Myomectomy; Removing the Fibroids
Myomectomy means removal of the myomas (leiyomyomas or fibroids).
When women wish to preserve childbearing potential, myomectomy may be performed.
Unlike hysterectomy in which the entire uterus is removed, myomectomy is a surgical procedure in which individual fibroids are removed.
Approximately 18,000 myomectomies are performed yearly in the United States.
In general, myomectomy diminishes menorrhagia (prolonged and/or profuse menstrual flow) in roughly 80% of patients presenting with this symptom.
Unfortunately, there is a significant risk of recurrence of fibroids after myomectomy; in some studies up to 10% of women who underwent an initial myomectomy required a second major operative procedure.
In addition, 1/4 to 1/2 of women who underwent myomectomies had evidence by ultrasound of recurrence of their fibroids within 1 to 10 years.
In general there is 2 types of myomectomy;
1. laparotomic (abdominal) myomectomy (open surgery)
2. laparoscopic myomectomy (close surgery)
However fibroids can be removed from vagina by using hysterescope (hysteroscopic myomectomy).
Although many fibroids can be removed through the laparoscope, the decision of which myomas should be removed laparoscopically and which by laparotomy depends on many factors.
A woman should discuss the advantages, disadvantages, and risks of each type of surgery with a surgeon who is experienced in all treatment methods.