Fibroids are benign growths of the muscle of the womb.
They are common and depending on race or age can be present in up to 30-40% of women.
Fibroids can be responsible for
Heavy periods
Urinary and bowel symptoms (due to pressure that large fibroids can exert on the bladder and bowels).
Fertility problems.
Though there are minimal access methods of treating fibroids, and increasingly more and more women benefit from laparoscopic myomectomy and transcervical resection of fibroids, some women will still require open surgery for the treatment of their fibroids.
An open myomectomy is where you have the operation through a traditional cut. Either a cut above the bikini line, or from the belly button downward. The way the cut is done is usually dictated by the size of the fibroid.
The most important factor for success in the treatment of fibroids is individualization of treatment based usually on:
Symptoms
Age
Desire for future fertility
Desire to retain womb even if fertility is not desired (this topic I have discussed in a previous blog).
Surgical considerations:
From the surgeons point of view the most important consideration as well as the above would be access to the fibroids. If it is possible to get round the fibroids it may be possible to perform the procedure laparoscopically irrespective of size (fibroids of more than 1Kg can be removed laparoscopically). (In my forth-coming publication regarding the laparoscopic management of fibroids in my unit we report laparoscopic management of a fibroid weighing 920g since then we have removed fibroids with a cumulative weight of more than 1kg).
The number of fibroids is also not a contraindication to laparoscopic surgery but the greater the number of fibroids the more complicated the procedure becomes.
Location of the fibroids are also important if there is one in the cavity of the uterus and the rest are on the outside and are not too many it is possible to combine transcervical resection of the fibroid with laparoscopic myomectomy.
However if there are large numbers in both locations and poor access then an open procedure will be required.
For women needing this type of surgery the one important factor is the experience of the unit and the surgeon undertaking the procedure. In terms of numbers and success of the operations they have performed.
Some of the most important complications to take into consideration are the adhesion risk as this can result in intestinal obstruction and fertility problems as well as pelvic pain. Infection and bleeding are also important factors to take into consideration. Infection increases the risk of adhesion formation and subsequent loss of potential fertility
They are common and depending on race or age can be present in up to 30-40% of women.
Fibroids can be responsible for
Heavy periods
Urinary and bowel symptoms (due to pressure that large fibroids can exert on the bladder and bowels).
Fertility problems.
Though there are minimal access methods of treating fibroids, and increasingly more and more women benefit from laparoscopic myomectomy and transcervical resection of fibroids, some women will still require open surgery for the treatment of their fibroids.
An open myomectomy is where you have the operation through a traditional cut. Either a cut above the bikini line, or from the belly button downward. The way the cut is done is usually dictated by the size of the fibroid.
The most important factor for success in the treatment of fibroids is individualization of treatment based usually on:
Symptoms
Age
Desire for future fertility
Desire to retain womb even if fertility is not desired (this topic I have discussed in a previous blog).
Surgical considerations:
From the surgeons point of view the most important consideration as well as the above would be access to the fibroids. If it is possible to get round the fibroids it may be possible to perform the procedure laparoscopically irrespective of size (fibroids of more than 1Kg can be removed laparoscopically). (In my forth-coming publication regarding the laparoscopic management of fibroids in my unit we report laparoscopic management of a fibroid weighing 920g since then we have removed fibroids with a cumulative weight of more than 1kg).
The number of fibroids is also not a contraindication to laparoscopic surgery but the greater the number of fibroids the more complicated the procedure becomes.
Location of the fibroids are also important if there is one in the cavity of the uterus and the rest are on the outside and are not too many it is possible to combine transcervical resection of the fibroid with laparoscopic myomectomy.
However if there are large numbers in both locations and poor access then an open procedure will be required.
For women needing this type of surgery the one important factor is the experience of the unit and the surgeon undertaking the procedure. In terms of numbers and success of the operations they have performed.
Some of the most important complications to take into consideration are the adhesion risk as this can result in intestinal obstruction and fertility problems as well as pelvic pain. Infection and bleeding are also important factors to take into consideration. Infection increases the risk of adhesion formation and subsequent loss of potential fertility
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