Myomectomy

Patient information leaflet

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Myomectomy is a surgical procedure to remove uterine fibroids. It can be done via keyhole surgery (laparoscopy) or open surgery (laparotomy).

子宫肌瘤切除手术可以通过微创手术（腹腔镜）或开放（剖腹手术）来完成。

Frequently asked questions

What is myomectomy?

Myomectomy is the surgical procedure to remove fibroid(s).

What are the risk of myomectomy?

Common risks:

• Pain

• Infection (wound, urine, chest)

• Bleeding

Uncommon risks:

• Damage to bladder or bowel

• Bleeding requiring blood transfusion / removal of womb

• Return to theatre

• Pelvic abscess/infection

• Blood clot in leg/lung

• Recurrence of fibroids

Future pregnancies:

• May need Caesarean section

• Risk of uterine rupture

How is the operation performed?

More than 50% women with fibroids have no symptoms. Treatment is not required in these women. However if fibroids have cause problems to your health, myomectomy may be required. Some examples of problems cause by fibroids:

• Heavy bleeding with/without pain

• Pressure symptoms (bladder and bowel symptoms, bloating, chronic pelvic pain)

• Fertility problems (difficult to get pregnant, miscarriages, preterm labour)

What are the advantages and disadvantages of laparoscopy (keyhole surgery) myomectomy compare to laparotomy (open surgery) myomectomy?

Benefits of laparoscopic myomectomy when compared to laparotomy:

• Less pain

• Less fever

• Smaller scar

• Recurrence - no difference

Disadvantages

• Unintended morcellation of uterine sarcoma (cancer) & worsening prognosis

• Disseminated/spreading of fibroids

How is the operation performed?

It can be done through keyhole (laparoscopy) surgery or open (laparotomy) surgery, depending on suitability.

When it is done laparoscopically, fibroids will be cut into small pieces (morcellation) to facillitate its removal from body. It can be done with/without a contained bag.

Are there any alternative treatment?

Yes, these includes:

• Medication

• Transcervical resection of fibroids

• Uterine artery embolization

• High intensity focused ultrasound

• Hysterectomy (removal of womb)

All these methods have it’s pros and cons. Discuss with your doctor to decide which method is best for you.