Myomectomy: Surgical Recovery and Further Precautions

Myomectomy is a type of surgery done to remove uterine fibroids without removing the whole uterus (hysterectomy). Uterine fibroids are abnormal growths that occur in the uterus. In most cases, women with the condition may not experience any symptoms at all.

Myomectomy is a procedure that removes only fibroids without causing any harm to the uterus. However, hysterectomy is a fibroid removal procedure that removes the entire uterus, meaning the woman may not be able to conceive in the future.

Usually, fibroids are diagnosed during a pelvic examination or prenatal ultrasound done for other reasons. Those who experience symptoms may have pain in the pelvic area, excess urination, heavy bleeding, enlarging abdomen, and irregular periods.

The symptoms may vary based on the location, size, and number of fibroids that are present. Your doctor may recommend surgery when fibroids interfere with your regular activities or affect your fertility.

The surgery can be performed in three types – Abdominal myomectomy, Laparoscopic myomectomy, and Hysteroscopic myomectomy. Recovery after myomectomy may vary depending on the approach and your overall health condition.

Things to remember before Myomectomy

Once your surgery is planned, your doctor will provide you with a complete guide to follow. Your doctor may prescribe certain medications to stop your period as myoma is affected by the same hormones responsible for the normal menstrual cycle. Depending on the size, cessation of menstruation may be planned a couple of months prior the operation.

You may need to undergo certain medical tests including blood tests, pelvic ultrasound, or MRI scan before the surgery.

Inform your doctor about the drugs and supplements you take. Your doctor may ask you to avoid certain medications and drugs that may interfere with the test.

Types of Myomectomy

The type of fibroid surgery you may undergo is based on the number of fibroids, their location, and the severity of the condition.

Abdominal myomectomy – This type of procedure is recommended when you have fibroids that are larger in size or have multiple fibroids. In this type of surgery, the surgeon will access your abdomen using an incision and remove fibroids.

Laparoscopic myomectomy – This type of procedure is recommended when you have small or fewer fibroids. In this type of surgery, the surgeon will insert a tube-like instrument called a laparoscope into your abdomen using a small incision. This is a minimally invasive approach which may be an option for those who would want to have smaller incision and faster recovery.

Hysteroscopic myomectomy – This type of procedure is recommended when you have smaller fibroids inside the cavity of your uterus (submucous myoma). In this type of surgery, the surgeon will insert a small scope into the vagina then through the cervix to access the uterus. The videoscope will identify where the attachment of the myoma is . This procedure does not necessitate any incision in the abdomen.

Myomectomy recovery

Your stay at the hospital may depend on the type of surgery you had. It may be for a couple of days depending on your pain threshold and condition. Once sent home, if you have an abdominal myomectomy, it may take one to two months for recovery; laparoscopic myomectomy may take less than a month for recovery; and hysteroscopic procedure may take less than a week for recovery. Recovery means you are back at your usual state prior to operation. This may vary from one patient to another depending on other medical conditions a person has.

Your doctor may help you with all the instructions you need to follow, which may also include restrictions on diet and certain activities. Surgical removal of fibroid is helpful to relieve symptoms you experience and improve fertility.

You may experience pain and discomfort for a few days after the operation. To relieve the discomfort, your doctor may prescribe pain medications.

Recovery also depends if there are any complications after the surgery. In most cases, women may not face any issues or symptoms after the surgery but that does not mean the fibroids will not come back. Even after the surgery, there are chances of fibroids coming back. It may be in another location in the uterus but the course may take a long while.

Depending on the procedure you had, there are chances of you having scars on the abdominal area incised. The scars are usually not permanent and may heal completely within a few months. Your doctor may also prescribe scar removal cream to apply to the operated area. If you feel any unusual changes or pain in the operated area, talk to your doctor.

Surgical complications

Like any other surgical procedure, this also possesses certain complications. Not all women may face complications after surgery. Some of the complications women may face after the surgery include infection in the operated area, severe bleeding, severe pain in the abdomen or in the operated area, and the development of new fibroids. If you experience any such side effects or complications, seek immediate medical help.

Myomectomy and Pregnancy

If you are planning a pregnancy, you must ask your doctor how long you may need to wait and the right time to conceive.

As mentioned earlier, this procedure helps get rid of fibroids keeping the uterus safe. After the surgical procedure, it is important to let your uterus heal completely. Depending on the severity of your condition, your doctor may ask you to abstain from having sex for at least a few months.

Even if the surgery helps to improve fertility, the chances of you getting pregnant completely depend on the location and number of fibroids, aside from other factors to consider including baseline medical conditions (i.e. Polycystic ovarian syndrome, Diabetes Mellitus Type 2, Antiphospholipid antibody syndrome etc.). Since the surgical procedure has a huge impact on the uterus, it is more likely to tear during the later stages of pregnancy or during delivery.

Because of this, your doctor will recommend you have a cesarean delivery. You will have to seek thorough consultation before planning your pregnancy and have good antenatal care to ensure a healthy delivery.

Here’s how to take care of yourself:

• Recovery may take some time. It is important to rest and let your uterus heal completely. At least two weeks of bed rest is advised.
• Avoid lifting heavy objects or performing any activities that may put pressure on your abdomen.
• Make sure you take all the medications prescribed by your doctor. Even if you feel better, you must take the complete dosage as recommended by your doctor.
• Your doctor may also recommend performing simple exercises after three to four weeks post-surgery.
• If you experience bleeding, itching, or any unusual symptoms, make sure you consult your doctor immediately.

Learn more about managing uterine fibroids here.