Hysterectomy and myomectomy are both common surgical procedures performed on the uterus. A hysterectomy removes the uterus entirely and may be performed for a number of reasons, including as a treatment for complications resulting from uterine fibroids, which are a common type of usually benign tumors growing on or in the uterus. Depending on the size and location of the fibroids, among several other factors, these tumors may instead be treated by myomectomy – a surgical operation which aims to remove the fibroids but leaves the uterus intact. Numerous factors must be weighed into consideration when deciding between hysterectomy vs. myomectomy in a specific case, and doctors and other medical professionals have a responsibility to ensure that patients are aware of the risks and benefits of their potential treatment options.
Unfortunately, not all medical care providers take informed consent as seriously as they should – too often leading to painful, life-altering consequences for their patients. Women who have been affected by botched gynecological surgeries such as hysterectomy or myomectomy, or who have been denied the right to make adequately informed decisions regarding their own health care, may be able to recover financial compensation, even if money can never truly repair the damage to their lives. To learn more, reach out to a New Mexico women’s health lawyer with Erin Marshall Law. Call 505-218-9949 today to schedule your free personalized consultation.
What Are Uterine Fibroids?
A fibroid is a type of benign (noncancerous) tumor that commonly grows on or within the walls of a woman’s uterus (hence uterine). Also called myomas, uterine fibroids are common in women of what is sometimes referred to as “childbearing” age – generally, between menarche (the date of a girl’s first period, usually close to the onset of puberty) and menopause (the close of a woman’s period of fertility, accompanied by hormonal changes and the end of regular periods). According to the Mayo Clinic, the typical range of uterine fibroids is from so small they can barely be seen with the naked eye to the dimensions of a grapefruit – but the Cleveland Clinic notes that in extreme cases they can grow even larger, approaching the size of a watermelon and making the person with the large fibroid appear pregnant. The size of the tumor, along with its placement, can influence the chance of complications and the options for treatment.
Complications From Uterine Fibroids
Even large fibroids may not always cause problems, and since the tumors do not generally pose a risk of malignancy (cancer), if the individual who has the myomas is not experiencing bothersome symptoms then in many cases doctors will not recommend any action. In some cases, however, myomas can be associated with heavy bleeding, abdominal pain, and other complications. When uterine fibroids become bothersome, the primary treatment options are surgical excision of the tumors from the uterus (myomectomy), or surgical removal of the uterus from the abdominal cavity (hysterectomy). The Cleveland Clinic reports that the chances of any particular myoma causing complications are related to the tumor’s size, location, and myoma sub-type.
Treatment Options for Uterine Fibroids
A 2012 article in Obstetrics and Gynecology International, available to New Mexico residents through the National Library of Medicine (NLM), indicates that pain and excessive bleeding during menstruation are among the most common problems caused by uterine fibroids. Accordingly, for patients whose symptoms are strongly correlated with their menstrual cycles, suppressing menstruation through the use of hormonal contraceptives may be preferred to surgery as an initial option for treating uterine fibroids. Other nonsurgical options may include pain relievers, hot or cold compresses, and other interventions aimed at managing symptoms.
If a patient’s symptoms do not improve on hormonal contraception, or if hormonal methods are contraindicated due to other considerations in a particular case, a doctor may recommend that the patient undergo evaluation for a possible surgery to remove the tumors or even the entire uterus. Surgery for fibroids may also be indicated when the complications present in a specific patient present a risk of renal or intestinal obstruction, or if a large myoma is expected to interfere with pregnancy. Any surgery poses some degree of risk, but failing to consider the full range of treatment options can negatively impact a patient’s quality of life. Strong doctor-patient communication is crucial to ensure that each patient understands the available options and their implications.
Choosing Between Hysterectomy vs. Myomectomy
When surgery for uterine fibroids is indicated, there are two main options that doctors and patients may consider. The first is myomectomy; this procedure excises the myomas from the uterus, but does not remove the uterus itself. The second is hysterectomy, which is the surgical removal of the uterus. Either option can be appropriate, but it is crucial for patients as well as doctors to be able to weigh the relative risks and advantages of the available options prior to proceeding with either surgery. If your options were not discussed with you prior to surgery and you have experienced negative consequences as a result, you may wish to speak with a women’s health lawyer at Erin Marshall Law to evaluate your legal options for seeking remedy.
Myomectomy
Myomectomy is usually the preferred option in women who have never given birth but hope someday to do so, or in patients who have already carried at least one child but think they might like to have more. Myomectomy may also be performed alongside a Caesarean section (C-section) when uterine fibroids interfere with a developing pregnancy.
A successful myomectomy offers the advantage of preserving a woman’s fertility; depending on a patient’s age and plans for future children, this factor alone can sometimes tip the balance in favor of a decision for myomectomy vs. hysterectomy. There are three main techniques for myomectomy:
- Abdominal myomectomy: Surgery is performed, and tumors are removed, through an incision in the patient’s abdominal wall. This is the most invasive option, but can be indicated in the case of very large tumors, or those that are growing on the outer wall of the uterus.
- Laparoscopic myomectomy: Incisions are made in the abdominal wall, generally smaller than those used in a traditional abdominal myomectomy, to allow for the insertion of very small tools and a camera. Often this version of the surgery is performed with robotic assistance, rather than traditional surgical implements. Because the incisions are generally smaller than those used for an abdominal myomectomy, the recovery time for the patient is also usually shorter.
- Hysteroscopic myomectomy: In some cases, particularly with tumors internal to the uterus, a myomectomy can be performed by dilating the patient’s cervix and inserting surgical implements through the vaginal canal, then removing the tumors themselves by the same passage – essentially, taking the tumors out by the same route a baby would take. John Hopkins Medicine indicates that this is the least invasive procedure for myomectomy and offers the shortest recovery period, but it may not be an option in all cases.
As with any surgery, the least invasive route that shows a strong chance of success is generally preferred. If your doctor or surgeon is uncomfortable with performing a particular procedure, you may wish to seek a second opinion to be sure you understand all of your options.
Hysterectomy
A hysterectomy may be indicated if a woman no longer desires fertility. In these instances a doctor and patient may especially consider hysterectomy vs. myomectomy if the patient is at increased risk for cervical cancer (removing the cervix during hysterectomy is a commonly chosen option), or if fibroids are positioned in such a way that removing them separately from the uterus is likely to prove difficult. In terms of incisions, equipment, and time to recovery, the options for performing a hysterectomy generally align with those for a myomectomy – with the caveat that the recovery time for a hysterectomy will typically be somewhat longer, given that even a minimally invasive hysterectomy still involves organ removal.
The major disadvantage of hysterectomy is that the removal of the uterus eliminates the possibility of carrying biological children in the future. On the other hand, unlike myomectomy a hysterectomy also eliminates the chance of more myomas growing in the future.
Speak With a Women’s Health Lawyer
Uterine fibroids can be asymptomatic or deeply disruptive, and in unusual cases may even become life-threatening. Options for treating fibroid tumors of the uterus are limited, with few reliable methods available outside of surgery. Any surgery involves some degree of risk, so it is important for doctors and patients to communicate effectively in determining whether to pursue surgical intervention in a particular case. If surgery is indicated, choosing between hysterectomy vs. myomectomy can still prove difficult, particularly in patients who still desire fertility but who are plagued with multiple tumors and disruptive symptoms. Crucially, patients must be a part of the decision-making process in order to maximize the chances for improved quality of life after surgery. To learn more about your rights as a patient, consider scheduling a consultation with a New Mexico women’s health lawyer at Erin Marshall Law. Call our Albuquerque office at 505-218-9949 today to get started.
