Our Summary

This research paper is about a study that was conducted to see if using a cellulose absorbable barrier could help reduce the risk of adhesions (scar tissue) forming after a myomectomy (a surgical procedure to remove uterine fibroids). The researchers looked at several different databases for clinical trials where a cellulose absorbable barrier was used during a laparoscopic myomectomy (a minimally invasive surgical procedure). They found three relevant trials to study, which involved a total of 366 participants. The results showed that women who received treatment with a cellulose absorbable barrier had a significantly lower risk of developing adhesions. However, the procedures that used the barrier took about 4 minutes longer than those that didn’t. Overall, the study found that using a cellulose absorbable barrier during a laparoscopic myomectomy can reduce the risk of postoperative adhesions.

FAQs

  1. What is a cellulose absorbable barrier and how is it used in a myomectomy?
  2. How effective is a cellulose absorbable barrier in reducing the risk of adhesions after a myomectomy?
  3. How does the use of a cellulose absorbable barrier impact the duration of a laparoscopic myomectomy procedure?

Doctor’s Tip

A helpful tip a doctor might tell a patient about myomectomy is to discuss the possibility of using a cellulose absorbable barrier during the procedure to help reduce the risk of adhesions forming afterwards. This additional step may slightly increase the length of the procedure, but it can ultimately improve the patient’s outcomes and reduce the likelihood of complications.

Suitable For

Patients who are typically recommended myomectomy are those who have symptomatic uterine fibroids that are causing heavy menstrual bleeding, pelvic pain, pressure, or other symptoms that are impacting their quality of life. Myomectomy may be recommended for women who wish to preserve their fertility or avoid a hysterectomy. Women who have fibroids that are causing infertility or recurrent miscarriages may also be recommended for myomectomy. Additionally, myomectomy may be recommended for women who have fibroids that are causing urinary or bowel symptoms.

In the context of the study mentioned above, patients who are undergoing a laparoscopic myomectomy and are at risk of developing postoperative adhesions may be recommended for treatment with a cellulose absorbable barrier to help reduce the risk of adhesions forming. Patients who have a history of previous abdominal surgery or are at higher risk for developing adhesions may also be candidates for treatment with a cellulose absorbable barrier during myomectomy.

Timeline

Before a myomectomy:

  1. Patient experiences symptoms of uterine fibroids, such as heavy menstrual bleeding, pelvic pain, and frequent urination.
  2. Patient consults with a gynecologist who recommends a myomectomy as a treatment option.
  3. Patient undergoes preoperative testing and evaluation to assess their overall health and suitability for surgery.
  4. Patient discusses the risks and benefits of the procedure with their healthcare provider and gives informed consent.
  5. Patient undergoes the myomectomy procedure to remove the uterine fibroids.

After a myomectomy:

  1. Patient is monitored in the recovery room for a few hours after the surgery.
  2. Patient may experience some pain and discomfort postoperatively, which is managed with pain medication.
  3. Patient is advised to rest and avoid strenuous activities for a few weeks to allow for proper healing.
  4. Patient may experience some vaginal bleeding and discharge for a few weeks after the surgery.
  5. Patient follows up with their healthcare provider for postoperative care and monitoring of any complications.
  6. Patient may undergo imaging tests, such as ultrasound, to assess the success of the surgery and ensure that the fibroids have been completely removed.
  7. Patient resumes normal activities and may experience improvement in their symptoms related to uterine fibroids.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a myomectomy procedure?
  2. How will the use of a cellulose absorbable barrier during myomectomy affect my recovery time?
  3. Will the use of a cellulose absorbable barrier during myomectomy increase the cost of the procedure?
  4. Are there any specific factors that may make me a better candidate for using a cellulose absorbable barrier during myomectomy?
  5. How long will I need to stay in the hospital after undergoing a myomectomy with a cellulose absorbable barrier?
  6. Will I need to follow any specific post-operative care instructions or restrictions if a cellulose absorbable barrier is used during myomectomy?
  7. Are there any long-term effects or considerations I should be aware of if I choose to have a myomectomy with a cellulose absorbable barrier?
  8. How does the use of a cellulose absorbable barrier during myomectomy compare to other methods of reducing the risk of adhesions?
  9. What are the success rates of using a cellulose absorbable barrier during myomectomy in terms of preventing adhesions?
  10. Are there any additional benefits or advantages to using a cellulose absorbable barrier during myomectomy that I should be aware of?

Reference

Authors: Raimondo D, Raffone A, Saccone G, Travaglino A, Degli Esposti E, Mastronardi M, Borghese G, Zullo F, Seracchioli R. Journal: Eur J Obstet Gynecol Reprod Biol. 2020 Feb;245:107-113. doi: 10.1016/j.ejogrb.2019.12.033. Epub 2019 Dec 24. PMID: 31891893