UTERINE fibroids continue to tremendously impact the quality of lives of Jamaican women.

Uterine fibroids are non-cancerous growths of the muscle of the uterus. The symptoms of uterine fibroids vary widely and may include: severe anemia (low iron levels causing shortness of breath, weakness and uncontrolled heart racing), painful, prolonged and heavy periods, an increase in abdominal size (due to the growth of the fibroids), constipation, shooting pains down the leg and urinary frequency.

One of the more frequent treatment options of fibroids is a myomectomy, which includes the surgical removal of fibroids with the preservation of the woman’s uterus allowing her to conceive in the future.

Here are five points about a myomectomy women should be made aware of before proceeding with surgery :

1. Every myomectomy is different

Fibroids can vary in location, number and size. As a result, every patient’s surgical approach is individualised.

Some patients may require a traditional (open) myomectomy, some may require a laparoscopic (keyhole surgery) myomectomy or some may require vaginal myomectomy (fibroids which have prolapsed through the cervix and into the vagina are surgically removed via the vagina).

These patient and uterine variations can result in various surgical times and potential specific complications depending on the scenario of the patient. No myomectomy is the same.

2. Possibility of a Caesarean section in the future

Most myomectomies involve removal of several fibroids throughout the entire level of the uterus. If fibroids are located and removed from the uterine cavity (where the baby develops) and this cavity is opened (and repaired), these patients are required to have a Caesarean section in the future.

The reason for this is that these patients when they become pregnant in the future are at risk of uterine rupture — a condition where the uterus opens under the pressure of labour and can lead to the baby dying and also the mother bleeding internally.

This is a catastrophic event and should be best avoided with planned Caesarean sections for women who had previous myomectomies.

3. The uterus can take up

Most women after myomectomy may experience a significant relief in symptoms the first month following surgery. However, some women may not.

The uterus can take up to four months to fully heal and restructure. As a result, during this time, even if all fibroids were removed, patients may still have symptoms.

4. Fibroids can return

The exact cause of fibroids are unknown. There have been links to genetics, family history and diet.

Patients must be informed that even though a myomectomy was successfully done, fibroids can return in the future. The time interval can be sporadic, and patients should still be encouraged to have yearly visits with their gynaecologists to identify any signs or symptoms of fibroid return.

5. Complications with surgery

All surgeries are associated with risks and benefits. The main benefit of a myomectomy is to improve a woman’s quality of life.

Patients must be made aware of all complications prior to surgery and informed written consent should be obtained prior to surgery also. Complications specific to myomectomy, although rare, include:

Infection

Bleeding

Risk of blood transfusion

Risk of emergency hysterectomy (removal of uterus — live-saving event)

Risk of blood clot formation (pulmonary embolism, deep vein thrombosis)

Injury to other organs — bowel, bladder

Risk of bowel obstruction

Death

Further, ensure your doctor details you properly on a myomectomy procedure.

Dr Daryl Daley is a cosmetic gynaecologist and obstetrician. His office is located at 3D Gynaecology Ltd. at 23 Tangerine Place, Kingston 10 and the office number is 876-929-5038/9. He can be contacted at ddaley@3dgynae.com.