Singapore Women's & Children's Medical Group

Do you need a myomectomy for your fibroids?

Fibroids Myomectomy
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Uterine fibroids, though typically benign, are not to be taken lightly. While many women may experience them without significant symptoms, for others, fibroids can be significantly uncomfortable. Excessive menstrual bleeding and a growing abdomen, for instance, can be painful and lead to complications.

In this article, we’ll explore these and other signs and discuss when a myomectomy is necessary for managing uterine fibroids.

What are uterine fibroids?

Uterine fibroids, or leiomyomas or myomas, are noncancerous growths that develop in the uterus. They are prevalent, affecting about 30% of women of reproductive age. These growths can range from small, pea-sized nodules to large lumps that distort the shape of the uterus. When fibroid symptoms are severe,  a hysterectomy or myomectomy may be necessary.

Symptoms of uterine fibroids

Several symptoms point to fibroids, including:

  • Heavy menstrual bleeding
  • Menstrual periods lasting longer than a week
  • Pelvic pain or pressure
  • Frequent urination
  • Difficulty emptying the bladder
  • Constipation
  • Backache or leg pains
  • Pain during sexual intercourse

Signs you need a myomectomy

A myomectomy is a surgical procedure designed to remove uterine fibroids. It preserves the uterus while removing fibroids. While not all fibroids require removal, the following are indications a myomectomy may be necessary:

  • Severe symptoms impacting quality of life: A myomectomy might be recommended to alleviate discomfort if fibroid symptoms significantly interfere with your daily activities.
  • Fertility concerns: If you find it harder to get pregnant or carry a pregnancy to birth due to fibroids, a myomectomy could be beneficial.
  • Rapid fibroid growth: If fibroids rapidly increase in size or number, this may indicate an underlying issue that warrants surgical intervention.

Myomectomy

Preparation

Before undergoing a myomectomy, your doctor will evaluate you thoroughly to assess your health and determine the best approach for the procedure. Assessments may include imaging tests such as ultrasounds or MRI scans to identify the fibroids’ size, number, and location.

Procedure

A myomectomy procedure can be performed through various techniques, including:

  • Abdominal myomectomy: A large incision is made in the abdomen to access the uterus.
  • Laparoscopic myomectomy: Small incisions are made to the abdomen, and a laparoscope is used to guide surgical instruments to remove the fibroids.
  • Hysteroscopic myomectomy: A hysteroscopy is performed to remove fibroids inside the uterus. The hysteroscope is a thin, lighted tube inserted through the vagina and cervix into the uterus.

Risk and complications

Myomectomy is generally considered safe, but like any surgical procedure, it carries certain risks and potential complications, including:

  • Excessive bleeding
  • Infection
  • Damage to surrounding organs
  • Formation of scar tissue
  • Adverse reactions to anaesthesia

Your surgeon will talk you through these potential complications and take appropriate measures to minimise them.

Recovery

Recovery time after a myomectomy will depend on the type of procedure performed and individual factors. Generally, an abdominal myomectomy requires a recovery period of four to six weeks, compared to minimally invasive techniques, which may only need two to four weeks.

You may experience discomfort, fatigue, and vaginal bleeding or discharge during the recovery phase. Your doctor will provide instructions on postoperative care, including pain management and activity restrictions.

Cost

The cost of a myomectomy in Singapore is influenced by the type of procedure, hospital fees, surgeon’s fees, anaesthesia, and postoperative care. It’s advisable to consult your gynaecology surgeon for a more precise price estimate.

Does myomectomy affect fertility?

One of the significant advantages of myomectomy is its potential to preserve fertility. By removing fibroids while leaving the uterus intact, myomectomy can improve fertility outcomes for women experiencing infertility or recurrent pregnancy loss due to fibroids. 

However, the success of fertility preservation depends on the size, number, and location of fibroids, the woman’s age and overall reproductive health.

Myomectomy vs hysterectomy

The choice of myomectomy vs hysterectomy for treatment of fibroids is mainly determined by the woman’s age and fertility wishes. Myomectomy is usually the treatment of choice in women who are young and keen to retain their fertility but carry a chance of fibroid recurrence. 

For older women who have completed their family, hysterectomy – the removal of the womb – eliminates the risk of recurrence and offers a permanent solution to fibroid symptoms but takes away the ability to conceive. A hysterectomy is usually recommended when there are:

  • Large or multiple fibroids
  • Recurrent fibroids
  • Significant fibroid symptoms
  • Other severe gynaecological conditions

When to see a doctor

Consult a doctor if you experience the following symptoms:

  • heavy menstrual bleeding
  • pelvic pain
  • difficulty conceiving

They will perform a thorough assessment and recommend appropriate treatment options for you.

Myomectomy in Singapore

Uterine fibroids can be uncomfortable and painful. A myomectomy can provide relief and preserve the reproductive health of women experiencing uterine fibroid symptoms, including fertility issues and rapid fibroid growth.

For women considering myomectomy in Singapore, the Singapore Women’s and Children’s Medical Group (SWC) offers comprehensive and specialised treatment for uterine fibroids. Our urogynaecology specialists also provide treatment for:

  • Overactive bladder
  • Pelvic organ prolapse
  • Urinary incontinence
  • Interstitial cystitis

Schedule a consultation with our specialists to learn more about myomectomy and treatment costs.

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