Myomectomy (open, hysteroscopic)

Question 1

What is a myomectomy?

Answer 1

Surgical removal of fibroids from the uterus – prior to surgery GnRH analogues used to shrink size to reduce bleeding

o The only fibroid treatment can improve pregnancy chances

Question 2

What are the indications of a myomectomy?

Answer 2

o Hysteroscopy – fibroids on inner wall

o Laparoscopy – removing 1 or 2 fibroids ≤ 2 inches that are growing outside the uterus

o Open – large fibroids, many fibroids, fibroids deep into the uterine wall

Question 3

What are the complications of a myomectomy?

Answer 3

o General = infection, bleeding, failure, damage to local structures (i.e. bladder)

o Hysterectomy if large haemorrhage

o Fibroids return in 10-20% of women (larger and more numerous are more likely to recur)