause pelvic pain or pressure and contribute to backache or leg pains.
A fibroid that grows on a stalk or stem is referred to as pedunculated. These can be submucosal or subserosal, depending on their location within or outside the uterine wall. Pedunculated fibroids can sometimes cause pain if the stalk twists (pedunculated torsion).
The symptoms and complications associated with fibroids can vary based on their type, size, and location. For example, submucosal fibroids may have a more significant impact on menstrual bleeding and fertility, while subserosal fibroids may lead to more pronounced pressure symptoms.
It's important to note that a woman may have a combination of these types of fibroids, and their symptoms can be influenced by factors such as the number and size of the fibroids.
Treatment of uterine fibroids, also known as fibroids or leiomyomas, depends on several factors, including the severity of symptoms, the size and location of the fibroids, and the patient's overall health and reproductive goals. Treatment options can range from conservative measures to surgical interventions. Here are some common approaches:
If fibroids are small and asymptomatic, regular checkups and monitoring of symptoms may be recommended.
Hormonal medications such as birth control pills, hormonal IUDs, or GnRH agonists may be prescribed to control menstrual bleeding and relieve symptoms. These medications do not eliminate fibroids but can manage symptoms.
Uterine artery embolization (UAE) involves blocking blood flow to fibroids, causing them to shrink.
MRI-guided focused ultrasound surgery (MRgFUS) uses high-intensity ultrasound waves to heat and destroy fibroid tissue.
Myomectomy is a surgical procedure to remove fibroids while preserving the uterus. It is an option for women who want to preserve their fertility or who want to preserve their uterus for other reasons. Myomectomy can be performed abdominally, laparoscopically, or hysteroscopically, depending on the size and location of the fibroids.
Hysterectomy involves surgical removal of the uterus and is considered the definitive treatment for fibroids. It eliminates the possibility of fibroids recurring but also results in loss of fertility.
The choice of treatment depends on the patient's individual circumstances and preferences. While conservative approaches may be appropriate for those with mild or no symptoms, more invasive interventions may be necessary for severe symptoms or where preservation of fertility is a priority.
There are various surgical procedures for the treatment of uterine myomas (myomas). The choice of surgery depends on factors such as the size, location, and number of fibroids, as well as the patient's symptoms, reproductive goals, and overall health. Types of myoma surgery:
In abdominal myomectomy, the surgeon makes an incision in the abdominal wall to reach the uterus and remove the fibroids. This approach is suitable for larger or multiple myomas and allows comprehensive examination of the pelvic organs.
Laparoscopic myomectomy is a minimally invasive procedure performed through small incisions using a laparoscope (a thin, lighted tube with a camera) and special surgical instruments. This approach reduces recovery time and scarring compared to abdominal myomectomy.
Hysteroscopic myomectomy is suitable for myomas located in the uterine cavity. A hysteroscope is inserted through the vagina and cervix into the uterus, allowing the surgeon to remove or resect fibroids without making an external incision.
Robotic-assisted myomectomy is a variant of laparoscopic myomectomy in which the surgeon uses a robotic system to control surgical instruments. This approach offers improved precision and dexterity, allowing complex procedures to be performed with smaller incisions.
Uterine Artery Embolization (UAE) is a non-surgical procedure that blocks blood flow to fibroids, causing them to shrink. It is performed by injecting small particles into the blood vessels that feed the fibroids and their embolization is achieved.
MRI Guided Focused Ultrasound Surgery (MRgFUS) is a non-invasive procedure that uses high-intensity ultrasound waves to heat and destroy fibroid tissue. Magnetic resonance imaging (MRI) is used to target and treat fibroids without surgery.
Hysterectomy involves the complete removal of the uterus and is considered the definitive treatment for fibroids. This option is usually recommended for women who have completed family planning or have severe symptoms that do not respond to other treatments.
The choice of surgical approach depends on factors such as the size, location, and number of fibroids, as well as the patient's general health status and preferences. It is important for individuals to discuss available options with their healthcare provider to determine the most appropriate treatment for their particular situation.
Laparoscopic myomectomy is a minimally invasive surgical procedure used to remove uterine fibroids (myomas) through small incisions in the abdomen. This approach offers several advantages over traditional open surgery, including shorter recovery times, less post-operative pain, and less scarring.
Before surgery, the patient undergoes a comprehensive evaluation that includes imaging studies (such as ultrasound or MRI) to determine the size, number, and location of fibroids. The surgery is performed under general anesthesia, ensuring that the patient is unconscious and does not feel any pain during the procedure.
The incision makes several small incisions in the abdominal wall, ranging in size from 0.5 to 1.5 centimeters. These incisions serve as access points for the laparoscope and other surgical instruments. The abdominal cavity is inflated with carbon dioxide gas, thus creating space for the surgeon to work and providing a clearer view with the laparoscope.
