Our Summary

This research paper investigates two methods of removing specimens after laparoscopic myomectomy surgery (a procedure to remove uterine fibroids): transvaginal retrieval (TVSR) and port-site specimen retrieval (PSSR). The study looked at data from 1980 to 2020 to compare the surgical outcomes of both methods. The results showed that there weren’t any significant differences between the two methods in terms of operation time, the time it took to retrieve the myoma (fibroid), blood loss, the rate of complications during surgery, and length of hospital stay. However, patients who had TVSR needed fewer painkillers after surgery compared to those who had PSSR. So, both methods are comparable in terms of performance, but TVSR might be a better option as it leads to less need for painkillers after surgery.

FAQs

  1. What are the two methods of removing specimens after laparoscopic myomectomy surgery studied in this research?
  2. Based on the research, are there any significant differences in surgical outcomes between Transvaginal Retrieval (TVSR) and Port-Site Specimen Retrieval (PSSR)?
  3. According to the study, which method between TVSR and PSSR leads to a lesser need for painkillers after surgery?

Doctor’s Tip

A doctor might advise a patient undergoing myomectomy to consider transvaginal retrieval as a method for removing specimens, as it may result in less post-operative pain and a decreased need for painkillers compared to port-site specimen retrieval.

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, infertility, or recurrent pregnancy loss. Myomectomy is often recommended for women who wish to preserve their fertility or who are not candidates for hysterectomy. It is important for patients to discuss their individual circumstances and treatment goals with their healthcare provider to determine if myomectomy is the right option for them.

Timeline

Before myomectomy:

  1. Patient experiences symptoms of uterine fibroids such as heavy menstrual bleeding, pelvic pain, and pressure.
  2. Patient undergoes diagnostic tests such as ultrasound or MRI to confirm the presence of fibroids.
  3. Patient discusses treatment options with their healthcare provider, including myomectomy as a surgical option to remove the fibroids.
  4. Patient undergoes pre-operative preparations such as blood tests, imaging studies, and possibly medication to prepare for surgery.

After myomectomy:

  1. Patient undergoes the laparoscopic myomectomy surgery to remove the fibroids.
  2. Depending on the method of specimen retrieval chosen (TVSR or PSSR), the surgeon removes the fibroids through the vagina or through small incisions in the abdomen.
  3. Patient may experience pain and discomfort after surgery, which is managed with pain medications.
  4. Patient is monitored for any complications such as infection or excessive bleeding.
  5. Patient is discharged from the hospital after a few days and continues to recover at home.
  6. Patient follows up with their healthcare provider for post-operative care and monitoring of symptoms.
  7. Patient may experience improvements in symptoms such as decreased menstrual bleeding and pelvic pain after the fibroids are removed.

What to Ask Your Doctor

Some questions a patient should ask their doctor about myomectomy include:

  1. What are the potential risks and complications associated with myomectomy surgery?
  2. How long will it take to recover from the surgery and when can I expect to return to normal activities?
  3. Will I be able to have children after myomectomy surgery?
  4. Are there any alternative treatment options to consider before undergoing surgery?
  5. What is the likelihood of the fibroids returning after the surgery?
  6. Will there be any impact on my fertility or menstrual cycle after the surgery?
  7. What is the expected outcome of the surgery in terms of pain relief and improvement in symptoms?
  8. Will I need to take any medications or follow a specific diet after the surgery?
  9. What type of follow-up care will be needed after the surgery?
  10. How experienced are you in performing myomectomy surgeries, and what is your success rate with this procedure?

Reference

Authors: Laganà AS, Vitagliano A, Casarin J, Garzon S, Uccella S, Franchi M, Cromi A, Ghezzi F. Journal: Gynecol Obstet Invest. 2022;87(3-4):177-183. doi: 10.1159/000525624. Epub 2022 Jun 21. PMID: 35728574