Fibroid Removal Surgery (Myomectomy)
Introduction
Fibroid removal (myomectomy) is a surgical operation to excision the fibroids and preserve the uterus. Uterine fibroids are benign neoplasms located in or at the uterine that affect women in their reproductive years. Despite being of a benign nature, fibroids may lead to symptoms, such as heavy bleeding, pelvic pain and infertility.
Myomectomy is the procedure of first choice for women wishing to preserve fertility or to refuse to undergo a total hysterectomy. It is a safe and efficacious procedure for normalization of uterine function and symptom relief caused by fibroids.
What is Fibroid Removal (Myomectomy)?
Myomectomy is a surgical operation for the excision of fibroids but retention of the uterus. Surgeons have alluded to a surgical approach selection based on different factors including the size, position, and number of fibroids in the successful complete extraction of the uterus with reduced damage to the uterus.
Fibroids are categorized based on their location:
- Intramural Fibroids: Develop within the muscular wall of the uterus.
- Submucosal Fibroids: Protrudes into the uterine cavity.
- Subserosal Fibroids: Grow on the outer surface of the uterus.
- Pedunculated Fibroids: Attached to the uterus by a stalk.
Why is Fibroid Removal Needed?
Fibroid removal is recommended for women experiencing:
- Heavy or Prolonged Menstrual Bleeding:
- Causes anemia and affects daily activities.
- Pelvic Pain or Pressure: Pelvic Pain or Pressure
- Discomfort is caused by large fibroids pressing on nearby organs.
- Infertility:
- Fibroids interfere with conception or pregnancy.
- Recurrent Miscarriages:
- Fibroids may affect the uterine milieu, causing miscarriage.
- Bladder or Bowel Issues: Bladder or Bowel Issues:
- Fibroids compressing the bladder/urethra can result in the syndrome of looking up to urinate (or the same) and constipation syndrome.
- Rapid Fibroid Growth:
- An increase in the volume of fibroids may suggest the necessity to conduct surgery.
Types of Myomectomy Procedures
Abdominal Myomectomy:
- Performed through an open abdominal incision.
- Ideal for large or multiple fibroids.
Laparoscopic Myomectomy:
- A tiny cannula (quite a small incision) and guided by vision (to look into the body).
- Suitable for smaller fibroids and offers quicker recovery.
Hysteroscopic Myomectomy:
- Performed through the vagina and cervix without external incisions.
- Effective for submucosal fibroids protruding into the uterine cavity.
Robotic-Assisted Myomectomy:
- Uses robotic technology for enhanced precision and control.
- Ideal for complex cases requiring meticulous dissection.
Procedure Steps
Pre-Surgery Evaluation:
- Pelvic examination, ultrasound, magnetic resonance imaging (MRI), quantification of the sizes of the myomas, area of involvement, and location.
- The medical team has to conduct blood tests and clear anesthesia before the surgery to prepare the patient.
Anesthesia:
- The medical team provides general anesthesia to profoundly sedate the patient for the procedure they will perform.
Fibroid Removal:
- The surgeon cauterizes the fibroids in the perivaginal area and leaves the structure of the uterus under the procedure in place.
- At least, laparoscopic/robotic access is gained by a few small injuries and fibroids are morselized (to shreds) during extraction.
Closure:
- The uterine wall is closed by sutures and incisional sutures, as well as surgical adhesives.
Post-Surgery Care:
- Medications are provided to manage pain and prevent infection.
- Patients are tracked by hours or days of operative access.
Benefits of Myomectomy
- Symptom Relief: Eliminates heavy bleeding, pelvic pain, and pressure.
- Preserves Fertility: Retains the uterus for future pregnancies.
- Improved Quality of Life: Alleviates fibroid-related discomfort and restores normal uterine function.
- Minimally Invasive Options: Early postoperative recovery and scarred improvement are offered by the laparoscopic and robotic approach.
- Prevention of Complications: Reduces the risk of fibroid-related infertility and miscarriages.
Cost of Fibroid Removal
- United States: $10,000 – $20,000
- United Kingdom: $8,000 – $15,000
- Thailand: $3,000 – $7,000
- India: $2,000 – $5,000
Best Hospitals in India for Fibroid Removal
Gynecological surgery is well-represented in India, among the top hospitals and offers state-of-the-art facilities by expert surgeons, etc. Notable options include:
Metro Hospital Faridabad: Metro Hospital Faridabad:
- Renowned for its advanced gynecological care and skilled specialists.
- Equipped with modern technology for laparoscopic and robotic procedures.
Fortis Healthcare (Delhi): Fortis Healthcare (Delhi)
- Provides a comprehensive range of women’s health care, with an emphasis on minimally invasive surgery.
- Known for its high success rates in myomectomy.
Max Healthcare (Delhi): Max Healthcare (Delhi)
- Specializes in fertility-preserving surgeries like myomectomy.
- Provides personalized care and advanced surgical techniques.
Risks and Complications
While myomectomy is generally safe, potential risks include:
- Infection: Preventable with proper postoperative care.
- Bleeding: Rare but may occur during or after surgery.
- Scar Tissue Formation: Adhesions may develop, affecting future fertility.
- Uterine Rupture: Latent complication for subsequent pregnancies; circumcision delivery via cesarean scar delivery should not be excluded.
- Recurrence of Fibroids: Fibroids may grow back over time.
Recovery
Immediate Recovery
- Hospital Stay: On average 1-2 days (respectively) for minimally-invasive surgery and up to 3-5 days, for abdominal myomectomy.
- First Week: Patients may experience mild discomfort, bloating, and fatigue. Pain medications and rest are essential.
Long-Term Recovery
- 2-4 Weeks: (Almost) patients can be discharged after light activities and back to work especially after laparoscopic/robotic surgery.
- 6-8 Weeks: Achieve full functional recovery for abdominal myomectomy; patients may want to exercise at a high-intensity physical activity.
- Follow-Up Care: Regular consultation helps with optimal wound healing and screening of fibroid recurrence.
