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General Practice 2023

Fibroids surgery: when to do it, risks and recoveryção

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Fibroids surgery: when to do it, risks and recoveryção
Fibroids surgery: when to do it, risks and recoveryção

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 medication, but in addition, the woman's interest in getting pregnant should be evaluated because the surgery can make future pregnancy difficult. Surgery is not necessary when symptoms can be controlled with medication or when a woman enters menopause.

Fibroids are benign tumors that arise in the uterus in women of childbearing age, causing intense discomfort such as menstrual bleeding and intense cramps, which are difficult to control. Medications can decrease its size and control symptoms, but when that doesn't happen, the gynecologist may suggest removing the fibroid through surgery.


Types of surgery to remove myoma

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 fibroid removal pass. This procedure is only used in case of myoma that is located on the external wall of the uterus;
  • Abdominal Myomectomy: a kind of "cesarean", 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 introduces the hysteroscope through the vagina and removes the fibroid, without the need for cuts. Only recommended if the myoma is located inside the uterus with a small part inside the endometrial cavity.

Usually surgery to remove the fibroid manages to 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 part of the uterus, about 10 years later. Thus, the doctor often chooses to remove the uterus, rather than just removing the fibroid. Learn all about removing the uterus.

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

What is recovery from surgery like

Normally recovery is fast but the woman needs to rest for at least 1 week to heal properly, avoiding all kinds 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 have symptoms such as a bad smell in the vagina, vaginal discharge, and very intense bleeding, which is bright red.

Possible risks of surgery to remove myoma

When the fibroid removal surgery is performed by an experienced gynecologist, the woman can be more relaxed because the techniques are safe for he alth and their risks can be controlled. But despite this, bleeding can occur during myomectomy surgery and the uterus must be removed, and in addition, some authors claim that the scar left in the uterus can favor uterine rupture during pregnancy or at the time of delivery, but this is rarely the case. happens.

When a woman is very overweight, before performing abdominal surgery, it is necessary to lose weight 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 get pregnant after surgery, due to scar adhesions that form 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.

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