Myomectomy (surgery to remove uterine myoma)

Uterine fibroids are a common condition affecting many women and require special attention and timely treatment. Specialists at the "Dobrobut" medical network use modern diagnostic and treatment methods to help maintain women’s health and ensure the normal functioning of the reproductive system.

Uterine fibroids, also known as leiomyomas, are benign tumors that develop from the muscular tissue of the uterus. They vary in size, number, and location in the uterus. The three main types of fibroids are:

• Intramural: Grow in the muscular wall of the uterus.
• Subserosal: Bulge beyond the outer surface of the uterus.
• Submucosal nodules: Extend into the uterine cavity.

Causes of Uterine Fibroids:

The exact cause of uterine fibroids remains unknown, but several factors may contribute to their development, including:

• hormonal imbalances, particularly levels of estrogen and progesterone;
• genetic predisposition;
• growth factors and other substances that help maintain tissue tone.

Symptoms of Uterine Fibroids:

Symptoms of uterine fibroids can vary in severity and often include:

• heavy and prolonged menstrual bleeding,
• pain and pressure in the pelvic area,
• frequent urination or difficulty emptying the bladder,
• constipation,
• back or leg pain,
• infertility or recurrent miscarriage.

If any symptoms appear, it is necessary to consult a doctor. It’s particularly important to seek medical help for heavy bleeding, chronic pelvic pain, or fertility problems.

Indications for Uterine Fibroid Removal:

Fibroids usually require removal when they cause significant symptoms or complications.

Overall, the indications for removal of fibroid nodules include:

• heavy menstrual bleeding leading to anemia;
• intense pelvic pain that is not alleviated by standard pain relief and pressure;
• rapid growth of the fibroid nodule;
• infertility and other reproductive health issues;
• negative impact on other organs or body functions.

Contraindications for Uterine Fibroid Removal:

In some conditions, removal of fibroid nodes is not recommended or might be challenging. These include pregnancy, acute infections, severe chronic diseases, and asymptomatic fibroids, which often require monitoring or conservative treatment.

Diagnosis:

The diagnosis of uterine fibroids typically involves a pelvic exam, ultrasound to confirm the presence and size of fibroids, more detailed imaging with MRI (if necessary), and hysteroscopy.

Modern Treatment Methods:

After diagnosing, the gynecologist at "Dobrobut" chooses the optimal treatment option. Depending on the type, size, location, and number of nodes, this may include:

• Medication therapy: Regulation of hormonal balance, symptom control, and reduction in fibroid size.
• Minimally invasive procedures such as uterine artery embolization (UAE) or laparoscopic myomectomy.
• Traditional surgery - hysterectomy (surgery to remove the uterus) is suitable for women with very large fibroids who do not plan to give birth again.

Types of Myomectomy

In surgical practice, the removal of myomatous nodes is performed using the following methods:

1. Abdominal Myomectomy:
   The surgeon makes an incision in the suprapubic area of the patient's abdomen to quickly remove myomatous formations by enucleating the nodes within healthy tissue. This method is often used for larger or multiple fibroids and requires a longer recovery period but provides thorough access for the removal.
2. Laparoscopic Myomectomy:
   This is a minimally invasive and relatively safe method of myomectomy, performed using special optical instruments. This technique is suitable if the necessary instruments and surgical expertise are available and is typically used for subserosal (when the woman does not plan pregnancy) or intramural fibroids.
3. Hysteroscopic Myomectomy:
   This method involves the removal of myomatous nodes through the vagina and is commonly used for fibroids located inside the uterus. It is a preferred method due to the minimal complications post-procedure.

The methods of uterine fibroid removal vary in complexity. Thus, the physician has the discretion to choose a particular method based on the nature of the nodes, the woman's age, and her reproductive plans.

Hysteroscopic Resection for Removing Submucosal Nodules:

Hysteroscopic resection is a minimally invasive surgical method for removing submucosal fibroids. It involves inserting a hysteroscope through the vagina and cervix into the uterus, allowing the surgeon to excise the fibroids using specialized instruments. According to reviews, this method is considered the most gentle and effective for removing uterine fibroids.

Recovery Period:

The term of rehabilitation after removal of uterine fibroids depends on the type of procedure:

• Non-invasive and minimally invasive procedures generally involve shorter recovery times, provided the doctor's recommendations are followed.
• Traditional surgical interventions usually require longer rehabilitation and more complex postoperative care.

Most patients need to follow specific care instructions and might experience mild pain or discomfort.

Complications:

The procedure for removing fibroid nodes is fairly safe, though possible complications can include:

• infections,
• bleeding,
• scar tissue formation,
• impact on reproductive function,
• recurrence of fibroids.

Prevention:

There is no certain way to prevent uterine fibroids, but a healthy lifestyle helps reduce risks. Regular exercise, maintaining a stable weight, and stress prevention can minimize hormonal imbalances and the associated development of fibroids.

Early diagnosis of uterine fibroids and appropriate treatment can alleviate symptoms, improve quality of life, and prevent potential complications.