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Myomectomy Treatment Information
What to Expect
Your doctor will order blood and imaging tests before the myomectomy to determine the size and location of the uterine fibroids and to make sure you are healthy enough for surgery. You may also take medicines or hormone treatments to shrink the fibroids before surgery. Some doctors prescribe leuprolide (Lupron) two to six months before surgery. The benefits of leuprolide include:
- Reduces the size of fibroids
- Stops menstruation, which allows anemic patients to improve their blood count
- Reduces the risk of excess blood loss during surgery
Be sure to tell your doctor about all the medicines you take before surgery, including any over-the-counter medicines and supplements. Your doctor may ask you to stop taking certain medicines before surgery.
Be sure to ask your doctor about the type of anesthesia you will receive during surgery. Your surgery team may use:
- General anesthesia. This type of anesthesia puts you to sleep. It is used for abdominal, laparoscopic and some hysteroscopic myomectomies.
- Spinal anesthesia. This kind of anesthesia medicine is injected into the spinal canal to numb the nerves in the lower half of the body. It is used for certain hysteroscopic myomectomies.
Follow your doctor's instructions the night before surgery. Typically, you will need to:
- Not eat or drink after midnight
- Restrict certain medicines
You should expect to stay in the hospital overnight or up to three days depending on the type of myomectomy performed. A laparotomy (abdominal myomectomy) usually requires a stay of two to three days. Laparoscopic and hysteroscopic myomectomies require an overnight hospital stay. Some hysteroscopic myomectomies do not require an overnight stay.
Be sure to arrive at the hospital on time on the day of your surgery.
- When you arrive at the hospital, you will be taken to the pre-op room where you will change into a hospital gown.
- You will then meet with your surgeon, the nurses and an anesthesiologist in the pre-op room. Be sure to ask any questions you may have about the procedure.
- The anesthesiologist may insert an IV line in your arm or wrist to deliver fluids and pain medicine. He or she may also prep you for anesthesia.
- You will be taken to the operating room once you are ready for surgery.
- The surgery team will attach devices to your body to monitor your heart rate and blood pressure.
- The anesthesiologist will give you general or spinal anesthesia so that you feel no pain during the surgery.
- The surgery team will monitor your heart rate, blood pressure, blood loss and breathing during the procedure.
- If you are undergoing a laparoscopy or laparotomy, a nurse will sterilize the areas where the incisions will be made. Then, the surgeon will numb the incision site or sites with a local anesthetic.
- After the surgeon removes the fibroids, he or she will repair any incision sites in the uterus. Any other incision sites on the abdomen or bikini line are sutured and covered with a dressing.
After surgery, you will be moved to a recovery room where a nurse will monitor your vital signs as you wake up. You will be given pain medicine to help you feel better. The surgeon will encourage you to get out of bed and move around as soon as possible to speed recovery and prevent blood clots in your legs.
Depending on the type of myomectomy, you will spend one, two or three nights in the hospital. You usually need two to three days to recover after an abdominal myomectomy.
The removal of uterine fibroids usually stops heavy menstrual bleeding and pelvic pain and pressure. New fibroids may appear, and they may or may not require treatment. If you only had one fibroid removed, you have a lower risk of needing treatment for any new fibroids.
Most women who have a myomectomy are able to become pregnant. However, you should wait three months after the procedure before trying to become pregnant. In some cases, the baby may need to be delivered by cesarean section if the uterine wall is weak.
You should expect some vaginal spotting for up to six weeks depending on the type of myomectomy performed.
It will take four to six weeks for you to fully recover and return to normal activities after an abdominal myomectomy.
The recovery time is shorter (between one and three weeks) for a laparoscopic or hysteroscopic myomectomy.
You will see your surgeon for a follow-up visit two to six weeks after the myomectomy. He or she will monitor your recovery and check for any new fibroids.
Your doctor usually performs a pelvic exam three months, six months and one year after the myomectomy to check for fibroids. An ultrasound may also be performed to check for any fibroid recurrence.
If no new fibroids are found after one year, your doctor will likely recommend annual exams.
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