Myomectomy

Myomectomy (from Greek mys – muscle, oma – tumor, ektomē – excision) is a reconstructive-plastic organ-preserving operation aimed at surgical removal of leiomyoma nodules with preservation of the uterine body and menstrual function.

Etiology and pathophysiology

The essence of the intervention is the dissection of the serous membrane and myometrium over the node, its excision (enucleation) from the pseudocapsule and careful layer-by-layer suturing of the bed. A critical stage is hemostasis and accurate juxtaposition of the layers of myometrium for the formation of a full-fledged, solid scar, able to withstand stretching in future pregnancies. Depending on the localization of nodules (submucosal, intramural, subserosal) access is chosen: hysteroresectoscopy, laparoscopy or laparotomy.

Clinical significance

Myomectomy is the gold standard for the treatment of symptomatic uterine myoma in women of reproductive age planning pregnancy. The surgery eliminates symptoms (bleeding, pain, compression of adjacent organs) and restores the anatomy of the uterus. The main risks include blood loss during surgery, adhesions formation and the risk of recurrence (growth of new nodes) in 15-30% of cases within 5 years after surgery.