Myomectomy
What is Myomectomy ?
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Why do you need Myomectomy ?
Myomectomy is indicated for:
- Symptomatic fibroids:
- Heavy menstrual bleeding (menorrhagia): Leading to anemia or fatigue.
- Pelvic pain or pressure: Due to fibroid size or location (e.g., pressing on the bladder or bowel).
- Infertility: Fibroids distorting the uterine cavity (submucosal) or blocking fallopian tubes.
- Recurrent miscarriages: Caused by fibroids interfering with implantation.
- Fibroid growth:
- Rapidly enlarging fibroids (concern for rare malignancy, e.g., leiomyosarcoma, <0.5%).
- Large fibroids (>5–6 cm) causing discomfort or organ compression.
- Patient preference:
- Desire to preserve the uterus for fertility or personal reasons, as an alternative to hysterectomy.
Types of fibroids addressed:
- Submucosal: Inside the uterine cavity.
- Intramural: Within the uterine wall.
- Subserosal: On the outer uterine surface.
The procedure aims to remove fibroids, alleviate symptoms, and improve fertility while keeping the uterus intact, making it a preferred option for women of reproductive age.
Why Do Myomectomy Costs Vary in Philippines?
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Myomectomy Procedure
- Before Surgery Evaluation:
- Diagnosis:
- Transvaginal ultrasound: Identifies fibroid size, number, and location.
- MRI (if needed): Maps fibroids for surgical planning, especially for multiple or deep intramural fibroids.
- Hysteroscopy (submucosal fibroids): Visualizes the uterine cavity.
- Blood tests: Checks hemoglobin (for anemia due to bleeding), clotting profile, and kidney/liver function.
- Medications: GnRH agonists (e.g., leuprolide) for 2–3 months pre-surgery to shrink fibroids; iron supplements for anemia.
- Consent: Risks, including bleeding and recurrence, are explained.
- Diagnosis:
- Surgical Techniques:
- Abdominal (Open) Myomectomy:
- Performed under general anesthesia, lasting 1–3 hours.
- A horizontal (Pfannenstiel) or vertical midline incision (5–15 cm) is made in the abdomen.
- Fibroids are excised from the uterine wall; the uterus is sutured to repair defects.
- Used for large (>10 cm), multiple, or deep intramural fibroids.
- Laparoscopic Myomectomy:
- Minimally invasive, lasting 1–3 hours, under general anesthesia.
- 3–4 small incisions (0.5–1 cm) in the abdomen; a laparoscope (camera) guides the procedure.
- Fibroids are removed using laparoscopic instruments; morcellation (cutting into pieces) may be needed for extraction.
- Best for smaller (<8 cm), fewer, or subserosal fibroids.
- Hysteroscopic Myomectomy:
- For submucosal fibroids, performed through the vagina, lasting 30–60 minutes.
- No abdominal incisions; a hysteroscope with a resectoscope (wire loop) removes fibroids.
- Done under general or spinal anesthesia, often outpatient.
- Robotic-Assisted Myomectomy:
- Similar to laparoscopic but uses robotic arms for precision; less common in India due to cost.
- Intraoperative Tools:
- Laparoscope/hysteroscope: Visualizes fibroids.
- Morcellator (laparoscopic): Breaks down fibroids for removal.
- Vasopressin injection: Reduces bleeding during surgery.
- Abdominal (Open) Myomectomy:
- After Surgery:
- Hospital stay: 1–2 days (laparoscopic/hysteroscopic); 3–5 days (abdominal).
- Pain management: IV analgesics (e.g., morphine) for 1–2 days, then oral (e.g., ibuprofen).
- Antibiotics: For 1–2 days to prevent infection.
- Pathology report: Within 5–7 days (rules out malignancy, e.g., leiomyosarcoma).
- Instructions: Avoid heavy lifting or intercourse for 6–8 weeks (abdominal/laparoscopic); 2–4 weeks (hysteroscopic).
