What is Hysteroscopic Myomectomy?
Hysteroscopic myomectomy is a minimally invasive surgery to remove fibroids from the inner lining of the uterus. These fibroids can cause heavy menstrual bleeding, pain and fertility issues. It is performed using a hysteroscope, a thin lighted tube inserted through the vagina and cervix, without any external incisions. This procedure helps relieve heavy menstrual bleeding, pelvic pain, and fertility issues while preserving the uterus.
Different Types of Myomectomy
Myomectomy can be performed using different surgical approaches, and the choice of procedure depends on the size, number, and location of fibroids as well as the patient's fertility goals.
Hysteroscopic Myomectomy
- Best for submucosal fibroids inside the uterine cavity.
- No external incisions; accessed through vagina and cervix.
- Minimally invasive with quick recovery and fertility preservation.
Laparoscopic Myomectomy
- Best for small to medium-sized fibroids on outer/middle uterine layers.
- Accessed via small abdominal incisions using a laparoscope.
- Minimally invasive with less pain.
Robotic-Assisted Myomectomy
- Best for complex or multiple fibroids.
- Performed using robotic arms for precision and visualization.
- Minimally invasive.
Abdominal (Open) Myomectomy
- Best for large, numerous, or deeply embedded fibroids.
- Accessed via a large lower abdominal incision.
- Longer recovery time required.
30-60 Minutes
Surgery Duration
Regional or General anesthesia
Anesthesia Used
4-6 Weeks
Full Recovery Timeline
When is Hysteroscopic Myomectomy Recommended?
Indications of Hysteroscopic Myomectomy include conditions where fibroids inside the uterus cause significant symptoms. Doctors usually recommend this procedure if you have:
- Heavy Menstrual Bleeding (Menorrhagia): Reduces anemia risk by removing fibroids, causing excessive bleeding.
- Pelvic Pain: Reduces discomfort from fibroid compression.
- Infertility/Reproductive Issues: Improves embryo implantation by removing fibroids linked to miscarriages.
- Pressure/Fullness: Relieves pelvic pressure caused by large fibroids.
- Abnormal Uterine Bleeding: Normalizes bleeding patterns affected by fibroids.
- Uterine Function and Fertility: Preserves the uterus for future pregnancies; avoids hysterectomy.
- Diagnostic Evaluation: Visualizes uterine cavity abnormalities.
Preparation for Hysteroscopic Myomectomy Surgery
Before undergoing the procedure, your doctor will guide you through certain steps to ensure safety and smooth recovery. Preparation may include:
- Medical evaluation with blood tests, pelvic exam, ultrasound, or MRI.
- Informing the doctor about current medications, especially blood thinners.
- Stopping certain medicines as advised before surgery.
- Fasting for a few hours before the procedure if anesthesia is required.
- Arranging for a family member or friend to accompany you, as you may not be able to drive after surgery.
- Following any special instructions given by your doctor for uterine preparation.
Hysteroscopic Myomectomy Procedure
Hysteroscopic myomectomy is a minimally invasive surgery designed to remove uterine fibroids while preserving the uterus, allowing for faster recovery and fewer complications compared to traditional open surgery.
- The surgery is usually done under general or regional anesthesia.
- A hysteroscope (a thin, lighted tube with a camera) is gently inserted through the vagina and cervix into the uterus.
- Saline solution is used to expand the uterus for clear visibility.
- Special surgical instruments are passed through the hysteroscope to cut and remove fibroids from the uterine lining.
- The removed tissue is taken out through the hysteroscope.
- Since no external cuts are made, recovery is usually quicker compared to open surgery.
Who Performs Hysteroscopic Myomectomy?
Hysteroscopic myomectomy is a specialized gynecological procedure performed by experienced women's health experts trained in minimally invasive surgery.
Gynecologists
- General gynecologists with training in hysteroscopic procedures can perform this surgery.
- They evaluate and treat fibroids affecting the uterine cavity.
Reproductive Endocrinologists / Fertility Specialists
- Often perform hysteroscopic myomectomy in women facing fertility issues.
