Why is this procedure done?
The uterus is an organ where the baby grows when a woman is pregnant. The uterus is also called the womb. The uterus is in the lower belly. Some women develop tough balls of muscle in the womb. These balls of muscle are called fibroids. You may have fibroids inside or outside of the womb. You may also have fibroids in the wall of the womb, which is the most common place. Fibroids may cause pain or pressure in the pelvic area. Fibroids may also cause too much bleeding during menstruation. ‚
A myomectomy is a procedure to take out the fibroids. Your doctor may suggest a myomectomy if you have fibroids and: ‚
- Want to get pregnant
- Have heavy menstrual bleeding
- Have pain or pressure from the fibroids
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What will the results be?
- Normal menstrual period
- Less pain and pressure in the pelvic area
- Better chance of getting pregnant
- May prevent the need for a total removal of the womb
What happens before the procedure?
- Your doctor will take your history. Talk to the doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some examples are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about all of your drugs.
- If you need to stop eating or drinking before your procedure.
- Your doctor will do an exam and may order:
- Ultrasounds
- X-ray of the inside of your womb
- The doctor may order a hysteroscopy. A hysterectomy will let the doctor look into the uterus through the vagina. This view is sometimes needed to help the doctor decide the best way to take out the fibroids. Hysteroscopy is a minor surgery and is done on an outpatient basis.
- Your doctor may order other treatments to shrink the fibroids before surgery is used. These treatments include adding iron supplements and hormones.
- You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.
What happens during the procedure?
- Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
- When you are asleep, the doctors put a tube in your mouth to help you breathe. They also put another small tube in your nose. This one goes down to your stomach to drain out any food or fluid that might come out during surgery. You will have a tube in your bladder to drain urine.
- Your doctor will make a cut along your bikini line or a vertical cut below your navel. The doctor will look for all the fibroids along the uterine wall and take them out.
- Your doctor will close your cut with stitches or staples and cover it with clean bandages.
- This procedure may take 2 hours.
What happens after the procedure?
- You will go to the Recovery Room and the staff will watch you closely. You may have to stay in the hospital for 2 to 3 days.
- You will continue to get drugs for pain. You may have an I.V. pain pump. The I.V. pain pump is controlled by a button that you push when you have pain. Ask your doctor about what options you will have to relieve your pain after the surgery.
- The tube in your bladder will be removed the day after your surgery. You may feel some burning the first time pass urine after the tube is removed.
- Within a day or two, you will get out of bed to a chair. The staff will help you begin to walk around. Doing coughing and deep breathing exercises will help keep your lungs clear.
- Moving your legs is important while in bed. Use a small pillow to put pressure on your belly. The pressure can make you more comfortable when you cough, laugh, or do other actions.
- You will be given clear liquids and ice chips after surgery. You can eat solid food after you are awake and your digestive tract is working after the surgery.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what you need to do.
- You may expect some bleeding from your vagina for a few weeks. Wear sanitary pads to absorb the blood. Do not use tampons or douche.
- You may feel belly pain for a few days. Take your drugs as ordered by your doctor. Do not drive if you are taking pain drugs.
- Take daily walks around your block once you are able. Walking may help prevent blood clots.
- Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages
- How to care for your cut sites
- When you may take a bath or shower
- If you need to be careful with lifting things over 10 pounds
- When you can go back to your normal activities like work, driving, or sex
What follow-up care is needed?
Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep your visits. Together you can make a plan for more care. Ask the doctor about when you may become pregnant after the surgery. ‚
What problems could happen?
- Bleeding or blood loss
- Infection
- Regrowth of fibroids
- Damage to nearby organs or tissues
- Scar tissue
- Injury to the uterus
- Longer healing time from this procedure
- Possibly needing a C-section for future deliveries
When do I need to call the doctor?
- Signs of infection such as a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, pain with passing urine, wound that will not heal, anal itching or pain.
- Signs of wound infection such as swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
- Blood is soaking through your bandages
- Bleeding from the vagina suddenly gets heavier
- Pain is not helped by taking drugs
Where can I learn more?
Better Health Channel ‚
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Myomectomy ‚
National Institute of Child Health & Human Development ‚
http://www.nichd.nih.gov/health/topics/uterine/conditioninfo/treatments/Pages/surgical-treatments.aspx ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