Myomectomy surgery in Iran used for Removal of Uterine FibroidsMyomectomy Surgery in Iran is fast emerging as a viable option for women from across the world held by the exorbitant cost of surgery and the long waiting periods in their native countries.
Myomectomy is a surgical procedure to remove uterine fibroids — also called leiomyomas (lie-o-my-O-muhs). These are common noncancerous growths that appear in the uterus, usually during childbearing years, but they can occur at any age.
The surgeon's goal during myomectomy is to take out symptom-causing fibroids and reconstruct the uterus. Unlike hysterectomy, which removes your entire uterus, myomectomy removes only the fibroids and leaves your uterus intact.
Women who undergo myomectomy report improvement in fibroid symptoms, including heavy menstrual bleeding and pelvic pressure.
'Myomectomy surgery' is a surgical procedure done to remove / excise uterine fibroids. There are three types of Myomectomy surgeries and an apt procedure is elected depending on the number, size and depth of location of fibroids.
Laparoscopic / robot-assisted Myomectomy
Laparoscopic myomectomy surgery is a minimal invasive and robot assisted surgery done under general anesthesia. Several small incisions are made on abdomen near the pelvic area. Surgeon introduces a laparoscope (instrument with tiny video camera at its tip) through one of these incisions that helps the surgeon to visualize the uterine cavity. Relevant surgical instruments are introduced via other incisions that are used to excise the fibroids. The fibroid derbies are removed via these incisions. In rare cases an incision is made in vagina for removing fibroid derbies.
Women presenting with multiple uterine fibroids that are large in size and sited deep in the uterine wall should undergo a laparoscopic surgery for fibroids to relieve symptoms. Women who are having chronic vaginal bleeding and severe pelvic pain due to fibroids are also recommended a Myomectomy surgery.
Immediate relive from troublesome symptoms of fibroids is anticipated following this surgery. Complete recovery takes place after 2-3 weeks after a laparoscopic Myomectomy, while abdominal / open Myomectomy requires 4-6 weeks for a complete recovery. Heavy and weight bearing activities such as lifting heavy objects, running, climbing stairs, driving and strenuous exercises are asked to be avoided during the recovery phase. Surgeon may also advice to avoid intercourse and using tampon till complete recovery takes place. It is also advisable to wait till three months after surgery before attempting for conception.
Myomectomy has a low complication rate. Still, the procedure poses a unique set of challenges. Risks of myomectomy include:
Excessive blood loss. Many women already have low blood counts (anemia) due to heavy menstrual bleeding, so they're at a higher risk of problems due to blood loss. Your doctor may suggest ways to build up your blood count before surgery. During myomectomy, surgeons take extra steps to avoid excessive bleeding, including blocking flow from the uterine arteries and injecting medications around fibroids to cause blood vessels to clamp down.
Scar tissue. Incisions into the uterus to remove fibroids can lead to adhesions — bands of scar tissue that may develop after surgery. Outside the uterus, adhesions could entangle nearby structures and lead to a blocked fallopian tube or a trapped loop of intestine. Rarely, adhesions may form within the uterus and lead to light menstrual periods and difficulties with fertility (Asherman's syndrome). Laparoscopic myomectomy may result in fewer adhesions than abdominal myomectomy (laparotomy).
Childbirth complications. A myomectomy can increase certain risks during delivery if you become pregnant. If your surgeon had to make a deep incision in your uterine wall, the doctor who manages your subsequent pregnancy may recommend cesarean delivery (C-section) to avoid rupture of the uterus during labor, a very rare complication of pregnancy.
Rare chance of hysterectomy. Rarely, the surgeon must remove the uterus if bleeding is uncontrollable or other abnormalities are found in addition to fibroids.
Strategies to prevent possible surgical complications
To minimize risks of myomectomy surgery, your doctor may recommend:
Iron supplements. If you have iron deficiency anemia from heavy menstrual periods, your doctor might recommend iron supplements to allow you to build up your blood count before surgery.
Hormonal treatment. Another strategy to correct anemia is hormonal treatment before surgery. Your doctor may prescribe a gonadotropin-releasing hormone (Gn-RH) agonist, birth control pills, or other hormonal medication to stop or decrease your menstrual flow. When given as therapy, a Gn-RH agonist blocks the production of estrogen and progesterone, stopping menstruation and allowing you to rebuild hemoglobin and iron stores.
Therapy to shrink fibroids. Some hormonal therapies, such as Gn-RH agonist therapy, can also shrink your fibroids and uterus enough to allow your surgeon to use a minimally invasive surgical approach — such as a smaller, horizontal incision rather than a vertical incision, or a laparoscopic procedure instead of an open procedure. In most women, Gn-RH agonist therapy causes symptoms of menopause, including hot flashes, night sweats and vaginal dryness. However, these discomforts end after you stop taking the medication. Treatment generally occurs over several months before surgery.
Evidence suggests that not every woman should take Gn-RH agonist therapy before myomectomy. Gn-RH agonist therapy may soften and shrink fibroids enough to interfere with their detection and removal. Cost of the medication and the risk of side effects must be weighed against the benefits.
Gather information. Before surgery, get all the information you need to feel confident about your decision to have a myomectomy. Ask your doctor and surgeon questions.
Follow instructions about food and medications. You'll need to stop eating or drinking anything in the hours before your surgery — follow your doctor's recommendations on the specific number of hours. If you're on medications, ask your doctor if you should change your usual medication routine in the days before surgery. Tell your doctor about any over-the-counter medications, vitamins or other dietary supplements that you're taking.
Discuss the type of anesthesia and pain medication you may receive. Abdominal, laparoscopic and robotic myomectomies are performed under general anesthesia, which means you're asleep during the surgery. Hysteroscopic myomectomy is performed under general anesthesia or spinal anesthesia, where medication is injected into your spinal canal to numb the nerves in the lower half of your body. Ask about pain medication and how it will likely be given.
Arrange for help. Your facility may require that you have someone accompany you on the day of surgery. Make sure you have someone lined up to help with transportation and to be supportive.
Plan for a hospital stay if necessary. Whether you stay in the hospital for just part of the day or overnight depends on the type of procedure you have. Abdominal (open) myomectomy usually requires a hospital stay of two to three days. In most cases, laparoscopic or robotic myomectomy only requires an overnight stay. Hysteroscopic myomectomy is often done with no overnight hospital stay.
Myomectomy is an option for women with fibroids who wish to get pregnant in the future, or who want to keep their uterus for another reason.
Unlike a hysterectomy, which takes out your entire uterus, myomectomy removes your fibroids but leaves your uterus in place. This allows you to try for children in the future.
The type of myomectomy your doctor recommends depends on the size and location of your fibroids:
Abdominal myomectomy may be best for you if you have many or very large fibroids growing in your uterine wall.
Laparoscopic myomectomy may be better if you have smaller and fewer fibroids.
Hysteroscopic myomectomy may be better if you have smaller fibroids inside your uterus.
Myomectomy cost in Iran depends on 3 factors:
Type of the hospital
Expertise, seniority, reputation and brand value of the surgeon/doctor.
City(Tehran,shiraz or mashhad)
Myomectomy surgery cost in Iran start from $470.