What is Open Myoma Surgery? Methods, Risks and Recovery Process

Open myoma surgery is a surgical procedure that removes myomas, which are benign tumors that develop in the uterus. This method is preferred when larger and deeper-seated myomas need to be removed or when minimally invasive methods are inadequate. During the operation, the surgeon reaches the uterus by making a large incision in the abdominal area and removes the myomas. This surgery is especially applied when there are very large myomas or multiple myomas. Open myomectomy, also known as open myomectomy, aims to preserve the uterus so that women can get rid of their fibroids without losing their fertility.


 

What is Open Myomectomy?

Open myomectomy is a surgical operation performed by making a large incision in the abdomen to remove fibroids in the uterus. This surgery is usually performed in cases of large fibroids or multiple fibroids. Open myomectomy aims to remove only the fibroids while preserving the uterus so that women do not lose their fertility. During the operation, the surgeon reaches the uterus by making an incision in the abdominal area and carefully removes the fibroids. This method is preferred for fibroids that are too large or deeply located to be removed laparoscopically or vaginally.

Why Do Myomas Form?

Myomas are benign tumors that develop in the muscle tissue of the uterus and are more common in women during their reproductive years. Although the exact causes of myoma formation are not known, some factors are thought to trigger the development of myoma.

Causes of Myoma Formation and Risk Factors:

• Genetic Predisposition: Women with a family history of myoma have a higher risk of developing myoma.
• Hormones: High levels of the hormones estrogen and progesterone in particular encourage the growth of myomas.
• Age: Myomas are generally more common in women between the ages of 30-40.
• Obesity: The risk of developing myoma is higher in overweight women. is high.
• Nutrition and Lifestyle: Red meat consumption, low fiber diet and excessive alcohol consumption can increase the risk of myoma.

These factors play an important role in the development of myomas, but may vary from woman to woman.

Symptoms of Myomas

Myomas can usually grow without symptoms and many women may not even be aware of their fibroids. However, when fibroids grow or increase in number, some symptoms may occur.

Common Myoma Symptoms:

• Heavy and Prolonged Menstrual Bleeding: Myomas can cause excessive bleeding during the menstrual cycle. This can lead to problems such as anemia.
• Pelvic Pain and Pressure: When fibroids press on the uterus, they can cause pain in the lower abdomen.
• Frequent Urination: Large fibroids can press on the bladder, causing the need to urinate frequently.
• Constipation: When fibroids press on the intestines, they can cause digestive problems such as constipation.
• Infertility: In some cases, fibroids can affect fertility and make it difficult to get pregnant.

These symptoms may vary depending on the size and location of the fibroids. If you experience such symptoms, you should see a doctor.

When is Open Myomectomy Required?

Most fibroids can be asymptomatic and do not require treatment. However, in some cases, the size or number of fibroids may require surgical intervention. Open myomectomy is preferred especially in cases such as large myomas, rapidly growing myomas or the presence of multiple myomas.

Conditions Requiring Open Myomectomy:

• Heavy Menstrual Bleeding: If myomas cause excessive and prolonged menstrual bleeding.
• Pelvic Pain: The presence of large myomas in the uterus can cause constant pain in the pelvic area.
• Infertility: When myomas cover the inside of the uterus, they can make it difficult for the embryo to attach, which can make it difficult to get pregnant.
• Pressure Symptoms: Frequent urination, constipation gIf there are symptoms that put pressure on organs.

When these symptoms seriously affect the patient's quality of life, open myomectomy surgery may be recommended.

How is Open Myomectomy Surgery Performed?

Open myomectomy surgery is an operation performed under general anesthesia. Myomas are removed by making a large incision in the abdominal area.

Step-by-Step Open Myomectomy:

1. Anesthesia: The surgery is performed under general anesthesia, so the patient is asleep during the operation and does not feel pain.
2. Making an Incision: The surgeon makes an incision in the abdominal area. This incision is usually made at the bikini line.
3. Removal of Fibroids: The surgeon reaches the uterus and carefully removes the fibroids. If the fibroids are large, they can be removed by cutting them into pieces.
4. Repair of the Uterus: After the fibroids are removed, the uterus is carefully repaired and the incision is closed.
5. Closing of the Incisions: The incision in the abdomen is closed with stitches or staples and the surgery is completed.

The surgery may take 2-3 hours, depending on the number and size of the fibroids.

