Laparoscopic Myomectomy Turkey

What is a fibroid?

Uterine fibroids are benign tumors that develop in the uterus and are composed of muscle and fibrous tissue. Most fibroids are asymptomatic and they may remain undiagnosed unless an ultrasound examination is made.

What are the symptoms of a fibroid?

Symptoms of fibroids can be summarised as:

• Heavy menstrual bleeding
• Bleeding between periods
• A feeling of fullness in your lower belly
• Bloating
• Pelvic pain or pressure
• Low back pain
• Pain during sex
• Frequent urination when the fibroid puts pressure on the bladder
• Complications during pregnancy or labor.

What happens to fibroids during pregnancy?

Fibroids may grow during pregnancy due to the hormone estrogen. This growth can sometimes lead to discomfort or pressure symptoms, depending on their size and location. There may be frequent urination if fibroids press on the bladder.

In some cases, fibroids may calcify (harden) during pregnancy, especially in the later stages, which can lead to reduced blood supply to the fibroid. This is more common in women with larger fibroids.

What happens to fibroids after menopause?

Fibroids are dependent on the hormone estrogen. Therefore they stop bleeding and gradually shrink in size after menapause. There is a change called degeneration which happens in the fibroid tissue after menopause.

Do all fibroids need to be treated?

Asymptomatic fibroids do not need to be treated and they can just be followed up. However myomectomy is often indicated for women experiencing symptoms such as heavy menstrual bleeding, pelvic pain, or pressure due to fibroids, especially if they want to preserve their fertility. Otherwise laporoscopic hysterectomy can be an alternative treatment for fibroids.

What are the Considerations for Treatment Choice

• Severity of Symptoms: Treatment is often tailored to the severity of symptoms and the patient’s lifestyle.
• Desire for Future Fertility: Options like myomectomy or non-invasive procedures are more suitable for those wishing to conceive.
• Overall Health: Comorbid conditions may influence treatment choices.

What are the treatment options for fibroids?

Treatment options for uterine fibroids vary based on factors like the size, location and number of fibroids, as well as the severity of symptoms and the patient's desire for future fertility. Here are the main treatment options:

1. Watchful Waiting

If fibroids are asymptomatic or causing minimal issues,they may be monitored over time without active treatment, This is often recommended for small fibroids that do not require immediate intervention.

2. Medications

Medical treatment may be the choice for patients who are not suitable for surgery, or are preparing for surgery and the symptoms need to be alleviated.

Hormonal Therapies:

• Birth Control Pills: Help regulate menstrual cycles and reduce bleeding.
• Progestin-Only Medications: Can alleviate heavy bleeding but may not reduce the size of fibroids.
• Progestin IUD:Can decrease pain and bleeding.

GnRH Agonists: Medications like leuprolide that temporarily shrink fibroids by inducing a menopause-like state. It can only be used short-term due to side effects.

Anti-Inflammatory Drugs: Over-the-counter pain relievers (e.g., ibuprofen) can help manage pain and reduce bleeding.

3. Non-Invasive Procedures

MRI-Guided Focused Ultrasound: A non-invasive technique that uses focused ultrasound waves to destroy fibroid tissue while preserving the surrounding area.

Uterine Artery Embolization (UAE): A minimally invasive procedure that blocks the blood supply to the fibroids, causing them to shrink. It is suitable for women who want to preserve their uterus but experience significant symptoms.

4. Minimally Invasive Procedures

• Laparoscopic Myomectomy: Removal of fibroids via small incisions in the abdomen, preserving the uterus.
• Laporoscopic hysterectomy: Removal of the uterus throught the vagina,assisted by laporoscopy
• Hysteroscopic Myomectomy: Involves removing fibroids through the cervix using a hysteroscope, suitable for fibroids within the uterine cavity.
• Endometrial Ablation: Destroys the uterine lining to reduce or eliminate menstrual bleeding, effective for women who do not wish to become pregnant.

5. Surgical Options

• Abdominal Myomectomy: An open surgical procedure to remove larger or multiple fibroids through a larger abdominal incision.
• Hysterectomy: Complete removal of the uterus, the most definitive treatment for fibroids, often recommended for women who no longer wish to have children or have severe symptoms.

6. Lifestyle Changes

Diet and Exercise: Some women find relief through lifestyle modifications, including a balanced diet and regular exercise, which may help manage symptoms.

What is laporoscopic myomectomy?

Laparoscopic myomectomy is designed to remove uterine fibroids while preserving the uterus. It is also known as keyhole surgery or closed surgery for fibroid treatment. Because there is not a big incision on the belly, instead several small 0.5 to 1 cm incisions are made on the belly to insert a camera and instruments.

This procedure is often preferred for women who wish to maintain their fertility or avoid a hysterectomy (surgical removal of the uterus).

Who are cadidates for laporoscopic myomectomy?

Women with symptomatic fibroids, those wanting to preserve their fertility, or women who have not responded to medical treatments are best cadidates for laporoscopic myomectomy.

Who is not a good candidate for for laporoscopic myomectomy?

Severe adhesions, very large fibroids, or certain medical conditions may make laparoscopic myomectomy unsuitable for certain patients.

