Hysteroscopic Myomectomy

An endometrial biopsy is a way for your doctor to take a small sample of the lining of the uterus (endometrium). The sample is looked at under a microscope for abnormal cells. An endometrial biopsy helps your doctor find problems in the endometrium. It lets your doctor myomectomy is the surgical removal of fibroids from the uterus. It allows the uterus to be left in place and, for some women, makes pregnancy more likely than before. Myomectomy is the preferred fibroid treatment for women who want to become pregnant. After myomectomy, your chances of pregnancy may be improved but are not guaranteed. Looking for professional Gynecologist Brooklyn? Doral Health and Wellness — Women’s Health Center is the most reputed company that leading the pride.

Before myomectomy, shrinking fibroids with gonadotropin-releasing hormone analog (GnRH-a) therapy may reduce blood loss from the surgery. GnRH-a therapy lowers the amount of estrogen your body makes. If you have bleeding from a fibroid, GnRH-a therapy can also improve anemia before surgery by stopping uterine bleeding for several months.

Surgical methods for myomectomy include:
• Hysteroscopy, which involves inserting a lighted viewing instrument through the vagina and into the uterus.
• Laparoscopy uses a lighted viewing instrument with one or more small cuts (incisions) in the abdomen.
• Laparotomy, which uses a larger incision in the abdomen.

The method used depends on the:
• Size, location, and several fibroids.
○ Hysteroscopy can be used to remove fibroids on the inner wall of the uterus that has not grown deep into the uterine wall.
○ Laparoscopy is usually reserved for removing one or two fibroids, up to about 2 in. (5.1 cm) across, that are growing on the outside of the uterus.
○ Laparotomy is used to remove large fibroids, many fibroids, or fibroids that have grown deep into the uterine wall.
• Need to correct urinary or bowel problems. To repair these problems without causing organ damage, laparotomy is usually required.

What To Expect After Surgery

The length of time you may spend in the hospital varies.
• Hysteroscopy is an outpatient procedure.
• Laparoscopy may be an outpatient procedure or may require a stay of 1 day.
• Laparotomy requires an average stay of 1 to 4 days.

Recovery time depends on the method used for the myomectomy:
• Hysteroscopy requires from a few days to 2 weeks to recover.
• Laparoscopy requires 1 to 2 weeks.
• Laparotomy requires 4 to 6 weeks.

Why It Is Done

Myomectomy preserves the uterus while treating fibroids. It may be a reasonable treatment option if you have:
• Anemia that is not relieved by treatment with medicine.
• Pain or pressure that is not relieved by treatment with medicine.
• A fibroid that has changed the wall of the uterus. This can sometimes cause infertility. Before an in vitro fertilization, myomectomy is often done to improve the chances of pregnancy.

How Well It Works

Myomectomy decreases pelvic pain and bleeding from fibroids.

Pregnancy

Myomectomy is the only fibroid treatment that may improve your chances of having a baby. It is known to help with a certain kind of fibroid called a submucosal fibroid. But it does not seem to improve pregnancy chances with any other type of fibroid. After myomectomy, a cesarean section may be needed for delivery. This depends in part on where and how big the myomectomy incision is.

Recurrence

Fibroids return after surgery in 10 to 50 out of 100 women, depending on the original fibroid problem. Fibroids that were larger and more numerous are most likely to recur. Talk to your doctor about whether your type of fibroid is expected to grow back.

Risks

Risks may include the following:
• Infection of the uterus, fallopian tubes, or ovaries (pelvic infection) may occur.
• Removal of fibroids in the uterine muscle (intramural fibroids) may cause scar tissue.
• In rare cases, scarring from the uterine incision may cause infertility.
• In rare cases, injuries to the bladder or bowel, such as bowel obstruction, may occur.
• In rare cases, uterine scars may break open (rupture) in late pregnancy or during delivery.
• In rare cases, a hysterectomy may be required during a myomectomy. This may happen if removing the fibroid causes heavy bleeding that cannot be stopped without a hysterectomy.
Check to see if your body’s hormone levels that affect the endometrium are in balance.

There are several ways to do an endometrial biopsy. Your doctor may use:
• A device shaped like a straw (pipette) to suction a small sample of lining from the uterus. This method is fast and may cause some cramping.
• An electronic suction device (Vabra aspiration). This method can be uncomfortable.
• A spray of liquid (jet irrigation) to wash off some of the tissue that lines the uterus. A brush may be used to remove some of the linings before the washing is done.

An endometrial biopsy may be done to find the cause of abnormal uterine bleeding, to check for overgrowth of the lining (endometrial hyperplasia), or to check for cancer.

When a woman is having a hard time getting pregnant, an endometrial biopsy may also be done to see whether the lining of her uterus can support a pregnancy.

An endometrial biopsy is sometimes done at the same time as another test, called hysteroscopy, which allows your doctor to look through a small lighted tube at the lining of the uterus. Are you searching for Gynecology Brooklyn? Doral Health and Wellness — Women’s Health Center is the best option for you.