Vaginal myomectomy

Myomectomy, sometimes also fibroidectomy, refers to the surgical removal of uterine leiomyomas,
also known as fibroids. In contrast to a hysterectomy the uterus remains preserved and the woman
retains her reproductive potential.
Myomectomy is a procedure in which uterine fibroids are surgically removed from the uterus. Uterine
fibroids (also known as myomas) affect 30% of women. While many fibroids do not need treatment,
others can cause abnormal uterine bleeding, pressure, pain, or other symptoms.
Indications:

The presence of a fibroid does not mean that it needs to be removed. Removal is called for when the
fibroid causes pain or pressure, abnormal bleeding, or interferes with reproduction.
Patients have many options in the management of uterine fibroids, including: observation, medical
therapy (such a GNRH agonists), hysterectomy, uterine artery embolization, and high-intensity focused
ultrasound ablation. Despite these many options, the surgical approach of selected fibroid removal
remains an important choice for those women who want or need to preserve the uterus for
reproduction.

Sometimes quite sizeable fibroids can be removed via the vagina without the need for any abdominal
incisions (laparoscopic or laparotomy). The procedure can also be suitable when a fibroid is too deep or
too large for hysteroscopic removal. One of several techniques can be used depending on the size and
position of the dominant fibroid, but essentially the fibroids are removed either through the cervix or
the top of the vagina.
The ideal case for vaginal myomectomy is someone who has small to medium sized fibroids which are
mostly affecting the back wall of the uterus. Examination and pelvic ultrasound can be very helpful in
identifying suitable patients for this technique.
You should expect to stay in hospital for 2-3 days after surgery, but thereafter, your recovery should be
relatively quick.

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