Our Summary

This research paper discusses a case of a woman who developed a growth in her abdomen six years after having a surgical procedure to remove uterine fibroids. These fibroids are common non-cancerous tumors that grow in the uterus. The surgery, called a laparoscopic myomectomy, involves breaking up large tissues like the fibroids into smaller pieces so they can be removed from the abdominal cavity. Sometimes, small fragments are accidentally left behind and can attach themselves to other structures in the abdomen, develop their own blood supply, and turn into new fibroids, known as parasitic myomas. These growths can cause different symptoms depending on their size and location. The study suggests that surgeons need to be careful during surgery to avoid leaving behind these fragments. It also recommends using a containment bag when breaking up the fibroids to reduce the risk of leaving fragments behind.

FAQs

  1. What is a laparoscopic myomectomy and why is it performed?
  2. What are parasitic myomas and how do they develop?
  3. What are the recommendations to avoid leaving fragments behind during surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about myomectomy is to discuss the possibility of parasitic myomas developing after surgery. Patients should be aware of the symptoms of these growths, such as abdominal pain or abnormal bleeding, and should promptly report any new or worsening symptoms to their healthcare provider. Additionally, patients should follow up regularly with their doctor for monitoring and evaluation to ensure the successful removal of all fibroid tissue. It is also important for patients to maintain a healthy lifestyle, including regular exercise and a balanced diet, to help prevent the recurrence of fibroids.

Suitable For

Patients who are typically recommended myomectomy include women who have symptomatic fibroids that are causing heavy menstrual bleeding, pelvic pain, pressure on the bladder or bowel, or fertility issues. Myomectomy is a good option for women who wish to preserve their fertility or who are not candidates for a hysterectomy. Additionally, myomectomy may be recommended for women who have large fibroids that are causing significant symptoms and are not responding to other treatments.

It is important for patients considering myomectomy to discuss their options with their healthcare provider and to weigh the potential risks and benefits of the procedure. Patients with multiple or very large fibroids may be at higher risk for complications during surgery, and may need to consider other treatment options. Additionally, patients with a history of pelvic inflammatory disease, endometriosis, or other pelvic conditions may have a higher risk of complications during myomectomy and should discuss these risks with their healthcare provider.

Overall, myomectomy can be a safe and effective treatment option for women with symptomatic fibroids who wish to preserve their fertility or avoid a hysterectomy. However, it is important for patients to carefully consider their individual circumstances and discuss their options with their healthcare provider to determine the best course of treatment for their condition.

Timeline

Before myomectomy:

  1. Patient experiences symptoms such as heavy menstrual bleeding, pelvic pain, and pressure on the bladder or rectum.
  2. Patient consults with a gynecologist who recommends a myomectomy to remove the fibroids.
  3. Patient undergoes pre-operative testing and preparation for the surgery.

During myomectomy:

  1. Surgeon performs the laparoscopic myomectomy to remove the fibroids from the uterus.
  2. Surgeon carefully breaks up the fibroids into smaller pieces for removal.
  3. Surgery may last a few hours, depending on the size and number of fibroids.

After myomectomy:

  1. Patient stays in the hospital for a few days for recovery and monitoring.
  2. Patient may experience pain, bloating, and fatigue in the days following the surgery.
  3. Patient is advised to avoid strenuous activities and heavy lifting for several weeks.
  4. Follow-up appointments are scheduled to monitor the patient’s recovery and address any concerns.
  5. Patient may experience relief from symptoms such as heavy bleeding and pelvic pain as the uterus heals and fibroids are removed.
  6. Patient may need to undergo additional imaging tests or treatments if new fibroids develop in the future.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a myomectomy procedure?

  2. How likely is it for small fibroid fragments to be left behind during the surgery?

  3. What measures will be taken during the surgery to minimize the risk of developing parasitic myomas?

  4. How will I be monitored post-surgery to ensure that no new fibroids develop?

  5. What symptoms should I watch out for that may indicate the presence of new fibroids?

  6. Are there any lifestyle changes or medications that can help prevent the recurrence of fibroids after a myomectomy?

  7. How often should I follow up with my doctor after the surgery to monitor for any new growths or complications?

  8. If new fibroids do develop, what treatment options are available to address them?

  9. Are there any alternative treatments or procedures that may be more effective in preventing the recurrence of fibroids?

  10. Can you provide me with more information about the containment bag technique and how it can reduce the risk of leaving fibroid fragments behind during surgery?

Reference

Authors: Oindi FM, Mutiso SK, Obura T. Journal: J Med Case Rep. 2018 Nov 15;12(1):339. doi: 10.1186/s13256-018-1873-y. PMID: 30428912