Uterine Fibroids Surgery: How To Choose Between A Hysterectomy And A Myomectomy

a photo of uterine fibroids that may require surgery options such as myomectomy or hysterectomy

Uterine Fibroids Surgery: How To Choose Between A Hysterectomy And A Myomectomy

Uterine fibroids (also called leiomyomas) are noncancerous growths of the uterus. They are the commonest benign tumour arising from the muscular layer of the uterus. Many women have uterine fibroids sometime during their lifespan. Since there are frequently no noticeable symptoms, one might not know that they have a fibroid.  They are commonly found during a routine pelvic exam or prenatal ultrasound. The size of fibroids can range from tiny masses barely detectable to the human eye to big masses that can distort and expand the uterus. In extreme cases, fibroids can grow to extend above the umbilicus and even up to the ribcage.

SHOULD I HAVE A MYOMECTOMY OR A HYSTERECTOMY? 

No treatment is required when the uterine fibroids are small and cause no symptoms.

Similar to chocolate cysts within the ovary (also known as endometriomas), uterine fibroids are almost always benign. Large fibroids can lead to pressure symptoms such as bloating, bowel pressure and urinary frequency. Some fibroids grow and distort the lining of the uterus (the endometrium) and cause heavy periods, even when small. When fibroids cause symptoms, it is best to consider treatment options early. As the fibroid grows and symptoms progress, treatment options remain possible but can become more challenging.

Non-surgical, radiological and surgical treatment options are available depending on the individual fibroid and patient circumstances. Surgery, either a myomectomy or hysterectomy, is commonly performed. Both options successfully remove fibroids and reduce symptoms. Myomectomy surgery is the targeted removal of a fibroid whilst retaining the uterus to allow the patient to conceive a future pregnancy. Women who have completed childbearing are usually offered a hysterectomy. Since a hysterectomy removes the uterus altogether, it is guaranteed to stop excessive or abnormal bleeding as there are no more periods. This also prevents potential regrowth of treated or new fibroids that may require more surgery in the future. There is also typically less risk of excessive bleeding during a hysterectomy compared to a myomectomy. Recovery following surgery is similar for both options.

WHAT ARE THE SURGICAL RISKS OF A MYOMECTOMY AND A HYSTERECTOMY? 

Most people who receive a hysterectomy or a myomectomy have no serious complications following their surgery. As with all procedures, however, there is potential for a complication. Your doctor should discuss these with you before surgery and you should highlight and discuss any specific concerns.

Potential complications specific to hysterectomy:

  • bleeding
  • infection (eg. skin wound, vaginal wound, bladder)
  • damage to internal organs (bladder, ureters, bowel, major blood vessels)
  • blood clots in legs or lungs
  • hernia at skin incision site

Potential complications specific to myomectomy:

  • bleeding (with subsequent blood transfusion in up to 10% of cases)
  • hysterectomy (in up to 1% of cases)
  • infection (eg. skin wound, bladder)
  • damage to internal organs (bladder, ureters, bowel, major blood vessels)
  • blood clots in legs or lungs
  • hernia at skin incision site
  • fluid overload and electrolyte disturbances (when performing hysteroscopic resection of submucosal fibroid)

 

FOOD AND MEDICATIONS PRIOR TO THE SURGERY

As both types of operations are performed under general anaesthetic, you will need to fast 4-6 hours before surgery. Your doctor will provide you with instructions to guide you in more detail. It is important to also talk to your doctor about whether you should change your usual medication routine, vitamins, or any other dietary supplements you are taking.

Both myomectomy and hysterectomy are highly effective treatments for uterine fibroids. The choice of surgery is usually tailored to the individual based on your fibroid and personal circumstances. It is crucial to talk to your doctor about which options are best suited to you. If you want to know more about uterine fibroid surgery or you have further queries about other gynaecological problems, you can contact us now or call (03) 9115 9338 today!   



CALL NOW MAKE A BOOKING