Recovery After Myomectomy
- Hospital Stay: 1–2 days (laparoscopic/hysteroscopic); 3–5 days (abdominal).
- Post-Surgery Care:
- Pain: Incision pain for 3–5 days (laparoscopic) or 1–2 weeks (abdominal), managed with analgesics; cramping for 1–2 weeks.
- Activity: Walking within 24 hours to prevent clots; avoid heavy lifting (>5 kg) or strenuous activity for 4–6 weeks (laparoscopic) or 6–8 weeks (abdominal); 1–2 weeks (hysteroscopic).
- Bleeding: Light vaginal spotting for 1–2 weeks; heavy bleeding is abnormal.
- Menstruation: Resumes in 4–6 weeks; often lighter post-surgery.
- Intercourse: Avoid for 4–8 weeks, depending on the approach.
- Pregnancy: Wait 3–6 months (laparoscopic/hysteroscopic) or 6–12 months (abdominal) to allow uterine healing.
- Diet: Start with liquids, progress to solids; high-protein foods (e.g., eggs, lentils) and fiber (e.g., fruits) aid healing; 2–3 liters water daily.
- Follow-Up:
- Visit at 1–2 weeks for wound check; 6 weeks for recovery assessment.
- Ultrasound: At 3–6 months to monitor recurrence.
Most resume normal activities in 2–4 weeks (laparoscopic/hysteroscopic) or 4–6 weeks (abdominal). Symptom relief: 80–90% experience reduced bleeding and pain; fertility improvement: 50–70% conceive within 1–2 years (if fibroids were the primary cause).
Risks and Complications
- Surgical Risks:
- Bleeding (5–10%): 1–3% may need transfusion; rare conversion to hysterectomy (1–2%) if uncontrolled.
- Infection (2–5%): Wound, urinary tract, or pelvic; treated with antibiotics.
- Blood clots (1–2%): Deep vein thrombosis (DVT); early ambulation reduces risk.
- Uterine Risks:
- Adhesions (5–10%): Scar tissue causing pain or infertility; higher with abdominal approach.
- Uterine rupture (0.5–1%): In future pregnancies, especially after deep intramural fibroid removal.
- Other Complications:
- Bowel/bladder injury (<1%, laparoscopic): Rare, requires repair.
- Recurrence (20–30% within 5 years): New fibroids may form; hormonal therapy (e.g., progestins) may reduce risk.
- Morcellation risk (laparoscopic, rare, <0.1%): If undiagnosed malignancy (leiomyosarcoma), may spread cancer cells.
- Fertility: Preserves fertility in 90–95% of cases; 5–10% risk of adhesions or uterine damage affecting pregnancy.
Report fever, severe pain, heavy bleeding, or difficulty urinating promptly.
Frequently Asked Questions (FAQs)
What causes fibroids?
Exact cause unknown; linked to estrogen/progesterone, genetics, and risk factors like obesity, nulliparity, or family history.
Can I avoid myomectomy?
Yes, for asymptomatic fibroids: Monitor with ultrasound; symptomatic: 50–70% improve with medical treatment (e.g., GnRH agonists, tranexamic acid) or uterine artery embolization (UAE).
Is myomectomy painful?
Not during surgery (anesthesia used); post-surgery pain (incisions, cramping) for 3–14 days, managed with medication.
How soon can I resume activities?
Light activities in 1–2 weeks; normal routines in 2–6 weeks, depending on the approach.
Is myomectomy covered by insurance in India?
Yes, for symptomatic fibroids; confirm with your provider.
Signs of complications?
Fever, severe pain, heavy bleeding, or difficulty urinating.
Will fibroids recur after myomectomy?
20–30% risk within 5 years; risk higher in younger women or with multiple fibroids.
Lifestyle changes post-surgery?
Avoid heavy lifting for 4–8 weeks, monitor for recurrence, consider pregnancy planning after 3–12 months, and attend follow-ups.
Conclusion
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Looking for Best Hospitals for Myomectomy
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.