Information about uterine fibroids
Minimally Invasive Therapy Unit & Endoscopy Training Centre
University Department of Obstetrics and Gynaecology
Royal Free Hospital
Pond Street
London NW3 2QG, UK


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A new website for gynaecologists interested in the surgical management of fibroids is now on line.

Vaginal myomectomy

Vaginal myomectomy involves removing fibroids through the vagina; as with hysteroscopic myomectomy, therefore, there are no external scars. This operation is done when the fibroids are moderate in size but too deep or numerous for hysteroscopic or laparoscopic myomectomy. It is easier in women who have children as there tends to be more space in the pelvis for this type of surgery.

The procedure is easiest when the fibroid(s) are at the back of the uterus, and most difficult when they are mainly at the top; in that situation, laparoscopic myomectomy may be preferred. Because conventional instruments are used, vaginal myomectomy generally takes less time than laparoscopic myomectomy and the repair of the uterus is stronger. Recovery in terms of hospitalisation and return to normal activities is similar, and faster than with laparotomy.

Fibroids can be sited anywhwere
Relatively short hospital stay
Recovery relatively quick
Probably less risk of adhesions than with laparotomy
Only suitable if fibroids are not very large
Difficult if fibroids are sited at the top of the uterus

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Different vaginal myomectomies

The term "vaginal myomectomy" can mean one of 4 techniques, depending on the position of the fibroid:

1. Vaginal removal of a pedunculated submucous myoma via the cervix.
2. Vaginal removal of a submucous myoma via Duhrssen's incision (incision into the cervix).
3. Vaginal removal of a submucous myoma via vaginal hysterotomy (incision into the cervix which extends into the lower part of the uterus).
4. Vaginal removal of myoma via anterior or posterior colpotomy (incision between the vagina and peritoneal cavity).