Our Summary

This research paper looks at two different methods of surgery for uterine fibroids, which are non-cancerous growths in the uterus. The two methods are abdominal myomectomy (AM), which is a traditional open surgery, and laparoscopic myomectomy (LM), which is a minimally invasive surgery. The researchers analyzed previous studies and found that LM could significantly decrease the amount of blood loss, shorten the time it takes for the intestines to start working normally again after surgery, and reduce the length of hospital stay. However, LM took longer to perform and was more expensive. The researchers concluded that LM seems to be a better choice for patients with uterine fibroids, but more studies are needed to confirm these results.

FAQs

  1. What are the two methods of surgery for uterine fibroids discussed in the research paper?
  2. What are the advantages of laparoscopic myomectomy (LM) over abdominal myomectomy (AM) as per the research findings?
  3. Despite the benefits, why might laparoscopic myomectomy not be the preferred method for some patients?

Doctor’s Tip

A doctor might tell a patient that a myomectomy can be a good option for removing uterine fibroids and relieving symptoms such as heavy menstrual bleeding and pelvic pain. They may also advise the patient that a laparoscopic myomectomy may have advantages such as less blood loss, faster recovery time, and shorter hospital stay compared to an abdominal myomectomy. However, the doctor may also mention that laparoscopic myomectomy may take longer to perform and be more expensive. Ultimately, the doctor will work with the patient to determine the best treatment option based on their individual circumstances and preferences.

Suitable For

Patients who are typically recommended myomectomy are those who have symptomatic uterine fibroids that are causing heavy menstrual bleeding, pelvic pain, pressure on the bladder or bowel, or fertility issues. Myomectomy may be recommended for patients who wish to preserve their fertility, as it removes the fibroids while leaving the uterus intact. Patients who are not candidates for other treatments such as medication or uterine artery embolization may also be recommended for myomectomy. Additionally, patients who have a preference for surgery over other treatment options may be recommended for myomectomy.

Timeline

Before myomectomy:

  1. Patient experiences symptoms of uterine fibroids, such as heavy menstrual bleeding, pelvic pain, and pressure on the bladder or bowels.
  2. Patient consults with a gynecologist and undergoes imaging tests to confirm the presence of fibroids.
  3. Gynecologist discusses treatment options with the patient, including myomectomy as a surgical option.

During myomectomy:

  1. Patient undergoes pre-operative preparation, which may include fasting and medication to reduce the risk of infection.
  2. Patient undergoes either abdominal myomectomy or laparoscopic myomectomy, depending on the surgeon’s recommendation and the patient’s preference.
  3. During the surgery, the surgeon removes the fibroids from the uterus while preserving the uterus itself.

After myomectomy:

  1. Patient is monitored in the recovery room for a period of time to ensure there are no immediate complications.
  2. Patient may experience pain and discomfort in the days following the surgery, which can be managed with pain medication.
  3. Patient is discharged from the hospital once they are stable and able to manage their pain at home.
  4. Patient is advised to rest and avoid strenuous activities for a period of time to allow for proper healing.
  5. Patient follows up with their gynecologist for post-operative care and monitoring of their recovery.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with myomectomy surgery?
  2. How long is the recovery time after myomectomy surgery?
  3. Will I still be able to have children after undergoing myomectomy surgery?
  4. How will my symptoms and quality of life be affected after the surgery?
  5. Are there any alternative treatment options for my uterine fibroids?
  6. How many myomectomy surgeries have you performed, and what is your success rate?
  7. Will I need to undergo any additional tests or evaluations before the surgery?
  8. How will my fibroids be removed during the surgery (i.e. removed in whole or in pieces)?
  9. Will there be any scarring or changes to my uterus after the surgery?
  10. What are the long-term outcomes and potential risks of myomectomy surgery in the future?

Reference

Authors: Chen R, Su Z, Yang L, Xin L, Yuan X, Wang Y. Journal: BMC Surg. 2020 Mar 20;20(1):55. doi: 10.1186/s12893-020-00703-0. PMID: 32192462