Myomectomy, or fibroid surgery is a commonly advised procedure. If you have been recommended for this surgery, then you must ask these five crucial questions to your doctor.
Is fibroid removal necessary for me?
If your ultrasound detects fibroids, it does not necessarily mean you need surgery. Fibroid removal surgery should only be considered in three conditions:
- If the fibroid has grown significantly and is causing compression symptoms.
- If you are experiencing fibroid symptoms such as heavy periods or painful menstruation, indicating that the fibroid is symptomatic.
- If the fibroid is leading to infertility issues.
Based upon these three conditions, you need to make decisions for fibroid removal surgery.
What type of fibroid surgery will be performed?
There are three primary methods for fibroid removal surgery:
Open Surgery or Open Myomectomy: This involves a large abdominal incision through which the fibroid is removed. It is an older surgical technique.
Laparoscopic Myomectomy: A minimally invasive procedure considered the gold standard for fibroid removal today. It involves making two or three small incisions in the abdomen, leading to faster recovery, minimal pain, and reduced chances of post-surgical adhesions that could impact fertility. This technique is suitable for fibroids of any size or number. Laparoscopic Myomectomy surgery is one that you should go with.
Hysteroscopic Myomectomy: If the fibroid is inside the uterine cavity (submucosal fibroid), this technique is used. It does not require abdominal incisions.
Is the surgeon skilled in laparoscopic myomectomy?
If your doctor is recommending laparoscopic myomectomy, ensure they have the necessary expertise. Additionally, check whether the hospital has high-quality endovision systems and the latest equipment for laparoscopic and hysteroscopic procedures, as these factors directly impact the success of the fibroid removal surgery.
How will the doctor remove a large fibroid through small incisions in laparoscopic surgery?
Since laparoscopic surgery involves small incisions, removing a large fibroid requires a technique called morcellation. This process involves breaking the fibroid into small pieces, which are then extracted through the tiny incisions.
A safer and more advanced approach is in-bag morcellation, where a protective bag is inserted into the abdomen. The fibroid is placed inside this bag, fragmented using a specialized device, and then removed entirely within the bag. This prevents small fibroid fragments from being left inside the abdomen, reducing the risk of damage to surrounding organs and eliminating the chance of spreading undetected cancerous cells (which occurs in less than 1% of cases).
Will the doctor address other conditions, such as ovarian cysts, during the surgery?
If you have an ovarian cyst or any other gynecological condition, discuss with your doctor whether they will treat it during the same procedure. Ideally, if you are undergoing fibroid surgery for infertility, you should request the doctor to assess your fallopian tubes to ensure they are open.
Additionally, if you have endometriosis or any other gynecological condition, it is best to have it treated during fibroid removal surgery.
Discuss Fibroid Recurrence
Fibroids can recur in about 5% to 10% of cases. Ask your doctor if you will need any medications or follow-up treatments to prevent recurrence after fibroid removal surgery.
When considering myomectomy, make a well-informed decision and clarify all doubts with your doctor.
