Myomectomy Surgery

Myomectomyin the womb. myoma is the surgical removal of benign tumors called fibroids. Fibroids are benign (non-cancerous) tumors that develop in the muscle tissue of the uterus. Common in women of reproductive age, fibroids are usually painless, but in some women they can cause problems such as heavy menstrual bleeding, pain and infertility. Myomectomy is the treatment of choice to relieve such symptoms and allow women to conceive naturally.

Fibroids and Causes

Fibroids are benign tumors that develop in the muscle tissue of the uterus and are often affected by hormones, especially estrogen and progesterone levels. Fibroids come in different sizes and can be single or multiple. These tumors can affect a woman's quality of life and cause a variety of symptoms:

• Heavy menstrual bleeding
• Pelvic pain
• Frequent urination due to pressure on the bladder
• Constipation
• Pain during sexual intercourse
• Difficulties in pregnancy (risk of infertility or miscarriage)

Indications for Myomectomy Surgery

Myomectomy is preferred when

• Heavy menstrual bleeding, bleeding that is heavy enough to cause anemia (anemia).
• Pelvic pain or a feeling of pressure.
• Infertility or complications during pregnancy (fibroids can have a negative effect on the shape or function of the uterus).
• Discomfort during sexual intercourse.
• Myomas grow and become uncomfortable for the woman.

Types of Myomectomy Surgery

Myomectomy can be performed with different surgical methods. Which method is chosen depends on the size, number and location of the fibroid:

1. Laparoscopic Myomectomy (Closed Surgery):
   • This is a surgery performed through small incisions and is usually preferred when fibroids are located inside the abdomen. The fibroids are removed using a laparoscopic camera and surgical instruments.
   • Advantages include smaller incisions, faster healing and less pain.
2. Laparotomy (Open Surgery):
   • If the fibroids are very large or located deep in the abdomen, the laparoscopic method may not be sufficient and open surgery may be required. In this method, a larger incision is made in the abdomen.
   • It is usually suitable for patients with large and multiple fibroids.
3. Hysteroscopic Myomectomy:
   • Hysteroscopy is a procedure used to remove fibroids inside the uterus. This is done through a hysteroscope (a device with a camera) that is inserted through the vagina into the uterus.
   • It is generally suitable for fibroids located inside the uterus, especially close to the uterine wall.
   • This procedure, which is performed vaginally without incision, usually provides a rapid healing process.

How Myomectomy Surgery is Performed

The surgical process may vary depending on the patient's general health and the location of the fibroids. In general, it is done in the following steps:

1. Anesthesia: Myomectomy is performed under general anesthesia, meaning the patient is put to sleep.
2. Making the Incision:
   • Laparoscopic methodsmall incisions are made and the surgeon removes the fibroids using a laparascope and special surgical instruments.
   • Open surgical methodwith a larger incision is made in the abdomen and a larger area is accessed.
   • Hysteroscopic methodthe myoma is removed by entering the uterus through the vagina.
3. Removal of fibroids: Fibroids are carefully removed by the surgeon. In some cases, fibroids can be destroyed by freezing or laser burning.
4. Closed position of the uterus: After the fibroid has been removed, the tissues are repositioned and closed with stitches so that the uterus can heal properly.
5. Termination of Surgery: At the end of the surgery, the incision site is closed properly and the patient is taken to the recovery room.

Postoperative Recovery

The recovery period after myomectomy surgery varies depending on the surgical technique, the patient's general state of health and the complexity of the operation:

• Length of Hospitalization: Laparoscopic myomectomy usually requires hospitalization for 1-2 days, while open surgery may take longer.
• Pain Management: Postoperative pain is usually controlled with medication. Recovery after laparoscopic surgery is faster and the pain may be milder.
• Physical Activity: Patients can usually return to normal activities within a few weeks. However, it is recommended to avoid heavy lifting and strenuous activities.
• Control Appointments: After surgery, the doctor recommends regular follow-up appointments to monitor recovery and prevent any complications.

Risks and Complications of Myomectomy Surgery

Like any surgical intervention, myomectomy carries some risks:

• Infection: Infections at the surgical site can be treated with antibiotic therapy.
• Bleeding: There is a risk of bleeding after myomectomy. This risk may be higher if large fibroids are removed.
• Adhesions: Adhesions can form in the abdomen, which can lead to pain or infertility.
• Uterine Injury: In rare cases, the uterus or other organs may be damaged during surgery.
• Myoma Reoccurrence: Fibroids can reoccur after myomectomy, but symptoms usually subside when existing fibroids are removed.

Success Rate of Myomectomy Surgery

Myomectomy surgery is usually performed successfully. Most women experience a marked improvement in symptoms after surgery. However, some patients may require repeat surgery, as fibroids can regenerate. Myomectomy is also effective in solving the problem of infertility, but in some cases, it may need to be supplemented with other treatment methods.