Do you need anesthesia for laporoscopic myomectomy?

General anesthesia is typically used, ensuring the patient is unconscious and pain-free during the procedure. However regional anesthesia can also be used during the procedure.

How do we organize fibroid treatment for international patients in our clinic?

We try to arrange a free online video consultation with our surgeon for all international patients before they arrive in Turkey. They will be asked questions about their medical and surgical history, given detailed information during this consultation and they can direct all of their questions to the surgeon who will operate them.

If they decide to have surgery, they need to book their flights and share with us so that we can arrange their appointment for surgery.

They will be picked up from the airport when they arrive and will have a face-to-face consultation at the clinic before surgery.

They will be taken to the hospital for preoperative tests and consultation with the anesthesiologist.

We try to organize that they have surgery as soon as possible after their arrival, so that they will have more time to rest after surgery.

They will be visited by their surgeon at the hospital during their hospital stay. They usually stay one night at the hospital after a laporoscopic myomectomy.

They will be picked up from their hotel and brought to the clinic for their final consultation before they leave Turkey.

They will able to reach us 24 hours during their stay in Turkey and even after they leave.

How many days do patients need to stay in Turkey after laporoscopic myomectomy?

Patients need to stay around 5 days after a laporoscopic myomectomy in Turkey. During their final consultation, if there are no problem sor complications, they will be able to fly back home.

Is there any preparations necessary before coming to Turkey for fibroid treatment?

• Patients may undergo imaging (like an ultrasound or MRI) to assess the size and location of fibroids.
• If they have any medical conditions like diabetes, thyroid disease, heart disease etc, they may need to adjust their medication doses, make blood tests and consultations to regulate their condition.
• They need to stop smoking before surgery
• They need to stop taking blood thinner medications such as aspirin, anti coagulants, supplements etc before surgery
• They need to start fasting one night before surgery

How is a laporoscopic myomectomy performed?

Laporoscopic myomectomy is performed through small incisions in the abdomen using a laparoscope (a thin tube with a camera) and specialized instruments.

• Anesthesia is administered (general or regional).
• An incision about 1 cm is made around the belly button, a special needle is inserted through this incision and carbon dioxide gas is introduced into the abdominal cavity to create space.
• The laparoscope( a specially designed camera) is inserted through this incision, allowing visualization of the pelvic organs.
• Other 0.5-1 cm small incisions are made on the belly to insert instruments
• Fibroids are identified and carefully removed using specialised instruments. They may be removed intact or in pieces, depending on their size and location.
• The uterus is repaired with sutures
• The incisions are closed with sutures.

What are the Types of Fibroid Removal Techniques

• Enucleation: Directly removing the fibroid from the uterine wall.
• Morcellation: Breaking larger fibroids into smaller pieces for easier removal, often done if the fibroid is too large to extract whole.

What are the advantages of laporoscopic myomectomy?

• Minimally Invasive: Smaller incisions result in less postoperative pain and quicker recovery.
• Shorter Hospital Stay: Often allows for outpatient or short-stay hospital treatment.
• Faster recovery: Patients may return to daily activities in a few weeks unlike open surgery
• Reduced Scarring: Smaller scars compared to open surgery.

What are the risks of laporoscopic myomectomy?

Just like all surgical interventions, complications may occur after alaporoscopic myomectomy. Potential risks include bleeding, infection, adverse reactions to anesthesia. Or injury to surrounding organs.

• Injury to Surrounding Organs: There is a small risk of injury to the bladder, intestines, or blood vessels.
• Uterine Rupture: Although rare, there is a risk in subsequent pregnancies if the uterus is not adequately repaired.
• Recurrence of Fibroids: There’s a possibility that new fibroids may develop after the procedure. Recurrence: Fibroids may grow back over time, and patients may require additional treatment.

Therefore if a patient does not desire future fertility, hysterectomy is a very good alternative to myomectomy to prevent recurrence of fibroids.

How is the post operative care after laporoscopic fibroid surgery?

• Hospital Stay: Many women go home the same day or the next day.
• Activity Restrictions: Women are ecommended to avoid strenuous activities, heavy lifting, and sexual intercourse for a few weeks.
• Pain Management: Over-the-counter pain relievers are usually sufficient, though prescription pain medication may be provided if needed.

How is the process after fibroid surgery?

• Monitoring: Follow-up appointments are typically scheduled 4-6 weeks post-surgery to monitor healing and address any concerns.
• Long-Term Outlook: Regular check-ups are important to monitor for any recurrence of fibroids and overall reproductive health.

What is the success rate of laporoscopic myomectomy?

• Symptom Relief: Symptom relief rates are high (70-90%) after surgery.
• Pregnancy Rates: Many women successfully conceive after laparoscopic myomectomy, although individual results may vary.

If you're considering this procedure, it's important to have a thorough discussion with a healthcare provider to evaluate your specific situation, understand the potential benefits and risks and establish realistic expectations for recovery and future fertility.

What is the cost of laporoscopic myomectomy in Turkey?

The cost of the surgery depends on several factors such as the city, hospital, number of fibroids and type of anesthesia. You can reach our clinic through our Whats App line for detailed information and a quote. You can also get a free online consultation with our surgeon through this line.