What Is a Hysteroscopic Myomectomy/Polypectomy?
A hysteroscopic myomectomy and hysteroscopic polypectomy are minimally invasive procedures used to remove uterine fibroids for polyps within the uterus through a tube called a hysteroscope. Myomectomy is the removal of fibroids, which are benign tumors developing within the uterine wall. Polypectomy removes polyps that are non-cancerous growths that are small in size and found on the lining of the uterus. Both conditions lead to abnormal uterine bleeding.
Untreated polyps and fibroids also can lead to PMS. Treatment is most effective with advanced tools like TruClear™ system and Aveta Systems® that reduce scarring and eliminate awkward tube management by providing precision and reducing damage.
The outcome of this procedure depends on the experience of the doctor. Dr. Felix Cohen at Cohen Medical Practice (CMP) is a NYC best gynecologist specializing in advanced hysteroscopy and a wide range of other gynecological services.
Why Might I Need a Hysteroscopic Myomectomy or Polypectomy?
Submucosal fibroids and polyps increase the chances of miscarriage; removal of these through vaginal myomectomy improves pregnancy outcomes.
And a hysteroscopic myomectomy or polypectomy provides much-wanted relief from symptoms such as:
- Heavy and prolonged bleeding
- Pelvic pain
- Frequent miscarriages
- Unusual spotting
A hysterectomy is also used to treat extreme uterine bleeding and pain, but the differentiating factor in myomectomy vs. hysterectomy is that hysterectomy is the removal of your uterus or other reproductive organs. It’s usually recommended for cancer and severe endometriosis.
When Is a Hysteroscopic Myomectomy or Polypectomy Not an Option?
Your CMP surgeon may believe that a hysteroscopic myomectomy or polypectomy is less effective and riskier for you.
Scenarios in which your surgeon may choose an alternative approach include:
- Large fibroids, when your surgeon may recommend an open myomectomy
- Multiple fibroids
- Fibroids on the outer surface of the uterus
- History of scar tissue from previous surgeries
- Pelvic inflammatory disease
- Cardiac or pulmonary conditions
- Cancerous polyps or fibroids
In cases where hysteroscopic myomectomy or polypectomy is necessary, using TruClear and Aveta provides your doctor with maximized visualization, enhancing the accuracy of removing the fibroids and reducing trauma to surrounding tissues. Both are designed to reduce your discomfort as well. These systems reduce hysteroscopic myomectomy complications and procedural invasiveness, which leads to a quicker recovery.
How Are Hysteroscopic Procedures Performed?
First, you undergo an evaluation so that the size, number and location of the fibroids or polyps are clear. To reduce pain, general anesthesia is given, though in some cases only local anesthesia might be enough.
Steps in a hysteroscopic myomectomy or polypectomy include:
- Being placed in a lithotomy position on the table, lying on your back with legs elevated and spread
- Inserting a vaginal speculum to widen the vaginal canal so that access is given to the cervix
- Placing a hysteroscope, which is a thin tube with a camera, through the cervix so that it goes into the uterine cavity, providing a clear image on a monitor
- Infusing a sterile fluid of saline or glycine into the uterine cavity, which expands the uterus
- Identifying the fibroids or the polys using the hysteroscope
- Inserting instruments like a resectoscope for cutting, cauterizing or grasping
- Relying on an ablation technique in some cases to destroy any remaining unwanted tissue
TruClear’s high definition imaging provides a detailed view of the uterine cavity, leading to error-free removal of fibroids or polyps. Aveta’s way of combining surgical functions into one system reduces time of setup and improves procedural efficacy. Both these systems show significant improvement in hysteroscopic surgeries.
Is Hysteroscopic Myomectomy or Polypectomy Surgery Painful?
Hysteroscopic myomectomy and polypectomy procedures aren’t painful as compared to invasive procedures. A hysteroscopic myomectomy takes somewhere between 30 minutes to 1.5 hours, whereas a hysteroscopic polypectomy takes about 15 to 20 minutes. You should be able to go home the same day.
After the procedure, you should rest for about two days. Avoid heavy physical activities and slowly return to your normal routine. Take medications, and use heating pads and cool packs to minimize discomfort. Until you receive the go-ahead from your doctor, avoid sexual intercourse and use pads instead of tampons.
Call your surgeon if you experience symptoms, such as:
- Heavy bleeding after hysteroscopic myomectomy
- Pain or fever
- Redness or swelling around the vaginal area
- Unusual discharge with a foul odor
- Urinary incontinence or difficulty urinating
- Nausea
- Chest pain or shortness of breathe
- Dizziness or feeling lightheaded
Are There Side Effects of Hysteroscopic Myomectomy and Polypectomy?
Hysteroscopic myomectomy and polypectomy come with possible risks and side effects like bleeding, infection, scarring or pain, but with expert management, these risks are manageable.
Dr. Felix Cohen with his extensive training creates approaches for you that greatly minimize those risks, such as:
- Detailed pre-op assessment that allows him to catch potential risks
- Use of tools like TruClear and Aveta Systems that enhance precision, which reduces the chances of scarring
- Continuous monitoring for early detection of complications
- Detailed wound care instructions, which reduce chances of infection and promote healing
- Experience in pain management ensuring minimal pain with the appropriate use of painkillers
Inexperience and incompetence of surgeons can lead to excessive bleeding after hysteroscopic myomectomy or even perforating the uterus, so don’t take chances: choose the best. Contact Dr. Cohen at Cohen Medical Practice today to ensure you receive the best treatment without compromise.