Surgery to remove fibroids: when to do it, risks and recovery

Surgery to remove the fibroid is indicated when the woman has symptoms such as severe abdominal pain and heavy menstruation, which do not improve with the use of medications, but in addition, the interest of the woman to become pregnant should be evaluated because the surgery can make pregnancy difficult. future. Surgery is not necessary when symptoms can be controlled with medication or when a woman enters menopause.

Fibroids are benign tumors that appear in the uterus in women of childbearing age, which cause severe discomfort such as menstrual bleeding and severe cramps, which are difficult to control. Medications can decrease their size and control symptoms, but when they don't, the gynecologist can suggest removal of the fibroid through surgery.

Types of surgery to remove the fibroid

Myomectomy is the surgery performed to remove the fibroid from the uterus, and there are 3 different ways to perform myomectomy:

  • Laparoscopic myomectomy: small holes are made in the abdominal region, through which a microcamera and the necessary instruments for the removal of the myoma pass through. This procedure is only used in the case of a fibroid that is located on the outer wall of the uterus;
  • Abdominal myomectomy: a kind of "cesarean section", where it is necessary to make a cut in the pelvis region, which goes to the uterus, allowing the removal of the fibroid;
  • Hysteroscopic myomectomy: the doctor inserts the hysteroscope through the vagina and removes the fibroid, without the need for cuts. Only recommended if the fibroid is located inside the uterus with a small part into the endometrial cavity.

Normally, surgery for the removal of the fibroid can control the symptoms of pain and excessive bleeding in 80% of cases, however in some women the surgery may not be definitive, and a new fibroid appears in another location of the uterus, about 10 years later . Thus, the doctor often chooses to remove the uterus, instead of removing only the fibroid. Learn all about the removal of the uterus.

The doctor can also choose to perform an ablation of the endometrium or embolize the arteries that are nourishing the fibroids, as long as it is at most 8 cm or if the fibroid is in the posterior wall of the uterus, because this region has many blood vessels, and it cannot be cut through surgery.

How is recovery from surgery

Normally the recovery is fast but the woman needs to rest for at least 1 week to heal properly, avoiding all types of physical effort during this period. Sexual contact should only be made 40 days after surgery to avoid pain and infection. You should go back to the doctor if you experience symptoms such as a stronger smell in the vagina, vaginal discharge, and very intense, red bleeding.

Possible risks of surgery to remove the fibroid

When the surgery to remove the fibroid is done by an experienced gynecologist, the woman can rest assured that the techniques are safe for health and their risks can be controlled. However, during myomectomy surgery, hemorrhage may occur and the uterus may be required to be removed. In addition, some authors claim that the scar that remains in the uterus may favor uterine rupture during pregnancy or at the time of delivery, but this is rarely happens.

When a woman is very overweight, before performing abdominal surgery, weight loss is necessary to reduce the risks of surgery. But in case of obesity, removal of the uterus through the vagina may be indicated.

In addition, there are studies that prove that some women, despite having their uterus preserved, are less likely to become pregnant after surgery, due to scar adhesions that are formed due to surgery. It is believed that in half of the cases, surgery can make pregnancy difficult in the first 5 years after the procedure.