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It is well known that myomectomy surgery is associated with a higher risk of uterine rupture in later pregnancy. [8] Thus, women who have had myomectomy (with the exception of small submucosal myoma removal via hysteroscopy, or largely pedunculated myoma removal) should get Cesarean delivery to avoid the risk of uterine rupture that is commonly ...
Previously, the primary treatment methods for fibroids were myomectomy or hysterectomy. Compared to surgery, UAE can be advantageous because blood loss is typically minimal, surgery and general anesthesia is avoided, recovery is shorter, and women can retain their uterus (relative to hysterectomy). [37]
A laparotomic myomectomy (also known as an open or abdominal myomectomy) is the most invasive surgical procedure to remove fibroids. The physician makes an incision in the abdominal wall and removes the fibroids from the uterus. Laparoscopic myomectomy has less pain and shorter time in hospital than open surgery. [65]
The Bonney myomectomy clamp is a surgical clamp developed in the interwar years by gynaecologist Victor Bonney to provide a blood free environment when performing a myomectomy to remove uterine fibroids. It allowed the conservation of the uterus and the resulting preservation of fertility in women of reproductive age who wished to have children.
Septal myectomy is associated with a low perioperative mortality and a high late survival rate. A study at the Mayo Clinic found surgical myectomy performed to relieve outflow obstruction and severe symptoms in HCM was associated with long-term survival equivalent to that of the general population, and superior to obstructive HCM without operation.
Longest recovery period and return to normal activities [83] May have a higher risk of bleeding compared with laparoscopic surgery [83] Vaginal or Laparoscopic technique preferred for people who are obese [97] Vaginal hysterectomy Shortest operation time [83] Short recovery period and discharge from hospital [83]
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This setback led to Bonney's lifelong advocacy for the more conservative surgery of myomectomy over the more radical hysterectomy, [2] [9] arguing that "Since cure without deformity or loss of function must ever be surgery's highest ideal, the general proposition that myomectomy is a greater surgical achievement than hysterectomy is incontestable."