Myomectomy is a surgical procedure that involves the removal of one or more uterine fibroids while preserving the uterus with the help of abdominal hysterectomy instrument set. These fibroids, also called myomas, are benign tumors that appear quite often in women over their forties. However, these lumps located in several places in the uterus do not always require an operation. In addition, the surgical approaches to remove them are very diverse. So when should you have a myomectomy and why? Follow this guide to learn all about uterine fibroids.
What is a fibroid?
Fibroids will develop in the uterus, the uterine cavity, in the muscular wall of the uterus and can sometimes be attached by a more or less wide pedicle. In the vast majority of cases, these non-cancerous tumors do not cause any symptoms and do not always require myomectomy. Most women are also not necessarily aware that they have them. So they eventually find out during a routine ultrasound.
The cause of the appearance of fibroids in a woman’s body is still not well understood. Indeed, they are believed to occur as a result of a combination of genetic, hormonal and environmental factors. It would therefore be a single cell in the uterine wall undergoing a genetic mutation and then multiplying in an uncontrolled manner.
Estrogen, female hormones, will also have a role and act on the growth of the fibroid. A few years before menopause, several fibroids can therefore appear, because during this period, the woman has a higher estrogen level. After menopause, this rate drops, which will tend to reduce the size of the fibroids.
There are different types of myomas, or uterine fibroids depending on their location:
Submucosal fibroma, located in the uterine cavity, forms under the lining of the uterus. This type of fibroid is the rarest, but it can cause heavy bleeding. It may then be necessary to have a myomectomy.
Subserous fibroma, it grows outside the uterus.
Intramural fibroma, it forms in the muscular layer of the wall of the uterus. This type of myoma represents nearly 70% of fibroids.
Each of these fibroids can grow directly on the wall or be attached by a pedicle of varying size in terms of size.
Why do a myomectomy?
While the majority of uterine fibroids go unnoticed and have no health consequences, there is still a risk of complications. In fact, a myomectomy may be necessary if the fibroids cause:
Bleeding: especially during menstruation, we will then speak of menorrhagia, they are often caused by the submucosal fibroma which is located in the uterine cavity.
Decreased fertility: Although most women with fibroids are fertile and have normal pregnancies, a fibroid that is too large can be the cause of reduced fertility. Its imposing size will then block the fallopian tubes.
Complications during pregnancy: depending on the size and location of the myomas in the uterus, a woman is more likely to have a miscarriage or to give birth before the pregnancy is due.
Compression of neighboring organs: a fibroid that is too large can compress the bladder, the rectum, or even the ureters, that is to say the channels that connect the kidneys to the bladder.
When fibroids present any of these symptoms in a woman’s body, or cause pain, a myomectomy should be considered.
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