what is Myomectomy (Fibroid)?
Cells of a benign tumor originating from the uterus is referred to as mother Nov. Fibroids are the most common tumors of the female reproductive system.
In every 4-5 or a small fibroid. Usually produce any symptoms at all fibroids, and is implicated in routine investigations and therefore does not need to be treated. With regular checks for the condition to be monitored and their size is usually sufficient. The masses are closed and stagnant for a period after menopause that they will not grow anymore, on the contrary, they tend to downsizing. If you submit more symptom of menstrual bleeding is the most common symptom, and accordingly, developing anemia. In some cases fibroids can cause infertility or recurrent miscarriages. The location of the fibroid determines the relationship between infertility. Stationed near the junction of the tubes with the uterus in the cornual area of the fibroids can affect the permeability of the tubes while distorting the layout of the endometrium fibroids can affect pregnancy establishment and embryo on the continuation of in a negative way. The road still may be more depending on of bleeding after birth, contractions of the uterus may not be enough. Another gripe is that the bass and organ pain due to UTI is the cause of neighbouring effects. Very large fibroids can lead to swelling in the abdomen.
Defined according to their location fibroids
As a general rule, if you are causing mom to moan, or, in other words if symptomatic should be treated. A fibroid is surgery. However, there are different ways of surgery. Of the uterus the most common method, taken as a whole, so the hysterectomy. However, in some cases the integrity of the uterus, only the fibroids may need to be removed intact. This surgical procedure is called a myomectomy.
American Association obstetrisyen and gynecologists (ACOG), according to complete removal of the uterus myomectomy fibroid cause infertility instead of only the ones that the state requires. On the other hand, infertility in women who do not want to be taken of the womb and the woman has completed her family is not an issue even though a myomectomy can be performed. For some women, the removal of the uterus is the source of a serious psychological problem and it is very important to be kept in place.
Atlee defined by myomectomy in 1844 for the first time and since then there has been a significant change in technique. Laparoscopic myomectomy the most important development in the field can be considered to be used in the treatment of myoma.
If you grew up in this case myo outwards from the uterine wall, the laparoscopic approach will be more meaningful. Fibroids can easily be retrieved with a process that lasts a very short time. On the other hand, in the presence of a large intramural myoma embedded within the wall of the uterus, laparotomy approach from the patient’s perspective may be more useful. The inner cavity of the uterus will be treated with hysteroscopy with fibroids growing towards. In this case, the patient do not have to stay in the hospital.
Of drugs called GnRH analogues before myomectomy for a short while with the woman’s short-term and in this way bring into menopause, have been proposed by some authors in the reduction of the fibroid. However, studies such an application after the fibroid contraction of the quantity of despite the destruction around himself that separates him from the capsule removed due to d aha was becoming more difficult so revealed. Small fibroids shrink and also thoroughly after the application of GnRH analogues can be found during the operation. This too increases the likelihood of recurrence of UTI and %63e is up. The analog implementation without cases %13dur.
A large myoma subseroz
Laparotomy or laparoscopic myomectomy?
METTLER and semm laparoscopic myomectomy at the beginning of the 1970s, scientists called for the first time years are defined. Removal of myomas from the uterine wall outwards subseroz of his first initiatives has been growing. From the beginning of the nineties with the recent developments in the equipment and techniques you need to work in parallel within the wall of the uterus intramural fibroids can be removed in this way also the idea that has started to gain popularity.
The most important advantages of laparoscopy to laparotomy in the postoperative period according completely opened the abdominal cavity is much more comfortable. The time these patients return to normal activity and hospital stay is much shorter. On the other hand, the lack of a scar also provides particular advantages in terms of cosmetics.
The most important disadvantage of laparoscopy compared to open surgery is directly dependent on the experience of the surgeon who will do the operation. However, longer duration of surgery, and in the presence of large or multiple fibroids with the problems, other disadvantages are the possibility of a return to open surgery when the problem occurs. During laparoscopy, because it is not able to feel with the hands very small fibroids that cannot be seen from the outside may be overlooked.
