What is Uterine-Sparing Myoma Surgery? Methods, Risks and Recovery Process

Uterine-sparing myoma surgery is a surgical procedure performed to remove fibroids in the uterus while preserving reproductive health in women. Myomas are benign tumors that develop in the smooth muscle tissue of the uterus and although they usually do not cause symptoms, they can sometimes cause problems such as excessive bleeding, pain and infertility. This operation, also known as myomectomy, removes the fibroids without removing the uterus, thus preserving the woman's fertility.


 

What is Uterus-Sparing Myomectomy?

Uterus-Sparing Myomectomy is a surgical procedure in which only the fibroids are removed while preserving the uterus. Myomas are benign tumors that grow in the uterine tissue and usually do not cause serious health problems. However, in some cases, large fibroids or multiple fibroids can cause severe pain, excessive menstrual bleeding, bladder or bowel problems, and even infertility. In such cases, surgical removal of the fibroids may be necessary.

The main purpose of uterine-sparing surgery is to preserve the uterus and maintain the patient's fertility. Also known as myomectomy, this operation is performed without removing the uterus, and thus women do not lose their chance of becoming pregnant.

Why Do Myomas Form?

Myomas are benign tumors originating from the uterine muscle tissue, and although it is not known exactly why they form, it is thought that many factors can lead to this condition.

Causes of Myoma Formation and Risk Factors:

• Genetic Factors: The risk of developing myomas is higher in women with a family history of myomas.
• Hormones: Estrogen and progesterone hormones play an important role in the growth of myomas. These hormones are factors that thicken the lining of the uterus and encourage fibroids to grow.
• Age: Fibroids are most common in women between the ages of 30 and 40. Fibroids may shrink when hormone levels drop during menopause.
• Obesity: The risk of fibroids is higher in women with a high body mass index.
• Diet and Lifestyle: A low-fiber diet, high red meat consumption, and excessive alcohol use can increase the risk of fibroids.

These factors can play a role in the development of fibroids, but how fibroids develop in each woman may vary depending on her personal health history.

Symptoms of Fibroids

Many women may not even realize they have fibroids because they often have no symptoms. However, when fibroids grow or become numerous, some symptoms may occur.

Common Fibroid Symptoms:

• Heavy and Prolonged Menstrual Bleeding: Fibroids can cause excessive bleeding during menstrual periods, which can lead to anemia.
• Pelvic Pain and Pressure: Large fibroids can press on the uterus, bladder, or intestines, causing pain and discomfort.
• Frequent Urination: The pressure of fibroids on the bladder can cause the need to urinate frequently.
• Infertility or Problems with Pregnancy: Fibroids can make it difficult to get pregnant can make intercourse difficult or cause complications during pregnancy.
• Pain During Intercourse: The location of fibroids can cause pain during intercourse.

These symptoms occur especially when fibroids grow and press on the uterine tissue.

When is Uterus-Sparing Myomectomy Necessary?

Although most fibroids do not require treatment, surgery may be necessary when fibroids grow excessively, cause symptoms, or affect fertility. Uterine-sparing myoma surgery is an ideal option, especially for women who want to preserve their fertility.

Conditions Requiring Surgery:

• Excessive Bleeding: When myomas cause excessive bleeding during menstruation and this condition reduces the quality of life.
• Pain: When there is severe pain or a feeling of pressure in the pelvic area.
• Infertility: When myomas have a negative effect on fertility.
• Growing Myomas: When there are rapidly growing or extremely large myomas.

If these symptoms reduce the quality of life and drug treatments are not sufficient If this does not work, surgical intervention may be considered.

Uterine-Preserving Myoma Surgery Methods

Uterine-preserving myoma surgery can be performed using various methods. The type of surgery is selected according to the size, number and location of the myomas.

Myoma Surgery Methods:

1. Laparoscopic Myomectomy: It is a minimally invasive surgical method performed by placing a camera and surgical instruments into the abdomen through small incisions. The recovery period is shorter.
2. Hysteroscopic Myomectomy: If the myomas are located on the inner surface of the uterus, a hysteroscope is placed into the uterus through the vagina and the myomas are removed. It is usually used for smaller fibroids.
3. Open Myomectomy: If the fibroids are large or numerous, a larger incision is made in the abdominal area and the fibroids are removed. This method is preferred for larger fibroids.

Each method has its advantages and disadvantages, so doctors choose the most appropriate method according to the patient's specific condition.

How is Uterus-Sparing Myomectomy Performed?

