Myomectomy. Surgery Overview. Myomectomy is the surgical removal of fibroids from the uterus. It allows the uterus to be left in place and, for some women, makes pregnancy more likely than before. Myomectomy is the preferred fibroid treatment for women who want to become pregnant. After myomectomy, your chances of pregnancy may be improved but are not guaranteed. Before myomectomy, shrinking fibroids with gonadotropin- releasing hormone analogue (Gn. RH- a) therapy may reduce blood loss from the surgery. Feature on natural homeopathic remedies for weight loss, obesity, fat loss in women. Facts on Homeopathic treatment, supplements and diet for obese. Gn. RH- a therapy lowers the amount of estrogen your body makes. If you have bleeding from a fibroid, Gn. RH- a therapy can also improve anemia before surgery by stopping uterine bleeding for several months. Surgical methods for myomectomy include: Hysteroscopy, which involves inserting a lighted viewing instrument through the vagina and into the uterus. Laparoscopy, which uses a lighted viewing instrument and one or more small cuts (incisions) in the abdomen. Laparotomy, which uses a larger incision in the abdomen. The method used depends on the: Size, location, and number of fibroids. Hysteroscopy can be used to remove fibroids on the inner wall of the uterus that have not grown deep into the uterine wall. Laparoscopy is usually reserved for removing one or two fibroids, up to about 2 in. To repair these problems without causing organ damage, laparotomy is usually needed. What To Expect After Surgery. The length of time you may spend in the hospital varies. Hysteroscopy is an outpatient procedure. Laparoscopy may be an outpatient procedure or may require a stay of 1 day. Laparotomy requires an average stay of 1 to 4 days. Recovery time depends on the method used for the myomectomy: Hysteroscopy requires from a few days to 2 weeks to recover. Laparoscopy requires 1 to 2 weeks. Laparotomy requires 4 to 6 weeks. Why It Is Done. Myomectomy preserves the uterus while treating fibroids. It may be a reasonable treatment option if you have: Anemia that is not relieved by treatment with medicine. Pain or pressure that is not relieved by treatment with medicine. A fibroid that has changed the wall of the uterus. This can sometimes cause infertility. Before an in vitro fertilization, myomectomy is often done to improve the chances of pregnancy. How Well It Works. Myomectomy decreases pelvic pain and bleeding from fibroids. Pregnancy Myomectomy is the only fibroid treatment that may improve your chances of having a baby. It is known to help with a certain kind of fibroid called a submucosal fibroid. But it does not seem to improve pregnancy chances with any other kind of fibroid. After myomectomy, a cesarean section may be needed for delivery. This depends in part on where and how big the myomectomy incision is. Recurrence. Fibroids return after surgery in 1. Fibroids that were larger and more numerous are most likely to recur. Talk to your doctor about whether your type of fibroid is likely to grow back. Risks Risks may include the following: What To Think About. When trying to get pregnant after myomectomy. Because fibroids can grow back, it is best to try to conceive as soon after a myomectomy as is safely possible and your recovery from surgery is complete. When incisions have been made into the uterine wall to remove fibroids, future pregnancy may be affected. Sometimes placenta problems develop, such as placenta abruptio or placenta accreta. During labor, the uterus may not function normally, which can make a cesarean delivery necessary. In rare cases, a hysterectomy is needed when the surgery reveals that the uterus is too overgrown with fibroids for a safe myomectomy. Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery. References. Citations. Parker WH (2. 01. In JS Berek, ed., Berek and Novak's Gynecology, 1. Philadelphia: Lippincott Williams and Wilkins. Practice Committee of the American Society for Reproductive Medicine, Society of Reproductive Surgeons (2. Myomas and reproductive function. Common Questions and Answers about Ovarian cysts and weight loss. Short description: Preg state, incidental. ICD-9-CM V22.2 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, V22.2. This entry was written by Bill Parker, MD, posted on July 5, 2009 at 7:49 pm, filed under Recent Fibroid Research and tagged fibroid number, fibroid size, fibroid. The American Journal of Gastroenterology (2009) 104:S230. Clinical Vignettes - Pancreatic/Biliary. Fertility and Sterility, 9. S1. 25- S1. 