One of the most difficult stages of laparoscopy separated from the uterine wall, the fibroid is taken out of the body. The largest of laparoscopy 10 mm. with the help of tools that are passed through the hole 3 in diameter, The monkey is greater than 10 millimetre holes because it was made to be taken out of the body by using it is impossible. However, this can be made possible by breaking down the fibroids. Shred hard and slippery due to the structure of the myoma is not easy. Formerly in the abdomen with the scissors to separate the pieces when I talked today, with the help of a tool called electromechanical morselator no matter the size of the fibroid, cut into strips 10 mm in diameter and are taken out of the abdominal cavity. A tube with 10 mm in diameter to a sharp point cuts into morselator as myoma, which is cylindrical, and a 10 millimeter hole through the cut piece is ejected. The process continues until all the mom is unplugged. Seeking job experience in electromechanical morselator use. A moment of inattention may cause the interruption of the intestinal tract, instead of mom. This process also improves the duration of operation. Another method of the fibroid is taken out of the body with an incision in the vagina.
Compared with laparotomy, laparoscopy stitch up the incision in the abdomen during the uterus is a very difficult process and requires experience. In the aftermath of laparoscopic suture of the seam in scientific circles there are doubts about the reliability still more in pregnancy.
A team of researchers to identify suitable candidates for laparoscopic myomectomy they’ve done studies and some suggestions are provided. However, none of these proposals has not been sufficient to reach a consensus. For example, some researchers a 15-inch or 2 larger than 8 inches will experience fibroids, even while the more conservative ones prefer to laparotomy in the presence of more than mom. In this regard the decision depends on the impression and experience of the surgeon who will do the operation.
Laparoscopy with laparotomy myomectomy done with the purpose of wants you want to protect the reproductive potential. However, the most important of this operation and the potential negative effects that arise dezavant ajlari of conceiving after the surgery-abdominal adhesions. Except for adhesions, infertility, chronic groin pain, ectopic pregnancy even bowel obstruction an increased risk of some complications such as the risks they bring. Which are seen after myomectomy adhesions (adhesions) after operations with the cause of infertility or recurrent miscarriages is of particular importance. Adhesions of the tubes prevents the destruction of the normal anatomy and function of both the permeability and in this way can cause difficulties in getting pregnant.
The rate of adhesion formation after myomectomy by laparotomy, 71.4% to 100. These adhesions 75% of the rest are moderate lighter. Fibroid in the back wall of the uterus, the probability of adhesion is 93% while at the top or at the front 55% when accounted for. Very large fibroid uterus, or severe is another factor that increases the risk of adhesion on the incision to be made.
One of the important features of laparoscopic procedures caused minimal surgical trauma. Therefore the risk of adhesion formation after myomectomy open surgery to be lower than expected. A limited number of work confirms this expectation. Overall, patients who had myomectomy by laparotomy, adhesion after laparoscopic myomectomy in determining this ratio at varying degrees of 89.6% and 51.1%.
Aimed at reducing the risk of adhesion formation after myomectomy despite treatment with many different drug and substance, none of them is not as effective as a careful and attentive surgery.
After 3-12 weeks after myomectomy some authors re-identified by performing a laparoscopy of adhesions and adhesion that could be useful to observe whether or not the opening claimed.
PREGNANCY AFTER A MYOMECTOMY
Made with the cause of infertility pregnancy rates after myomectomy are positive. Pregnancy rate after myomectomy depending on the age of the patient %of patients and range between 22-66 the average of 57% i.e. more than half become pregnant. Ratio is significantly higher in women under 35. Pregnant in 80% of patients carried the pregnancy without any additional treatment. Slightly lower pregnancy rates in couples with infertility have more than one.
In 1999, more studies of pre-myomectomy, 60% of the rate of spontaneous abortion after the operation, which was around 24% shows how it descends.
DELIVERY AFTER A MYOMECTOMY
According to their localization and number of myoma during myomectomy one or more incisions are made in the uterine wall, mom is subtracted, and the resulting space is closed with sutures. For this reason, only C-section, as in integrity in the wall of the uterus is disrupted. Pregnancies after myomectomy occurred therefore the risk of uterine rupture is slightly higher. Because of this risk, many gynecologists are in consensus about the methods of cesarean birth after myomectomy.