Indications for a myomectomy
- a solitary myoma with complaints of pijn of bleedings
- a pedunculated myoma at the outside
- a myoma of less than 8 cm in the wall
Otherwise alternatives should be considered
- multiple myoma’s : consider an hysterectomy
- a submucous myoma : consider an hysteroscopic myomectomy
Technique ?
- Small myomas : incision - excision and
- laparoscopic suture which is the main difficulty
- for bigger or multi!ple myoma’s : first clip the uterine artery.
- hospitalisation 1-2 days
Results
- a removed fibroma has no ecurrences
- symptoms are gone
- fertility increases
- the risk of a miscarriage is lower
What is quality
- laparoscopy is generally better
- little blood loss
- hort duration of surgery
- adequate laparoscopic suturing
- little adhesions
The patient should decide
The patient should decide
I was 43 because of a late marriage and had a very big uterus. The medical indication was : hysterectomy. I nevertheless opted for a laparoscopic hysterectomy and 18 myoma’s were removed.
Less than 1 year i delivered a boy. I probably have been lucky.
a general practitioner
The gynecologist advises and informs.
The gynecologist advises and informs.