Uterus-sparing myomectomy surgery is performed using different methods depending on the type and location of the fibroids. Generally, during surgery, myomas are carefully removed and the uterine tissue is preserved.

Step by Step Procedure:

1. Anesthesia: The surgery is performed under general anesthesia, so the patient is asleep and does not feel pain.
2. Making the Incisions: Depending on the surgical method chosen, small incisions are made in the abdominal area or through the vagina.
3. Removal of Myomas: Myomas are carefully removed through incisions. The uterine tissue is reconstructed while preserving it.
4. Closing the Incisions: After the myomas are removed, the incisions are closed and the surgery is completed.

The surgery usually takes 1-3 hours and the recovery period varies depending on the type of surgery.

Post-Operative Recovery Process

The recovery process after uterus-preserving myomectomy surgery may vary depending on the type of surgery. The recovery period is usually faster in minimally invasive methods.

Things to Consider During the Recovery Process:

• Rest: Care should be taken to rest for the first few weeks.
• Pain Management: There may be mild pain after surgery, painkillers recommended by the doctor can be used.
• Wound Healing: Keeping the incisions clean and dry reduces the risk of infection.
• Physical Activity: Heavy lifting should be avoided during the recovery process and physical activities should be started gradually.
• Sexual Intercourse: After surgery The doctor will determine when sexual intercourse can begin, and a 6-week rest is usually recommended.

The complete recovery period after surgery can vary between 4-6 weeks.

Risks of Uterus-Sparing Myomectomy

Like any surgical intervention, uterus-sparing myomectomy also carries some risks. However, these risks are generally rare and it is important to discuss them with your doctor before surgery.

Possible Risks:

• Infection: The risk of infection in the surgical area.
• Bleeding: The risk of excessive bleeding during or after surgery.
• Uterine Damage: The risk of damaging the uterine tissue, but this is minimized by experienced surgeons.
• Adhesions: Adhesions may form in the abdomen after surgery.

Although these risks are low, it should be remembered that every surgical intervention has its own risks.

Uterine-Sparing Myoma Surgery and Pregnancy

Uterine-sparing myoma surgery is a suitable option for women who want to preserve their fertility. Preserving the uterus after surgery can increase the chance of pregnancy.

Effect on Pregnancy:

• Fertility: Fertility is preserved after uterus-sparing surgery and many women can become pregnant.
• Pregnancy Planning: After the surgery, pregnancy can usually be achieved within 6-12 months.

Fertility status after surgery can vary from person to person, so pregnancy planning should be done with a doctor.

Post-Operative Recurrence Risk

Myomas can reoccur after surgical removal. This is especially common in women with multiple fibroids.

Possibility of Recurrence of Fibroids:

• Age: The risk of recurrence of fibroids is higher in women who have surgery at a younger age.
• Number and Size of Fibroids: If multiple fibroids are removed during surgery, the risk of recurrence may be higher.
• Regular Check-ups: Regular doctor check-ups are important to see if fibroids are recurring.

It would be beneficial to make a regular follow-up plan with your doctor to prevent the risk of recurrence of fibroids.

Myoma Surgery and Alternative Treatments

Not every case of myoma requires surgical intervention. In some cases, fibroids can be managed with medication or minimally invasive methods.

Alternative Treatment Options:

• Drug Therapy: Hormone treatments can be administered to prevent fibroids from growing or to relieve symptoms.
• Embolization: This is a minimally invasive method that preserves the uterus and is used to shrink fibroids.
• Focused Ultrasound: High-intensity sound waves are used to shrink fibroids.

These alternatives may be preferred depending on the size, location, and symptoms of the fibroids.

Frequently Asked Questions (FAQ)

1. Can I get pregnant after myomectomy?

Yes, fertility is preserved after uterus-sparing myomectomy surgery and many women can get pregnant.

2. How long does it take to recover after myomectomy?

The recovery period varies depending on the surgical method, but full recovery is usually expected within 4-6 weeks.

3. Do myomas grow back?

Yes, myomas can reoccur after surgical removal. Regular doctor check-ups are important in this regard.

4. Is the surgery painful?

The surgery is performed under general anesthesia, so you will not feel any pain during the procedure. There may be some mild pain after the surgery.

5. When can I start having sex after myomectomy?

You can usually start having sex 4-6 weeks after surgery, but the doctor's advice should be taken into account.

6. Will my menstrual cycle change after myomectomy?

The menstrual cycle may become regular after surgery, but this may vary from person to person.