Postoperative period after myomectomy surgery

• Myomectomy is the removal of uterine fibroids, generally benign, by surgical techniques.
• The postoperative period of the myomectomy operation differs depending on the surgical technique, but it is usually approximately 1 or 2 hours. 2 days in the hospital.
• Total recovery from the myomectomy operation is between 1 and 6 weeks, depending on the surgical technique and each case. We explain more here.

Uterine fibroids are hormone-dependent tumors, usually benign, formed from the smooth muscle cells of the uterus.

Depending on their size, location and number, they may cause different symptoms that affect the daily life of the woman who suffers from them.

The presence of uterine fibroids in women increases with age until menopause, and from then on it increases. It decreases due to the lack of hormonal stimulation.

If fibroids cause bothersome symptoms for the woman or if she is undergoing treatment, considering the possibility of having children, it is possible that the Gynecology specialist will recommend their removal through uterine fibroid surgery. 

Types of uterine fibroids

Although uterine fibroids can be classified according to size and the amount of uterus they occupy, the usual classification is according to their location, which may be:

• Subserous fibroids: appear and grow under the serous layer of the uterus (outermost layer of the uterus), giving the uterus a swollen appearance if we look at it from outside.
• Intramural fibroids: They are inside the muscle wall of the uterus, they grow inward, therefore increasing the size of the uterus. They are the most common.
• Submucosal fibroids: They are located under the endometrium, the innermost layer of the uterus. They are the least common although they cause the most symptomatic lesions.
• Pedunculated fibroids: Initially they are subserosal or submucous that when they grow are attached to the uterus by a small piece of tissue called a pedicle.

Once it is decided to operate on uterine fibroids, regardless of the type of fibroid it is, one of the factors that will most affect the postoperative aspect of myomectomy is the type of surgical technique that is performed to solve the problem. 

Both laparoscopic myomectomy and abdominal myomectomy last between approximately 30 and 120 minutes, depending on the size and number of fibroids to be removed, as well as the duration of the procedure. as well as the particular characteristics of each patient.

In both surgeries, the patient will have to undergo general anesthesia so the first postoperative steps will be the same:

• Once the surgery is finished, the patient does not leave the operating room until she has regained consciousness and can move and speak spontaneously.
• Then go to the resuscitation room, where the patient will be. It will take a few hours until you recover from the effects of the anesthesia little by little and you will be administered. an analgesic treatment.

From here the patient goes to the room, where the postoperative period in the hospital varies a little depending on the type of intervention performed on the patient. 

Laparoscopic Myomectomy consists of making small cuts in the abdomen through which the laparoscope (thin sterile tube with a lens at the end) and the necessary instruments are inserted. manipulate, cut and remove uterine fibroids.

Normally, it is the technique chosen due to the lower morbidity, hospitalization time and presenting fewer postoperative problems because it is not necessary to make a large incision. as in the case of abdominal myomectomy.

We can divide the myomectomy postoperative period into two phases, in the hospital and at home:

Postoperative of laparoscopic myomectomy in the hospital

In the operating room, at the end of the intervention, the gynecological surgeon places a dressing inside the vagina that will act as a barrier in the closing suture of the vaginal dome with the aim of avoiding bleeding.

Within 24 hours, if there is no bleeding, the wound will be removed. This cap will be removed and used a vaginal compress.

On the other hand, the probe that is placed at the beginning of laparoscopic myomectomy is left in place for 24 hours. Then it is removed and spontaneous urination is checked.

In the immediate postoperative period (just after surgery), the patient is fed and hydrated through drips, after 6 hours a liquid diet is started and, if well tolerated, within 12 hours you begin with a semi-liquid diet, progressively continuing with a soft diet and then with more consistent foods until after 24 hours complete digestive function is recovered.

Laparoscopic myomectomy surgery is a minimally invasive intervention, so the patient should start moving within the first 12 hours after the intervention. This is important so that recovery takes place more quickly and the rhythm of normal activity is recovered in the shortest time possible.

Hospital discharge is 1 day after the intervention, provided that the patient can eat a normal diet, urinate spontaneously, does not have fever, does not present vaginal bleeding and abdominal pain subsides. can be controlled with regular analgesics. After that, you move on to the postoperative period at home.

Postoperative at home after laparoscopic myomectomy

Once at home, it is important that the woman moves but without making excessive efforts, being able to resume her daily activities as long as these do not require significant abdominal effort that could compromise the operated area.

Total recovery after the laparoscopic myomectomy operation is usually 1 or 2 weeks after the intervention, although it will depend on the patient's particular case.

Sexual relations will not be resumed until the doctor indicates it.

After discharge from the hospital, the first check-up is usually 15 days later. During that time, as we mentioned, the patient must Avoid strong abdominal efforts and treat small abdominal incisions to avoid infections.

During that visit, the Gynecology Specialist will verify the vaginal suture, and if the appearance of the small abdominal incisions is correct, the suture will be removed. the points if necessary.

After that, as long as the doctor does not give you after medical discharge, the patient may have to return a month after the surgery so that, if everything is correct, the doctor can give her a follow-up. discharge.

In the case of the abdominal myomectomy operation, the surgeon accesses the pelvic cavity through an incision in the abdominal wall to remove the fibroids.

This is a somewhat more invasive intervention since the incision made in the abdominal area (a transverse incision is usually made in the abdomen and below the navel) is larger than the one performed in laparoscopic fibroid surgery, which will involve that the hospital stay will be up to 2 days.

Postoperative in the hospital of abdominal myomectomy

After the abdominal myomectomy procedure and already in the room, the patient during the first hours will have parenteral feeding (through drips) that will go away progressively normalizing (1st liquid diet, 2nd semi-liquid diet, 3rd soft diet and 4th more consistent diet) as tolerated, until the patient is on a normal diet before hospital discharge .

During the 24 hours following the operation, the skin will be removed. the urinary catheter, placed at the beginning of the operation, to achieve spontaneous urination that is recovered before hospital discharge.

During the first hours after the abdominal myomectomy procedure, the patient should be at rest, but after a while, the sooner she moves, the better, since it will help This will reduce recovery time, fix the sutured areas and prevent pain. the formation of clots.

The nursing team will explain the patient how to clean the wound and the necessary instructions so that complications do not occur in the postoperative period at home.

Discharge from the hospital after the abdominal myomectomy operation will be after 2 days as long as there is no bleeding, infection, normal urination and normal diet is tolerated.

Postoperative at home after abdominal myomectomy operation

At home the patient should Treat the wound according to the instructions received at the hospital.

After the first postoperative week of abdominal myomectomy, normal activity can be carried out but taking special care not to make great abdominal efforts so as not to open the surgical wound.

As in the case of laparoscopic myomectomy, sexual activities should not be restarted until the doctor indicates it.

15 days after the abdominal myomectomy operation, the first check-up with the specialist is performed. If the wound is The abdominal suture stitches will be removed. will be cited He returned to the patient two weeks later for the last review if deemed necessary. Full recovery after abdominal myomectomy surgery is 4-6 weeks after the intervention.

If you are thinking about having fibroid removal surgery, remember that you can request a surgical evaluation consultation with one of our specialists in Gynecology and Obstetrics so that you can get to know him, evaluate your case and decide. What is the best way to solve your fibroid problems? You can request the consultation by clicking below: