If you are considering a myomectomy (surgical removal of fibroids) as treatment, the table below will help you understand which type of myomectomy is the most appropriate in your case:
|
Open (abdominal)
myomectomy
|
Hysteroscopic
myomectomy |
Laparoscopic
myomectomy |
Vaginal
myomectomy |
| What is it? |
Fibroids removed via a larger abdominal incision (laparotomy) |
Fibroids are removed through the cervix/vagina using a hysteroscope |
Fibroids are removed via several small (1/2 - 1 cm) abdominal incisions |
Fibroids are removed via the vagina |
| Which fibroids are suitable? |
All fibroids are suitable irrespective of size, site or number - the only option with large, multiple fibroids |
Typically a single, small (< 5cm) fibroid which is sited or growing towards the inside of the uterus (uterine cavity) |
Maximum of 3 fibroids with a maximum total diameter of 15 cm which are on the outside of the uterus |
Fibroids which have prolapsed through the cervix into the vagina. In special cases, vaginal myomectomy can be used with smaller fibroids sited on the outside of the uterus |
| What are the major advantages of this route? |
Greatest chance of all fibroids being removed (if there are multiple fibroids) |
|
No external scars, day-case surgery which can be done under local anaesthesia, quick recovery |
Avoids a laparotomy incision with shorter hospitalisation and quicker recovery than open myomectomy |
No external scars, shorter hospitalisation, relatively quick recovery |
| What are the major disadvantages of this route? |
Involves laparotomy with inherent risk of wound infection, deep vein thrombosis, pelvic haematoma |
Only removes submucous fibroids, so symptoms may recur if there are multiple fibroids present |
Long operating (anaesthetic) time, smaller fibroids may be missed so recurrence of symptoms more likely than with open myomectomy |
Pelvic haematoma |
| How long does it take? |
1-3 hours |
15-60 minutes |
2-3 hours |
30-60 minutes |
| How long will I be in hospital? |
3-5 days |
Usually day case surgery |
2-4 days |
Day case or up to 2 days |
| When am I likely to be able to resume normal activities? |
4-6 weeks |
Few days |
2-4 weeks |
1-2 weeks |
| What is the risk of hysterectomy? |
Probably < 1% |
Virtually zero |
Probably < 1% |
Probably < 1% |
| What will happen to my periods? |
Periods usually become lighter and less painful
|
Periods usually become lighter and less painful
|
Periods usually become lighter and less painful |
Periods usually become lighter and less painful |
| Can I become pregnant afterwards? |
Yes |
Yes |
Yes |
Yes |
Information about uterine fibroids