With the placement of the laparoscope, the laparoscope, which is a thin, lighted tube with a camera at the end, is inserted through one of the incisions. The camera transmits images of the pelvic area to a monitor, allowing the surgeon to visualize the uterus and fibroids. Additional small incisions are made to insert special surgical instruments. These instruments are used to manipulate and remove fibroids.
He then identifies and carefully removes each fibroid, taking into account factors such as its size, location, and blood supply. Techniques such as morcellation (breaking fibroids into smaller pieces) may be used to facilitate removal.
After all fibroids are removed, the incisions are closed with stitches or surgical staples. In some cases, absorbable stitches are used, eliminating the need for subsequent removal.
After the procedure, most patients can go home the same day or the day after surgery.
Laparoscopic myomectomy is a suitable option for women with smaller to medium-sized fibroids and offers the advantage of faster recovery and less scarring compared to open surgery. However, it may not be suitable for every case and the choice of surgical approach depends on individual factors and the surgeon's judgment.
Hysteroscopic myomectomy is a minimally invasive surgical procedure used to remove uterine myomas (myomas) located in the uterine cavity. Unlike other surgical approaches, no external incisions are made in hysteroscopic myomectomy. Instead, it is performed by accessing the uterus through the cervix. It is suitable for submucosal myomas that protrude into the uterine cavity.
Before hysteroscopic myoma surgery, the patient undergoes an evaluation that may include imaging studies such as ultrasound or hysteroscopy to visualize the fibroids. The surgeon reviews medical history and discusses the procedure and potential risks with the patient.
Hysteroscopic myomectomy is usually performed under general anesthesia. In some cases, local or regional anesthesia with sedation may be used. The hysteroscope, a thin, lighted tube with a camera at the end, is inserted into the uterus through the vagina and cervix. Carbon dioxide gas or saline solution is often used to expand the uterine cavity, providing the surgeon with a clear view.
He then visualizes the fibroids and surrounding uterine tissue on a monitor connected to the hysteroscope. Special instruments, such as a resectoscope or hysteroscopic morcellator, are inserted through the hysteroscope to cut or remove fibroids. The surgeon carefully removes the fibroid tissue while minimizing damage to surrounding healthy tissue.
In the case of hysteroscopic morcellation, fibroid tissue is usually divided into smaller pieces for easier removal from the cervix. Once the fibroids are removed, the hysteroscope is withdrawn and no external incisions are required. The procedure does not involve stitches or staples.
Most women can go home the same day or the day after hysteroscopic myomectomy.
Hysteroscopic myomectomy is an effective option for treating submucosal fibroids and may be especially helpful for women who experience symptoms such as heavy menstrual bleeding or fertility problems related to these fibroids. As with any surgical procedure, the suitability of hysteroscopic myomectomy depends on individual factors, and the healthcare provider will discuss the most appropriate treatment options based on the patient's specific situation.
The specific method of performing myoma surgery depends on several factors, including the size, location, and number of fibroids, as well as the patient's symptoms and overall health. There are different surgical approaches to myoma surgery and the technique chosen will be tailored to the individual case. Myoma surgery is performed using different approaches.
The choice of surgical approach depends on the characteristics of the fibroids, the patient's symptoms, and the desired outcome, such as preservation of fertility.
Fibroid surgery is commonly performed using either minimally invasive techniques, such as the keyhole method (including robotic, laparoscopic, and hysteroscopic surgeries),or the open method.
In the robotic or laparoscopic approach, the incisions are small, typically around 0.5-1 cm. The surgery is conducted through these small openings, with a camera providing visualization on a monitor. The advantage of these smaller incisions is a more comfortable postoperative experience.
Hysteroscopic surgery, on the other hand, involves accessing the uterus through the vaginal canal to remove fibroids that have developed inside. Similar to laparoscopic procedures, hysteroscopic surgery is less invasive and generally results in reduced postoperative discomfort. Patients undergoing laparoscopic or hysteroscopic myomectomies often have the option to be discharged on the same day or the following day.
In contrast, the open method requires a larger incision, typically between 10-15 cm, made in the lower part of the abdomen. This approach is considered in cases where there are numerous fibroids (more than 10-15) or when the fibroids are located in the posterior region, potentially extending the duration of the surgery.
For women who have completed their fertility period, there is an alternative option: the complete surgical removal of the uterus, instead of focusing solely on removing the fibroids, if deemed necessary.
Following myomectomy, a significant number of women can successfully conceive and have children. However, there is a 10% chance of fibroid recurrence in some patients.
It's essential to consult with a healthcare professional to determine the most suitable surgical approach based on individual circumstances and preferences.
The price of myoma surgery in Turkey varies depending on the surgical method to be applied and the procedures to be performed. You can call us for detailed information about the price of myoma surgery.
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