Benefits of Open Myomectomy

Open myomectomy allows complete removal of large or multiple myomas. This method has some advantages:

Advantages of Open Myoma Surgery:

• Complete Myoma Removal: Large myomas and multiple myomas can be completely removed with this method.
• Uterine Preservation: Fertility is maintained by preserving the uterus.
• Relief from Heavy Bleeding and Pain: Heavy menstrual bleeding and pain caused by myomas can be ended with this surgery.
• Long-Term Solution: Complete removal of myomas provides long-term relief and reduces the risk of recurrence decreases.

These benefits offer significant advantages for women who want to get rid of their myomas.

Post-Operative Recovery Process

The recovery process after open myomectomy surgery may be longer compared to closed (laparoscopic) surgeries. However, some factors to consider during this process can accelerate recovery.

Things to Consider During the Recovery Process:

• Rest: It is important to rest for the first few weeks after surgery. Physical activities should be avoided.
• Pain Management: There may be mild or moderate pain after surgery. These pains can be relieved with painkillers prescribed by the doctor.
• Hygiene: Keeping the surgical area clean and dry reduces the risk of infection.
• Wound Care: In order for the surgical incision to heal properly, regular dressings should be applied and attention should be paid to signs of infection.
• Physical Activity: Heavy exercises should be avoided for the first few weeks, and light walks can be started with the doctor's recommendation.

The healing process usually takes 4-6 weeks, but this period may vary depending on the patient's general health status and the extent of the surgery.

Risks of Open Myomectomy

As with any surgical operation, open myomectomy also has some risks. However, these risks are usually minimal and are rare when the surgery is performed by experienced surgeons.

Possible Risks:

• Infection: There is a risk of infection after surgery, but this risk can be minimized by paying attention to hygiene rules.
• Bleeding: Excessive bleeding may occur during or after surgery.
• Uterine Damage: There is a risk of damaging the uterine tissue during surgery, but this risk is minimized by experienced surgeons.
• Adhesions: Adhesions may occur in the abdomen after surgery, which may cause pain in some patients.

Your doctor will inform you about these risks before surgery. will inform.

Open Myoma Surgery and Pregnancy

Open myoma surgery preserves the uterus and ensures that fertility continues. It is important to follow the doctor's recommendations for a healthy pregnancy after the surgery.

Effect on Pregnancy:

• Fertility is Preserved: Since the surgery is performed by preserving the uterus, fertility is
• Pregnancy Planning: After complete recovery from surgery, pregnancy can usually be achieved within 6-12 months.
• Uterine Repair: Since the uterus is carefully repaired, the risk of problems during pregnancy is minimal.

The pregnancy plan after surgery should be evaluated with your doctor.

Risk of Recurrence of Myomas

Myomas can grow back after surgical removal. However, when the myomas are completely removed with open myomectomy, the risk of recurrence is low.

Possibility of Recurrence of Myomas:

• Age: The risk of myomas growing back is higher in women who have myomectomy at a young age.
• Hormonal Factors: High estrogen levels can cause myomas to reoccur.
• Regular Checkups: Regular doctor visits are important to check whether the myomas have recurred.

These risks can be controlled by regular monitoring by the doctor.

Alternative Methods in Myoma Treatment

Not every myoma requires surgery. In some cases, when fibroids do not cause symptoms or are smaller, alternative treatment methods can be used.

Alternative Treatment Options:

• Drug Therapy: Hormone therapy can be applied to stop the growth of fibroids or relieve symptoms.
• Uterine Artery Embolization: A treatment method that stops blood flow to the uterine vessels can be applied to shrink fibroids.
• Ultrasound Therapy: High-intensity focused ultrasound waves can be used to shrink fibroids.

These alternative methods can help treat fibroids without requiring surgical intervention.

Frequently Asked Questions (FAQ)

1. Is open myomectomy painful?

The surgery is performed under general anesthesia, so there is no pain during the procedure. However, there may be mild or moderate pain after the surgery, which can be relieved with painkillers.

2. How long is the recovery period after open myomectomy?

The recovery period is usually between 4-6 weeks. This period may vary depending on the patient's general health and the difficulty of the surgery.

3. Do myomas grow back after surgical removal?

Yes, myomas can grow back after surgical removal. However, this risk will be monitored by your doctor with regular check-ups.

4. Is fertility affected after open myomectomy?

No, the surgery is performed by preserving the uterus, so fertility is preserved and the chance of pregnancy continues.

5. How long does open myomectomy take?

The surgery usually takes 2-3 hours, but the time may vary depending on the number and size of the myomas.

6. What are the risks of open myomectomy?

Risks such as infection, bleeding, uterine damage and adhesions in the abdomen may occur, although rarely.