Fibroids, also known as uterine leiomyomas, are noncancerous growths that develop in or on the uterus. These growths are common, particularly in women of reproductive age. Although many fibroids are asymptomatic and do not require treatment, others can cause significant symptoms and necessitate medical intervention. One common surgical treatment for symptomatic fibroids is myomectomy, which involves the removal of fibroids while preserving the uterus. This page will explore the different types of fibroids and the various myomectomy procedures available.
If you desire a myomectomy and would like to discuss your options with Dr. Sanchez, do not hesitate to send her an email or make an appointment.
Types of Fibroids
Fibroids are categorized based on their location in the uterus:
- Intramural Fibroids
- Description: These fibroids grow within the muscular wall of the uterus.
- Symptoms: Depending on their size, they can cause heavy menstrual bleeding, pelvic pain, and pressure.
- Treatment Considerations: Intramural fibroids are often treated surgically if they cause significant symptoms or fertility issues.
- Subserosal Fibroids
- Description: These fibroids develop on the outer surface of the uterus.
- Symptoms: They may cause pressure and pain, but typically do not affect menstrual flow. Large subserosal fibroids can press on surrounding organs, leading to symptoms like frequent urination, constipation, bloating and back pain.
- Treatment Considerations: Treatment is often necessary if they cause discomfort or interfere with organ function.
- Submucosal Fibroids
- Description: These fibroids grow just beneath the lining of the uterine cavity, and may extend into the muscle of the uterus.
- Symptoms: They are more likely to cause heavy menstrual bleeding and fertility problems.
- Treatment Considerations: Because they impact the uterine cavity, submucosal fibroids often require treatment to manage bleeding or improve fertility outcomes.
- Pedunculated Fibroids
- Description: These fibroids are attached to the uterus by a thin stalk or peduncle, which can grow either inside the uterine cavity (pedunculated submucosal) or outside the uterus (pedunculated subserosal).
- Symptoms: They can cause pain or pressure and may twist on their stalks, causing severe pain.
- Treatment Considerations: Surgical removal is often recommended if they cause significant symptoms or complications.
- Cervical Fibroids
- Description: These rare fibroids develop in the cervix.
- Symptoms: They can cause bleeding, pain, and pressure.
- Treatment Considerations: Depending on their size and symptoms, cervical fibroids may require surgical removal.
Types of Myomectomies
Myomectomy is a surgical procedure that removes fibroids while preserving the uterus, making it an option for women who wish to maintain their fertility. There are several types of myomectomy, each suited to different fibroid locations and sizes:
- Abdominal Myomectomy (Laparotomy)
- Procedure: This involves making a large incision in the abdomen to access and remove the fibroids.
- Advantages: Allows the removal of large or multiple fibroids.
- Recovery: Requires a hospital stay and a longer recovery period compared to less invasive methods.
- Laparoscopic or Robotic myomectomy
- Procedure: Small incisions are made in the abdomen, and a laparoscope (a thin tube with a camera) is used to guide the removal of fibroids.
- Advantages: Minimally invasive, smaller incisions, shorter hospital stay, quicker recovery, and less pain compared to open surgery.
- Suitability: Ideal for smaller or fewer fibroids.
- Hysteroscopic myomectomy
- Procedure: A hysteroscope (a thin tube with a camera) is inserted through the vagina and cervix to remove fibroids from the inside of the uterine cavity.
- Advantages: No abdominal incisions, shorter recovery time, and suitable for submucosal fibroids.
- Suitability: Best for fibroids that protrude into the uterine cavity.
When to seek treatment
Fibroids can cause a range of symptoms depending on their size, number, and location, including:
- Heavy or prolonged menstrual periods
- Pelvic pain or pressure
- Frequent urination or difficulty emptying the bladder
- Constipation
- Pain during intercourse
- Backache or leg pain
If you experience any of these symptoms, it’s important to consult with a healthcare provider. They can diagnose fibroids through pelvic exams, ultrasound, or other imaging studies and discuss appropriate treatment options.
Decision-Making and Recovery
Choosing the appropriate myomectomy procedure depends on several factors, including the size and location of the fibroids, your symptoms, and your reproductive plans. A thorough discussion with your healthcare provider is essential to determine the best approach.
Myomectomy Recovery: Recovery times vary based on the type of myomectomy. Abdominal myomectomy typically requires a longer recovery period (6-8 weeks) compared to laparoscopic, hysteroscopic, or robotic myomectomy (2-4 weeks). In my practice, laparoscopic surgeries are same-day (you go home after the procedure), and abdominal myomectomies have a 1-2 day admission. During recovery, it is important to follow your doctor’s advice on rest, activity restrictions, and follow-up care.
Conclusion
Fibroids are a common and often treatable condition. Understanding the different types of fibroids and myomectomy procedures can help you make informed decisions about your health. If you are experiencing symptoms or have concerns about fibroids, consult with your healthcare provider to discuss the best treatment plan tailored to your individual needs.
About the author: Dr. Sanchez is a Board Certified Obstetrician Gynecologist and Menopause Society Certified Practitioner. If you are looking for a new Ob/Gyn in Miami to talk to about myomectomy and other uterine surgeries, you can always make an appointment byΒ calling the clinicΒ orΒ booking online. Dr. Sanchez explores this and other subjects onΒ her Instagram, so make sure to follow along!
Disclaimer: All content is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis or medication treatment of a qualified physician. Resources listed here do not imply endorsement of any content. Should the reader have any health concerns, promptly seek a consultation with your physician.