SCF: 30-31, SECTOR-11, HUDA, URBAN ESTATE, Panipat, Haryana 132103 SCF: 30-31, SECTOR-11, HUDA, URBAN ESTATE, Panipat, Haryana 132103Uterine fibroids (also called leiomyomas or myomas) are benign tumors that grow in or on the uterus’s smooth muscle cells and fibrous connective tissue. They can be the size of a pea or large enough to alter the shape of the uterus. Many women with fibroids have no symptoms and are diagnosed incidentally during routine pelvic exams or during prenatal care. However, fibroids can be problematic depending on size and location and may require surgical removal or myomectomy. Fibroids are classified by their location in the uterus as intramural, subserosal, submucosal, or pedunculated. Your gynaecologist will perform imaging tests to understand the exact location.
Not all fibroids require removal. Gynaecologists recommend myomectomy in case the symptoms affect the quality of life. These include:
Laparoscopic, hysteroscopic, and open surgical methods are generally adopted for fibroid removal. The choice of treatment depends on the number of fibroids, their size, location, symptoms, age, fertility plans, history of previous surgeries, and overall health. Advantages of hysteroscopic removal of submucosal fibroids include:
The diagnosis will be made by the gynaecologist with a physical examination and medical assessment. This includes pelvic ultrasound, blood tests, and MRI (for rare cases only if required). Remember to discuss your overall health status, previous history of surgeries, and any ongoing medication. The doctor may recommend to stop using blood thinner medication for a few days.
The hysteroscopic fibroid removal is a scar-free surgical procedure. The gynaecologist will rely on a camera-guided hysteroscope rather than open surgery. The procedure follows the steps mentioned below:
Recovery from hysteroscopic fibroid removal is usually rapid, and most women can resume light activities within a few days to a week. Expect mild cramping, light spotting, and watery discharge for 1 to 2 weeks. While complete uterine healing takes 4-6 weeks, most women can return to desk work and light household chores within a week. Between weeks 2 and 4, you can gradually return to your normal non-impact exercise routine. Refrain from heavy exercises during the early days.
The chances of fibroids showing up after surgery do exist. The gynaecologist laparoscopic surgeon will remove the existing fibroids. This does not remove or alter the inherent tendency of the tissues to develop newer fibroids, which remains the same. Younger women are at increased risk for recurrence, but early detection is possible with regular follow-up.
The likelihood of complications is very low when performed by a qualified and experienced professional. Heavy bleeding, infection, uterine perforation, and fluid overload are rare but possible complications. Internal scar tissue may develop eventually.
Myomectomy (removing fibroids) generally improves or preserves fertility by correcting the shape of the uterus and creating a better environment for an embryo to implant. Many women find it easier to conceive, and the procedure lowers the risk of miscarriage.
Many women have highly successful pregnancies after fibroid removal (myomectomy). The procedure dramatically improves fertility by removing physical barriers to implantation. However, the surgery leaves scars on the uterine wall, so you should wait 3 to 12 months to conceive to allow the uterus to heal completely. This eliminates the rare but serious risk of uterine rupture. Many women will need to have a planned Cesarean section (C-section), particularly if the fibroid removal requires deep incisions into the uterine wall. This prevents the healing uterine scar from being torn by the stress of labor. Your pregnancy may need additional ultrasound checkups to monitor fetal growth and the condition of the uterine wall.
Hysteroscopic fibroid removal (myomectomy) is generally not painful because it is performed through the vagina and cervix without any abdominal incisions. The procedure is usually done under general or regional anesthesia. Post-operatively, you can expect mild-to-moderate uterine cramping comparable to strong period cramps.
A hysteroscopic fibroid removal is a minimally invasive outpatient procedure, meaning a hospital stay is usually not required. After a few hours of observation to recover from anesthesia, most patients can go home the very same day.
No, a hysteroscopic fibroid removal (hysteroscopic myomectomy) leaves no external skin scars. Because the surgeon accesses the uterus by passing a thin, telescopic instrument through your natural vaginal and cervical openings, there are no abdominal incisions required. However, there is a small possibility of internal scarring forming within the uterine lining (Asherman’s syndrome) as the uterus heals. To prevent the uterine walls from sticking together and creating scar tissue inside the womb, doctors may temporarily insert a small balloon or gel spacer following the procedure.
No, not all fibroids can be removed hysteroscopically. This is limited to submucosal fibroids (those that grow completely or partially within the uterine cavity). Subserosal fibroids are on the outer surface of the uterus. Intramural fibroids are within the wall of the uterus. They require different surgical approaches.
For hysteroscopic removal, fibroids generally need to be under 3 to 4 centimeters in diameter. This procedure is exclusively for submucosal fibroids (those that grow into the uterine cavity). Bigger or deeply embedded fibroids need abdominal or laparoscopic surgery. Removing fibroids (regardless of which tool is used) is more a matter of their location and symptoms than size alone. More than 5 to 6 cm, especially if they cause pressure on surrounding organs, distort the uterine cavity irrespective of size, and cause infertility or recurrent miscarriages, or cause severe pelvic pain, bloating, or heavy bleeding leading to anemia.
Yes, your periods should be much lighter and more predictable after the surgical removal of fibroids (myomectomy). But the first few cycles can be irregular or temporarily heavier as your uterus heals. It generally takes about three to six months for a full cycle of stabilization as your hormones and uterine lining normalize.
Yes, uterine fibroids do tend to shrink during and after menopause. The hormones estrogen and progesterone make fibroids grow. When your periods stop, these hormones drop naturally, and the growths shrink, and the symptoms disappear.
