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DEFINITION
A Myomectomy is the removal of fibroid tumors (leiomyoma, myoma) from the uterus through incisions in the lower abdomen.
If you are considering a hysterectomy for fibroid tumor removal:The presence of fibroids, in itself, is not sufficient reason to consider a hysterectomy unless it is a lifesaving measure for a woman who is in danger of hemorrhaging severely from a large fibroid. This surgical removal of the uterus is the Western Medical remedy for fibroids. Frequently women are advised by their health care providers to have their uteruses removed, often for no better reason than fibroids were felt a during routine examination. This occurs so often that by the time women have reached the age of 60, more than one-third of all American women will have given up their uteruses to their surgeons. Fully half of these women will experience loss of sexual desire, urinary problems, and severe early menopausal symptoms (even when the ovaries are retained during surgery). Adhesions frequently form on the intestines after a hysterectomy and can cause emergency surgery and/or death.
MoonDragon's ObGyn Information: Uterine Fibroids
REASONS FOR PROCEDURE
Pelvic pain.
Anemia caused by excessive loss of blood.
Pressure on the bladder.
Abnormal uterine bleeding.
Difficulty in becoming pregnant.
Discomfort with sexual intercourse.
RISK INCREASES WITH
Obesity.
Smoking.
Poor nutrition, especially inadequate iron intake that has led to anemia.
Illness that has reduced strength.
Use of drugs such as cortisone, antihypertensives, beta-adrenergic blockers, or diuretics.
Use of mind-altering drugs, including narcotics; psychedelics, hallucinogens; marijuana; sedatives; hypnotics; or cocaine.
DESCRIPTION OF THE PROCEDURE
A general anesthetic will be administered.
One or more incisions are made in the lower abdomen.
The muscles are separated and connective tissues are cut free to expose the uterus.
There are 3 major types of fibroids (determined by location in the uterus). Subserous appear on the outside of the uterus, intramural are confined to the wall of the uterus, and submucous appear inside the uterus. Rarely, fibroids can involve the cervix.
Each tumor is removed separately, and each incision is repaired.
The internal structures are closed in layers.
The skin is closed with sutures or skin clips, which can be removed about 2 to 7 days after surgery.
For some fibroid growths, the surgery may be done with a hysteroscopic loop cautery, laser myoma resection or the tumors can be removed using laparoscopic surgery.
EXPECTED OUTCOME
If the uterus is left intact, and you will have menstrual periods. Your next period may be heavier than usual, but should occur at about the expected time. Allow about 6 weeks for recovery from surgery.
If a hysterectomy was performed, your menstrual periods will cease.
POSSIBLE COMPLICATIONS
Heavy excessive bleeding and anemia.
Perforation of the bowel during surgery.
Recurrence of the tumor. Fibroids may return following surgery to remove them.
Surgical-wound infection.
POST-PROCEDURE CARE
GENERAL MEASURES
A hard ridge should form along the incision. As it heals, the ridge will recede gradually.
Use an electric heating pad, a heat lamp or a warm compress to (possibly soaked in comfrey leaf infusion) relieve incisional pain.
Bathe and shower as usual. You may wash the incision gently with mild unscented soap.
Wear sanitary pads - not tampons - to absorb blood.
Do not smoke.
SOME HERBAL OR HOLISTIC RECOMMENDATIONS MAY INCLUDE:
- Use 25 drops of echinacea root tincture 1 to 3 times a day, for three days before the operation and 7 to 10 days after.
Herbal Remedies: Echinacea Tincture, Nature's Way, Alcohol Free, 1 fl. oz.
- Try acupuncture treatments, before and after surgery.
- Avoid blood-borne diseases by donating some of your own blood to be used during the surgery.
- Create a "ritual" for "giving all or part of my uterus away" rather than "giving up on my uterus". By mentally changing your outlook about the surgical outcome, turn it around and make it a positive affirmation and response to your particular situation. This will help to prevent or alleviate any post-surgical emotional issues and depression.
MEDICATION
Antibiotics are often prescribed to help prevent infection following surgery.
Prescription pain medication should generally only be required for 2 to 7 days following the procedure.
You may use non-prescription drugs, such as acetaminophen or ibuprofen, for minor pain.
Vaginal creams or medicated douches, if vaginal discharge develops an unpleasant odor. Consult with your health care provider before using any over-the-counter vaginal creams, medications, and douches.
ACTIVITY
To help recovery and aid your well-being, resume daily activities, including work, as soon as you are able.
Have someone drive you home following the procedure. Resume driving about 2 weeks after returning home.
Sexual relations may be resumed after one month or when your health care provider gives you the okay.
DIET
Clear liquid diet until the gastrointestinal tract functions again.
However, when you are able to resume normal eating patterns, you should follow a healthy, balanced nutritional program for a healthy immune system and to assist in a rapid recovery from your surgery.
NOTIFY YOUR HEALTH CARE PROVIDER IF...
Any of the following occurs:
- You experience vaginal bleeding that soaks more than 1 pad per hour.
- You develop signs of infection: headache, muscle aches, dizziness or a general feeling of ill health and fever.
- You have abdominal swelling or severe abdominal pain.
- The urge to urinate frequently persists longer than one month.
- Excessive vaginal discharge persists beyond 1 month after surgery.
If you have any concerns or unusual symptoms, contact you health care provider. Medications used in your treatment may have some side effects.
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Some of the information for this page was obtained from
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