Our Summary

This research looks at the safety of performing a cesarean myomectomy, a procedure to remove fibroids from the womb, during a cesarean section. The researchers looked at 23 studies involving 8,016 women, some of whom had a cesarean myomectomy and others who had a cesarean section only. The results showed that the women who had a cesarean myomectomy had a higher risk of blood loss, required more blood transfusions, and had longer operations and hospital stays compared to those who only had a cesarean section. However, there was no increase in fever rates after the operation. The researchers concluded that there are risks involved with this procedure, especially for women with larger or multiple fibroids. However, if performed by experienced surgeons using the right techniques, cesarean myomectomy can be a safe option for certain patients.

FAQs

  1. What is a cesarean myomectomy?
  2. What risks are associated with performing a cesarean myomectomy during a cesarean section?
  3. Can a cesarean myomectomy be a safe option for some patients?

Doctor’s Tip

One tip a doctor might give a patient considering a myomectomy is to discuss the risks and benefits of the procedure with their healthcare provider. It is important for patients to understand the potential complications and outcomes associated with myomectomy, especially if they are considering it in conjunction with another procedure such as a cesarean section. Patients should also inquire about the experience and expertise of the surgeon performing the myomectomy, as this can impact the success and safety of the procedure. Additionally, patients should follow their doctor’s post-operative instructions carefully to ensure a smooth recovery.

Suitable For

Patients who are typically recommended for a myomectomy include:

  1. Women who have symptomatic fibroids causing heavy menstrual bleeding, pelvic pain, or pressure symptoms.
  2. Women who have fibroids that are affecting fertility or causing recurrent pregnancy loss.
  3. Women who have fibroids that are rapidly growing or causing other complications such as urinary or bowel symptoms.
  4. Women who wish to preserve their uterus and fertility, as myomectomy removes the fibroids while leaving the uterus intact.
  5. Women who are not candidates for other fibroid treatment options such as uterine artery embolization or hormone therapy.

It is important for patients to discuss their individual medical history, symptoms, and treatment goals with their healthcare provider to determine if a myomectomy is the best treatment option for them.

Timeline

Before myomectomy:

  1. Patient experiences symptoms such as heavy menstrual bleeding, pelvic pain, and pressure.
  2. Patient undergoes a physical examination, ultrasound, and possibly other imaging tests to diagnose the presence of fibroids.
  3. Patient discusses treatment options with their healthcare provider, including myomectomy as a surgical option to remove fibroids.
  4. Patient may undergo preoperative testing and preparation before the scheduled myomectomy surgery.

After myomectomy:

  1. Patient undergoes the myomectomy surgery to remove the fibroids from the uterus.
  2. Patient may experience postoperative pain, discomfort, and fatigue.
  3. Patient stays in the hospital for a few days for monitoring and recovery.
  4. Patient may experience some bleeding and discharge after the surgery.
  5. Patient follows up with their healthcare provider for postoperative care and monitoring.
  6. Patient may experience improvements in symptoms such as reduced menstrual bleeding and pelvic pain after the fibroids are removed.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a myomectomy procedure, especially during a cesarean section?
  2. How experienced are you in performing myomectomies during cesarean sections?
  3. Are there alternative treatment options for my fibroids that may be less risky?
  4. What is the likelihood of needing a blood transfusion during or after the procedure?
  5. How will the presence of fibroids affect my recovery time and potential complications after the cesarean section?
  6. What are the chances of the fibroids returning after the myomectomy procedure?
  7. Will the myomectomy procedure affect my fertility or ability to conceive in the future?
  8. How long will I need to stay in the hospital after the procedure?
  9. What follow-up care or monitoring will be necessary after the myomectomy?
  10. Are there any specific lifestyle changes or precautions I should take before or after the myomectomy procedure?

Reference

Authors: Huang Y, Ming X, Li Z. Journal: J Matern Fetal Neonatal Med. 2022 Jul;35(13):2619-2627. doi: 10.1080/14767058.2020.1791816. Epub 2020 Jul 16. PMID: 32674632