Myomectomy is a surgical procedure to remove fibroids, that is, benign growths in the uterus, also known as myomas. Myomectomy involves making an incision into the uterus to remove the tumors.
There are three main types of myomectomy: laparotomy, during which a surgeon gains access to the uterus through an incision in the abdomen; laparoscopy, during which s/he instead inserts a laparoscope through the navel for the same purpose; and hysteroscopy, which involves the insertion of a hysteroscope through the vagina and cervix to view the uterus from the inside and a laser or a resectoscope to burn it off. The advantages of laparotomy are that the surgeon can use sight and touch to detect and remove all the fibroids, that the fibroids can be removed whole, and that the surgeon can more easily repair the uterus by stitching; the disadvantage is that the procedure is invasive surgery with a relatively long recovery time. Laparopscopy is much less invasive and is usually performed as day surgery, but on the downside larger fibroids must be cut into pieces and removed or destroyed in situ, which can be a lengthy process; it can be harder to detect smaller fibroids; and it is not as easy to repair the uterus, potentially compromising a woman's fertility. Hysteroscopy too is day surgery, and is best used on fibroids that protrude into the uterine cavity.
While fibroids that have been surgically removed will not regrow, others may form. However, for women experience extreme discomfort due to fibroids but do not want a hysterectomy because they wish to preserve their fertility, at present myomectomy is generally considered the best treatment option.
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