Myomectomy Surgery: Fibroids Removal in Melbourne

What is performed during a myomectomy procedure?

If you’re seeking expert care and advice from a myomectomy surgeon in Melbourne, please call us.

Call Dr Kuswanto at (03) 9115 9338

What are the Indications for a Fibroid Removal Surgery?

A myomectomy is advised for a range of gynaecological issues. Common indications include:

• Symptomatic fibroids: Heavy bleeding, pelvic pain, or pressure.
• Infertility: Fibroids affecting conception or causing recurrent miscarriages.
• Urinary/bowel symptoms: Compression of the bladder or bowel, causing frequency, urgency, or constipation.
• Abdominal distension: Visible swelling from large fibroids.
• Pain/pressure: Chronic pain, especially from degeneration or torsion.
• Anaemia: Caused by excessive bleeding from fibroids, leading to iron deficiency.

What size of fibroid can be removed in minimally invasive way?

Size is not the only determinant whether a fibroid can be removed laparoscopically or hysteroscopically. It depends also on location, number, together with preference and experience of your gynaecologist.

The size of a normal uterine cavity in women of reproductive age is approximately 4cm. While a 2-3cm submucosal fibroid can be resected through a hysteroscope, a larger submucosal fibroid may require repeated procedures to achieve complete resection and symptom relief. Hysteroscopic resection may not be suitable if the submucosal fibroid is larger than the size of a normal cavity (4cm).

The location of a subserosal or intramural fibroid also determines its suitability for laparoscopic myomectomy. A larger fibroid (such as 10cm) may be more likely to be removed laparoscopically if it is more superficial (rather than deep into the muscle of the uterus) and closer to the top of the uterus (fundus) rather than the bottom (cervix). Laparoscopic myomectomy is also more achievable when there is a single or fewer fibroids compared to numerous large fibroids.

While it is always preferable to perform the myomectomy in minimally invasive way to minimise risks associated with open surgery and allow quicker recovery, it is also important to do so safely, based on your gynaecologist’s assessment. For an assessment and opinion in myomectomy procedure in Melbourne, Dr Kent Kuswanto is available for a consultation – reach out today.

Who should be performing your robotic myomectomy surgery in Melbourne?

Robotic myomectomy or laparoscopic myomectomy should be performed by specialist gynaecologists who have completed additional training either in minimally invasive gynaecology surgery, or in surgical gynaecological oncology in order to learn techniques and procedures to complete the most complex surgeries with lower complication rates and quicker recovery period. They also perform higher volume of more complex cases. For a Myomectomy in Melbourne, Dr Kent Kuswanto is available to see his private patients in Epworth Freemasons in East Melbourne and Werribee.

For Patients Undergoing Myomectomy Surgery (Fibroid Removal) with Dr Kuswanto in Melbourne

Clear communication with your surgeon will contribute to a smoother procedure and recovery process. You should ensure you follow instructions regarding fasting, medication adjustments, lifestyle changes, and undertake all prescribed preoperative assessments (including blood tests and imaging). You should also arrange for transportation after surgery and plan for recovery time accordingly.

How can I prepare for a myomectomy?

🗓️ 1-2 weeks before your surgery

Present to any Melbourne Pathology centres (list of addresses behind Melbourne Pathology form) for pre-operative blood tests – checking your blood counts, kidney and liver function, clotting profile and blood group and hold (in case you need blood transfusion). Please do not go to other pathology centres as the hospital you have been booked to have surgery in – Epworth uses Melbourne Pathology as their provider. Please stop blood thinning medications such as aspirin at least 7 days before the surgery. This also includes fish oil, ginkgo, ginger, garlic supplements. Please let us know if you are on long term prescription blood thinning medications.

🗓️ 2 days before your surgery

Have a soft, light diet that is easily digestible until your surgery. Avoid anything too chunky.

Do I have to fast before my myomectomy procedure?

Yes, you must start fasting at least 6 hours before the planned surgery time. This means no food, no water, no fluids, and no chewing gum. However, you can take your usual medications with sips of water as early as possible on the day of surgery.

🗓️ After the surgery – in the hospital

After your surgery, Dr. Kuswanto will update your next of kin about your status. Pain and nausea medication will be administered, along with a blood-thinning injection to reduce clot risks. A urinary catheter, if used, will be removed the following morning, and blood tests will be conducted.

You may experience some pain, fatigue, and light vaginal bleeding during your recovery. Your medical team will manage your pain and monitor your vital signs. You will be encouraged to move around and can usually be discharged after one night. If you have existing medical conditions, a specialist may oversee your care.

• Vaginal bleeding: Light bleeding is common after a myomectomy, especially if the fibroids were inside the uterine cavity, but it should gradually lessen.
• Urinary catheter: Not all patients will need a urinary catheter; its use depends on the surgical approach and patient circumstances.
• Discharge timing: Discharge after one night is typical for many patients, but this can vary based on individual recovery.

🗓️ After the surgery – following discharge from hospital

After surgery, patients may experience shoulder tip pain due to diaphragm stretching, this usually resolves within a few days. It’s important to keep dressings dry and note that sutures are self-dissolving. You may remove your dressings after 7 days. Some vaginal bleeding is normal for up to 6 weeks. Avoid vaginal insertions for 6-8 weeks for healing. Heavy lifting, straining and sexual intercourse should be avoided during this time. Refrain from driving for 2 weeks and check with your insurer. Return to work varies by job type, typically 2-3 weeks post-surgery, with a medical certificate provided for recovery duration.

• Avoid vaginal insertions for 6-8 weeks to allow for proper healing.
• Avoid heavy lifting, straining, and sexual intercourse during this period.
• Do not drive for 2 weeks, and check with your insurer.
• Return to work typically occurs 2-3 weeks post-surgery, depending on the nature of your job. A medical certificate will be provided for recovery time.