Gorovitz & Borten, P.C.
Attorneys at Law

400 Totten Pond Road, 2nd Floor
Waltham, Massachusetts 02451
Tel: (781) 890-9095
Myomectomy Complications
Uterine leiomyomas (fibroids) are one of the most common conditions
requiring gynecologic care. It affects approximately 20% of women of
reproductive age. By the age of 50 years, 70% to 80% of women will be
diagnosed with fibroids in their uterus. Uterine fibroids tend to appear at a
younger age in black women. They can be small or large, single or multiple
and located at different levels within the uterine wall. Abdominal and pelvic
pain, uterine bleeding, pelvic pressure and infertility are amongst the most
frequent complaints caused by uterine fibroids. Although uterine fibroids are
the most frequent indication for hysterectomy in the United States, the desire
to preserve childbearing capabilities and fear of losing the uterus require
conservative management. Myomectomy (removal of fibroids) with
preservation of the uterus is the most common alternative used.

While nonsurgical methods to treat uterine fibroids are available (hormone
suppression, uterine artery embolization), surgical myomectomy by
laparoscopy, hysteroscopy or abdominal approach are the most frequently
used methods to treat uterine symptomatic fibroids. At times, the combination
of hormonal suppression (GnRH analogues) to reduce the size of the fibroids
is followed by surgical removal of the fibroids. Indications for myomectomy are
the same indications supporting the use of hysterectomy for fibroids. They
include:

  • Large asymptomatic fibroid(s) (abdominally palpated)
  • Excessive uterine bleeding (anemia, fatigue)
  • Pelvic discomfort (including abdominal pain)
  • Bladder pressure with urinary frequency

Location of the fibroids within the uterine wall helps to classify the uterine
leiomyomas as:

  • Intramural (within the wall of the uterus)
  • Submucosal (protruding into the uterine cavity)
  • Subserosal (protruding into the abdominal cavity)
  • Pedunculated (small stock protruding into the abdominal cavity)

Complications associated with the surgical treatment of uterine fibroids varies
in accordance with the technique used. Complications found when
hysterectomy is selected are those associated with the hysterectomy itself in
addition to those complications related to injury to adjacent organs caused by
the distortion of the normal anatomy that accompanies large size uterine
fibroids.

Abdominal myomectomy is associated with short and long term complications.
They include;

Short Term Complications

  • Excessive bleeding
  • Infection
  • Injury to adjacent organs (bowel, ureter)
  • Thrombophlebitis
  • Thromboembolism
  • Conversion of myomectomy into a hysterectomy

Long Term Complications

  • Recurrence (greater than 50% over 5 years)
  • Uterine rupture during future pregnancy
  • Cesarean section needed if endometrial cavity was entered during
    myomectomy
  • Intraabdominal  adhesions (bowel, omentum)

Laparoscopic myomectomy complications are usually associated with the
degree of difficulty of the surgical procedure itself. Conversion to open
(laparotomy) procedures, intraoperative transfusion and length of surgery are
mainly reported. The preoperative use of GnRH analogues to reduce the size
of the fibroid and reduce the amount of intraoperative bleeding has been
recommended.

Uterine artery embolization was associated with a higher rate of subsequent
interventions. While the operative time may be reduced for the initial
procedure the rate of postdischarge complications is greater compared with
other procedures treating uterine fibroids.

Gynecologists performing myomectomies are responsible for the diagnosis
and management of short and long term complications that arise during and
following the surgical procedure. If you believe that you or your loved have
been misdiagnosed, victims of a traumatic myomectomy or wrongly treated
and suspect the postpartum complications may be the result of a medical
provider’s error that was diagnosable, avoidable and/or preventable, you may
have a valid cause of action. The injury may be the result of a medical
provider's mistake in handling your condition and the result of medical
negligence.
Dr. Borten has over 35 years of experience as an obstetrician
and gynecologic surgeon to fully evaluate the merits of your potential case.
Allow the Boston area medical malpractice attorneys at Gorovitz & Borten help
you assert your rights and get the compensation you deserve.
Contact Information
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(when possible), please contact us by phone, fax or e-mail with your question
or concern.

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