- Help improve chances of conception by removing fibroids that interfere with pregnancy.
Minimally Invasive Gynecologic Surgeons (MIGS Specialists)
- Gynecologists with advanced training in hysteroscopic and laparoscopic techniques.
- Skilled in handling complex fibroid cases while preserving the uterus.
Hospital or Fertility Center Teams
- The procedure is usually carried out in a hospital or advanced fertility clinic setting.
- Anesthesia specialists and trained surgical staff assist the gynecologist to ensure safety and comfort.
Recovery after Hysteroscopic Myomectomy Surgery
Care after a hysteroscopy myomectomy is usually smoother compared to open surgeries, as it is a minimally invasive procedure, leading to faster recovery, less discomfort, and a quicker return to daily activities.
Immediate Recovery
- Observe in the recovery room post-anesthesia.
- Discharge same day with possible overnight stay.
- Manage cramping with prescribed painkillers.
- Expect light vaginal bleeding/discharge.
Recovery at Home
- Rest for a few days; avoid heavy lifting/sex.
- Stay hydrated and maintain a nutritious diet.
- Attend follow-up appointments for stitch removal.
Longer-Term Recovery
- Return to work within 1-2 weeks.
- Gradually resume physical activity.
- Menstrual cycles may temporarily disrupt.
- Discuss fertility plans with your doctor.
Lifestyle Changes After Hysteroscopic Myomectomy
Making certain lifestyle changes after hysteroscopic myomectomy can help your body heal faster, reduce complications, and improve overall well-being during the recovery period.
- Rest and gradual activity: Take enough rest in the first few days and slowly return to daily routines as advised by your doctor.
- Healthy diet: Eat iron-rich foods (like green leafy vegetables, beans, and lean meats) to restore blood levels if you had heavy bleeding before surgery.
- Stay hydrated: Drink enough water to support healing and prevent constipation.
- Avoid heavy lifting: For at least 1-2 weeks, avoid strenuous exercises or lifting heavy objects.
- Good menstrual care: Use sanitary pads instead of tampons for a few weeks to lower the risk of infection.
- Regular follow-ups: Attend all scheduled doctor visits to check healing and monitor for fibroid recurrence.
- Stress management: Practice yoga, meditation, or light walking to maintain overall well-being.
Benefits of Hysteroscopic Myomectomy
Hysteroscopic myomectomy is a minimally invasive procedure that removes uterine fibroids while preserving the uterus, offering faster recovery and improved reproductive health.
- Uterus Preservation: Unlike traditional surgery, this procedure removes fibroids without removing the uterus, helping women maintain fertility.
- Minimally Invasive: Performed through the vagina and cervix with no external incisions. Reduces pain, scarring, and risk of infection compared to open surgery.
- Faster Recovery: Most patients return to normal activities within a few days. Shorter hospital stay and quicker overall healing.
- Relief from Symptoms: Effectively treats heavy menstrual bleeding, pelvic pain, and pressure symptoms caused by fibroids.
- Improved Fertility Outcomes:Removing fibroids that interfere with the uterine cavity can increase the chances of conception and a healthy pregnancy.
- Reduced Complications: Less blood loss and lower risk of adhesions or post-surgical complications compared to traditional open myomectomy.
Risks and Complications of Hysteroscopic Myomectomy
While hysteroscopic myomectomy is generally safe, like any surgical procedure, it carries certain risks and potential complications that patients should be aware of before undergoing the treatment.
- Cramping/light bleeding.
- Infection or blood clots.
- Uterine perforation or organ damage.
- Adhesion formation or incomplete removal.
- Allergic reactions to anesthesia.
- Increased C-section risk post-procedure.
Hysteroscopic Myomectomy Cost in India
The typical cost for hysteroscopic myomectomy in India ranges between Rs. 45,000 and Rs. 90,000, with most cities averaging around Rs. 65,000. In major metros like Bangalore, Hyderabad, Mumbai, and Delhi, prices usually fall within Rs. 50,000 to Rs. 84,000, though estimates in some reports go as high as Rs. 130,000.
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