30. Credits. By. Healthwise Staff. Primary Medical Reviewer. Sarah Marshall, MD - Family Medicine. Kathleen Romito, MD - Family Medicine. Specialist Medical Reviewer. Divya Gupta, MD - Obstetrics and Gynecology, Gynecologic Oncology. Current as of. July 2. British Fibroid Trust- fibroids, myomectomy, hysterectomy, uterine artery embolisation, hysteroscopic resection. This site was last modified on Monday 1 August 2. Answers to FAQs on Fibroids of the Uterus Are fibroids hereditary? My mother had a complete hysterectomy at 4. My sister 6 years younger than I, recently had a hysterectomy. She only had 1 fibroid but she said the lining was in pieces with ovaries o. Now I have the same problem, is this a hereditary problem? As far as we know, fibroids are not hereditary. They do have a strange genetic pattern, however, in that many fibroids are monoclonal (derived from the same cell). In other words, if a woman has multiple fibroids, sometimes all of those fibroids come from a single cell as if that cell were cloned. This has led some people to postulate that a virus is involved in producing the fibroid cells that then grow and replicate like a cancer, but in a controlled, non- invasive fashion. If that is true, (we're really guessing) then people in the same family could be susceptible; not because of genetics, but because of exposure to the same virus. Submucosal fibroids and want to become pregnant. I have 2 submucosal fibroids. I have been a very heavy bleeder for years but it's getting worse. I've heard of taking Lupron. Should I just keep waiting and get a myomectomy later if needed or wait to see if arterial embolization becomes ? I assume this was diagnosed by hysteroscopy or by a saline sonohysterogram or a traditional hysterosalpingogram? I ask because some submucosal fibroids can be easily removed at hysteroscopy and D& C which is an outpatient procedure and I would recommend it. Other fibroids are actually mostly in the muscle of the uterus (intramural) and by virtue of their size or position they . Week By Week Golden Retriever Pregnancy Infertility Facts Week By Week Golden Retriever Pregnancy Early Signs Of Pregnancy One Week 7 Weeks Preg Symptoms A Pregnant. The apparent weight loss effects of water have been subject to some scientific research. This evidence has been used by some of the scientists who worked on this. Those are the ones which need to be . I don't like arterial embolization for fibroids because I've seen major complications when blood vessels of the pelvis get embolized when they weren't supposed to during the procedure. Lupron. As far as I'm concerned it is never a long term solution for fibroids because of expense and because the estrogen deficiency it causes affects a long term increase in heart disease and osteoporosis in addition to its side effects of hot flashes, vaginal dryness and irritability. See how ovarian function will affect a disease or symptom when considering removal of the ovaries and as treatment for endometriosis to allow the body to heal or scar over active endometriotic lesions. Also, is there a much increased risk of ovarian cancer with 5 IVF cycles? There is no risk of ovarian cancer from using Lupron. Also, risk seems zero to minimal with less than 1. IVF. Endometrial ablation for fibroids I have prolonged periods due to 2 small fibroids. The doctor wants to remove the fibroids and then do an endometrial ablation. I know that bleeding is a sign of problems. If I have the ablation done, will this mask other potential problems? If the fibroids are causing the bleeding, why have the ablation after removing them? We need more of the story. Endometrial ablation can mask any endometrial abnormality that develops. During an ablation, only about 8. If any abnormality develops in that 2. I was told the fibroids are small and it was felt that they are not solely the cause of bleeding. My periods are not heavy since I took hormone medication, just long 1. I am a little bit hesitant about having the ablation. How old are you? Over 4. Have you had an endometrial biopsy in the office? Does the ultrasound suggest the fibroids are distorting the endometrial cavity? Are you taking any medicines that might affect coagulation such as aspirin, coumadin other pain meds or hormones? Have you had a trial with hormonal therapy such as BC pills or progestins to regulate the flow? All of these things and others are pertinent to your decisional dilemma. I did have all of those tests you mention. The blood work is normal, the biopsy was normal, there are no clotting problems, hormones normal, nor was I on any medication that would cause this. I did try the BC pills as well as the progesterone. The pills cause chest pain possibly due to a heart murmur. BC pills don't usually do that but it's possible. The bleeding did get lighter but the duration went from 1. The bleeding that continues past the normal period length is light then spotting. The sonohysterogram notes 2 . There is mild impression in the endometrial stripe. Those are relatively small but poorly located (for you). An outpatient procedure from which you should recover in 2- 3 days seems preferable to putting up with that bleeding assuming you are in good health in general. Chances of curing problem I would estimate at 8. No endometrial ablation? Correct. No endometrial ablation. Since the bleeding is mechanical, i. Either you cure the bleeding by removing the fibroids. Or if you don't, you don't want bleeding from the fibroids . Endometrial ablation is mainly for dysfunctional, endocrine based bleeding rather than anatomical/mechanical bleeding. It's possible