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Chapter 48 - Myomectomy

from Section 10 - Operative Gynaecology

Published online by Cambridge University Press:  24 November 2021

By
Claire Cardaillac ,
Edouard Vaucel ,
Norbert Winer ,
Anais Mortier ,
Pauline Gueudry ,
Vincent Dochez  and
Thibault Thubert
Edited by
Tahir Mahmood ,
Charles Savona-Ventura ,
Ioannis Messinis  and
Sambit Mukhopadhyay
Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona-Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
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Summary

Uterine leiomyomas or fibroids are common benign tumours of the uterus. Myomectomy is performed via laparoscopy, laparotomy or hysteroscopy depending on the location of the myoma, the size and the symptoms. Before myomectomy, the patient must be informed of the risk to undergo conversion of the surgical techniques as well as about myoma recurrence. Administration of a GnRH agonist for 4 months before myomectomy improves pre and postoperative haemoglobin levels and reduces the size of the myoma. In the case of submucosal myomas of FIGO type 0, 1 and 2, which are <4 cm in diameter, hysteroscopic myomectomy is the preferred approach and significantly improves pregnancy rates. The laparoscopic approach is feasible when the number of fibroids is low, and they have a small diameter.

Keywords

myomasfibroidsmyomectomylaparoscopichysteroscopic
Type
Chapter
Information
The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
Gynaecology
 , pp. 424 - 431
Publisher: Cambridge University Press
Print publication year: 2021

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References

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