Hysteroscopic Myomectomy

Hysteroscopic myomectomy is a minimally invasive surgical procedure used to remove fibroids (myomas) from the uterus through the hysteroscope—a thin, lighted tube that is inserted through the vagina and cervix into the uterus. This procedure is typically done when the fibroids are located inside the uterine cavity, often referred to as submucosal fibroids.

Key aspects of the procedure:

  1. Indication:
    • Symptomatic fibroids causing issues like heavy menstrual bleeding, pelvic pain, or infertility.
    • Fibroids that distort the shape of the uterine cavity or affect implantation in fertility patients.
  2. Procedure:
    • The procedure is performed under general or regional anesthesia.
    • A hysteroscope is inserted through the cervix to visualize the fibroids inside the uterus.
    • Once located, the fibroids are carefully removed using specialized instruments. Sometimes, laser or electrical devices are used to vaporize or cut the fibroid tissue.
    • The procedure generally lasts around 30 minutes to an hour, depending on the size and number of fibroids.
  3. Advantages:
    • Minimally invasive: No external incisions are required. Only a small incision through the cervix is needed.
    • Short recovery time: Many patients can go home the same day and recover in a matter of days to weeks, compared to the longer recovery of traditional surgery.
    • Preservation of the uterus: It avoids the need for a hysterectomy and preserves fertility.
  4. Risks:
    • As with any surgery, there is a risk of infection, bleeding, or injury to the uterus or surrounding organs.
    • In some cases, fibroids may recur or grow back.
  5. Outcomes:
    • The procedure is effective in relieving symptoms of fibroids such as heavy bleeding, pelvic pressure, and pain.
    • Success rates for improving fertility have been positive, particularly in women with submucosal fibroids.

This procedure is considered a good option for women who have symptomatic fibroids but wish to preserve their uterus and avoid more invasive procedures like hysterectomy. However, not all fibroids are suitable for removal via this method—large or deeply embedded fibroids may require different approaches.