you could have both problems, but the evidence points to mechanical (fibroids) as I understand it. Can fibroids cause kidney pain and urine problems? I know I have fibroid tumors. During a laparoscopy in 1. During the last four months I have had increased flow and large blood clots as well as delayed start (5 days). During the past month I have been taking Arthrotec. Beginning Sunday I noticed increased frequency of urinating as well as tremendous pain right before but not during urination. I thought it might be a kidney problem, but Dr. He thought maybe fibroid tumor problem. Since I don't have much confidence in him, I would like to know if that is reasonable? I should have mentioned that the pain is in my kidney/flank area only. Fibroids can cause urinary frequency if they are putting pressure on the bladder. Usually it is not an acute process however. The quick urinalysis that you mention is probably a dipstick test for nitrites and white blood cells. It is pretty good but it can be wrong. If you have upper tract disease (in kidney . Urine infections almost always cause one to get up 2 or 3 or more times at night (other things can cause that too). If the frequency is only during waking hours, it may be due to pressure on the bladder. In any case, if symptoms of pain and frequency keep up over next day or two, don't hesitate to return to doctor to have it checked again. Fibroid of the fallopian tube Is it possible to have a fibroid in the fallopian tube. I was looking over my report from a lap done over 1. I have done some reading, and according to that it said that salpingitis is almost always associated with PID or some other infection, which I did not have. I actually had no other abnormal finding at that time (except for the comment about a possible bicornuate uterus, on HSG report). I remember the doctor remarking also that I could have been born that way.. Fibroids of the fallopian tube are rare. Its more likely that there could have been a fibroid in the uterus close to the insertion of the tube into the uterus. Actually the report said it was in the tube. Only about 1/2cm away from the uterus. What other options than hysterectomy for fibroids? I was diagnosed with a fibroid today. The doctor says hysterectomy. Are there any options? Fibroids of the uterus are present about 2. They actually require no treatment in most cases. The only times they require any therapy at all are: by position or size they cause irregular (usually heavy and prolonged) uterine bleeding that cannot be controlled with hormonal therapy or removal of a polyp- like fibroid (submucosal) from the inside of the uterus at time of hysteroscopy & D& C (an outpatient procedure). This is not common at all but when they cause pain, it is quite colicky like a kidney stone; not like menstrual cramps. Treatments can vary from just removing the fibroid(s) (myomectomy or submucosal resection) to hysterectomy. There are some medicines to help shrink uterine muscle and fibroids but they are only temporary treatments. How many fibroids can they see on scan? How big are the fibroids? What treatments have already been tried? What symptoms are you having? There is just one fibroid. I'm not sure about the size. Doctor said small, but size is relative. I didn't know to ask. I haven't had any treatments yet. As far as symptoms go, I have severe pain, very heavy bleeding, irregular periods, fatigue, frequent urination, pressure, and fertility problems (not sure if all are because of fibroid). Irregular periods and fatigue shouldn't be symptoms of fibroids. If you are trying to get pregnant, I certainly wouldn't undergo hysterectomy. You may need to see a reproductive endocrinologist to get more information about whether the fibroid is causing infertility. Other studies may need to be done such as sonohysterogram, hysteroscopy, laparoscopy etc., if these have not been done. Ultrasound report on fibroids - what does it mean? I had an ultrasound showing fibroids and don't completely understand the results. Uterine length 1. A smaller 2 cm X 3 cm fibroid located in the posterior aspect of the fundus and a third in the posterior body. The latter measures 4. X3. 0, 7. X4. 3cm. The endometrial stripe is distorted. No intrauterine fluid collection. Ovaries normal in size and configuration. The right ovary is 3. Left is 3. 1 cm long with 1 cm follicular cyst. This report indicates the uterus is enlarged in size to 6. X6. 4. X1. 1. 4 cm, Normal size is about 4. X5. X8cm. The enlargement is due to at least 3 fibroids, one in the top of the uterus (fundus) measuring 7 cm., one in the back top measuring 2. X3 cm., and third one in the back of the uterus measuring 3. X4. 3. X7 cm. The fibroids are big enough to impinge upon the endometrial cavity which may explain any abnormal bleeding. If you were trying to get pregnant or had had miscarriages, this distortion of the cavity would also explain that. The cavity is not blocked (no fluid collection) by the fibroids. The ovaries are both normal size and have normal size follicles (eggs).
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