Our Summary

This research paper explores the topic of uterine fibroids, a condition affecting 25% of women globally. Women who show symptoms can be treated using medicine or surgery. The advent of endoscopic surgery has significantly transformed how this condition is managed. Nowadays, laparoscopic or laparoscopic robot-assisted surgeries are commonly used, but there’s no universally agreed-upon guideline on surgical techniques, the best operative route, or the value of treatment before surgery. Hysteroscopy, a less invasive surgical procedure, is highlighted as a major advancement in managing this condition. The paper essentially reviews existing literature on the surgical treatment of fibroids.

FAQs

  1. What is a myomectomy and how is it used in the management of uterine fibroids?
  2. What are the different surgical techniques used in the treatment of fibroids and how do they differ?
  3. Is preoperative treatment necessary before undergoing a myomectomy or hysterectomy for fibroids?

Doctor’s Tip

One helpful tip a doctor might tell a patient about myomectomy is to discuss with your healthcare provider the benefits and risks of different surgical techniques, such as laparoscopic or hysteroscopic myomectomy, to determine the best option for your individual situation. It is important to have a thorough understanding of the procedure and post-operative care to ensure a successful outcome. Additionally, discussing any concerns or questions with your doctor can help alleviate any anxiety or uncertainties about the surgery.

Suitable For

Patients who are typically recommended myomectomy are those who are experiencing symptoms such as heavy menstrual bleeding, pelvic pain, pressure on the bladder or bowels, or infertility due to the presence of uterine fibroids. Women who desire to preserve their fertility may also be candidates for myomectomy, as this surgical procedure removes the fibroids while leaving the uterus intact. Additionally, patients who are not suitable candidates for other treatments such as medication or embolization may be recommended myomectomy as a treatment option.

Timeline

Before myomectomy:

  1. Patient experiences symptoms such as heavy menstrual bleeding, pelvic pain, and pressure.
  2. Patient visits a healthcare provider for evaluation and diagnosis of uterine fibroids.
  3. Treatment options are discussed, including medical management, myomectomy, or hysterectomy.
  4. Patient undergoes preoperative evaluation, which may include imaging studies such as ultrasound or MRI.
  5. Decision is made to proceed with myomectomy surgery.

After myomectomy:

  1. Patient undergoes myomectomy surgery, which can be performed using laparoscopic, robotic-assisted, or hysteroscopic techniques.
  2. Recovery period varies depending on the type of surgery performed, with patients typically returning to normal activities within a few weeks.
  3. Follow-up appointments are scheduled to monitor healing and address any postoperative complications.
  4. Patient experiences relief from symptoms such as heavy menstrual bleeding and pelvic pain.
  5. Patient may consider fertility preservation options if desired, as myomectomy can preserve the uterus for future pregnancies.
  6. Long-term follow-up is recommended to monitor for recurrence of fibroids.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with myomectomy surgery?
  2. How long is the recovery period after a myomectomy surgery?
  3. Will there be any impact on my fertility after undergoing a myomectomy?
  4. Are there any alternative treatment options to consider before undergoing a myomectomy?
  5. How many fibroids do I have and what is their size and location?
  6. What is the likelihood of the fibroids growing back after a myomectomy?
  7. Are there any specific dietary or lifestyle changes I should make before or after myomectomy surgery?
  8. Will I need to undergo any additional testing or procedures before the myomectomy surgery?
  9. What is the success rate of myomectomy in treating my symptoms and improving my quality of life?
  10. How experienced are you in performing myomectomy surgeries, and what is your success rate with this procedure?

Reference

Authors: Thubert T, Foulot H, Vinchant M, Santulli P, Marzouk P, Borghese B, Chapron C. Journal: Best Pract Res Clin Obstet Gynaecol. 2016 Jul;34:104-21. doi: 10.1016/j.bpobgyn.2015.11.021. Epub 2016 Jun 22. PMID: 27400649