Uterine fibroids are abnormal growths that transpire on the inside and outside walls of the uterus. One of the main symptoms is heavy menstrual bleeding, but fibroids can also cause pelvic pain and pressure along with interfering with pregnancy. There are two surgical options available in the treatment of fibroids: hysterectomy and myomectomy. While the former consists of the removal of the uterus, the latter is a fertility-preserving option. Both of these surgeries could be conducted through laparoscopic means.
What is laparoscopic myomectomy like?
Laparoscopic myomectomy is performed through tiny incisions using a camera and specialized instruments. After inflating the abdomen with gas, the surgeon inserts the laparoscope through the belly button to view the uterus and fibroids on a monitor. The fibroids are removed in pieces or whole, depending on location and size. The best gynaecologist surgeon repairs any damage to the uterine wall afterwards.
The effectiveness of laparoscopic myomectomy in improving fertility
Compared to open abdominal myomectomy, the laparoscopic approach results in less pain, scarring, blood loss, and recovery time. Most patients can go home the same day and resume normal activities within 1-2 weeks. Through the precise laparoscope view, surgeons can better identify and remove even small fibroids that could hinder pregnancy. This enhances fertility after myomectomy.
Though not confirmed in controlled studies, some observational surgical trials have suggested myomectomy can successfully restore fertility. Reported pregnancy rates in these uncontrolled trials range from 44% to 62% after surgery. Additionally, the majority of successful post-myomectomy pregnancies happen relatively quickly, with approximately 80% conceived within the first year following the procedure. However, controlled trials are still needed to conclusively demonstrate improved fertility from myomectomy.
Risks are similar to other laparoscopic procedures and include bleeding, infection, damage to reproductive organs, blood clots, and adverse reactions to anaesthesia. Myomectomy also carries a risk of fibroids recurring later. Women trying to conceive should wait 3-6 months after surgery to allow complete healing.
For women suffering from fibroid symptoms who wish to become pregnant, laparoscopic myomectomy is an effective fertility-sparing option. When performed by an experienced gynaecologist, most patients are able to conceive naturally after surgery. A multidisciplinary approach, including the best pregnancy specialists and reproductive endocrinologists, can further improve outcomes for pregnancy.
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