What Is Vaginal Fibroid Surgery? How Is Hysteroscopic Myomectomy Performed?
This article is for general information only; the surgical method can only be determined by a gynecologist's evaluation.
"Vaginal fibroid surgery" refers to removing certain fibroids that grow into the uterine cavity through the vagina and cervix, without an abdominal incision. Medically, this is called hysteroscopic myomectomy. A thin camera instrument (hysteroscope) is advanced into the uterus, the cavity is viewed directly and suitable fibroids are removed with special instruments. Not every fibroid can be removed this way; location, size, depth in the muscle and number decide the method. Op. Dr. Hüseyin Kılıç evaluates patients with fibroids in Ziyapaşa, Adana.
Which Fibroids Can Be Removed Vaginally?
Mainly submucosal fibroids that bulge into the uterine cavity. These may be associated with heavy or prolonged periods, bleeding between periods, anemia, infertility and some pregnancy problems. Very large fibroids, those extending deep into the muscle or multiple fibroids in different areas may not be removable in one session; sometimes treatment is done in two stages.
How Is It Performed?
- Examination and ultrasound: size, position, extension into the cavity and number are assessed; further imaging may be used.
- Anesthesia: sedation or general anesthesia depending on the extent of the procedure.
- Entering the uterus: the hysteroscope passes through the vagina and cervix – no abdominal incision.
- Viewing the cavity: the uterus is distended with fluid.
- Removal: the fibroid is removed in small pieces with a surgical loop or mechanical tissue removal system.
- Follow-up: bleeding and general condition are monitored; discharge timing is individual.
Advantages and Recovery
In suitable patients there is no abdominal incision or scar, the uterus is preserved, same-day discharge may be possible and recovery is usually shorter than after abdominal surgery. Mild cramping, light bleeding or spotting may occur. Advice on exercise, intercourse, tampons and swimming is given individually. Heavy bleeding, increasing pain, high fever, foul-smelling discharge, marked weakness or fainting require contacting the doctor.
Risks
Possible risks include bleeding, infection, injury to the uterine wall, intrauterine adhesions and complications related to the distension fluid. Complications are generally uncommon, but difficulty varies with the fibroid's characteristics.
Pregnancy and the Uterus
Hysteroscopic myomectomy removes only the fibroid and preserves the uterus; it is different from hysterectomy. Submucosal fibroids distorting the cavity may be associated with infertility or recurrent pregnancy loss, so this surgery may be considered for women planning pregnancy. The waiting time before trying to conceive depends on the extent of surgery.
Hysteroscopic vs. Laparoscopic Surgery
Hysteroscopy enters the uterine cavity through the cervix without incisions and suits submucosal fibroids. Laparoscopy uses small abdominal incisions and suits suitable fibroids in the muscle wall or on the outer surface. The fibroid's anatomical position, rather than preference, determines the method. Operating time depends on size, number, depth and the system used.
Can a Fibroid Fall Out by Itself?
Some pedunculated submucosal fibroids can move toward the cervix or vagina. This should not be regarded as routine; bleeding, pain or a feeling of a mass requires evaluation.
Who Is Not Suitable?
Subserosal fibroids, deep intramural fibroids and very large or complex fibroids may not be suitable; laparoscopic or open myomectomy may then be considered.
Frequently Asked Questions
Is the abdomen cut?
No. Instruments are passed through the vagina and cervix.
Can I get pregnant afterwards?
Since the uterus is preserved, pregnancy may be possible; timing is decided by the doctor.
Vaginal Fibroid Surgery in Adana
Op. Dr. Hüseyin Kılıç evaluates fibroids with examination and imaging at his clinic in Ziyapaşa, Adana, and explains which method may be suitable. Patients from Seyhan, Çukurova, Yüreğir and Sarıçam can contact the clinic.
