Almost 75% of the women in the U.S. will experience uterine fibroids in their lifetime, and many will not even know they have them. There is no single known cause behind these benign growths that form in or on the uterus, but they can range in size from a piece of rice to that of a pumpkin.
Most uterine fibroids do not cause medical issues, but if they become large or are numerous, they can create chronic symptoms that can diminish a woman’s quality of life. Women who experience issues such as pain, pelvic pressure, and heavy, prolonged bleeding that can trigger anemia, and more eventually will seek treatment from their OB-gyn to find relief.
In many cases, fibroid removal surgery will be recommended using either a hysterectomy, which removes the woman’s uterus, or a myomectomy, which removes the fibroids one by one. Today, we are going to talk about myomectomy and C-section surgery and the links that exist between the two.
What Is The Difference Between C-Section And Myomectomy Surgery?
Both a C-section and a myomectomy involve surgery that is performed on the uterus, and sometimes they require the same type of incision, but they are done for different reasons.
The Purpose
- C-Section (Cesarean Section)
- This surgery is performed to deliver a baby when a vaginal birth is not possible or safe for the mother or baby. It involves making an incision in the lower part of the mother’s abdomen and through the uterus to remove the baby.
- Myomectomy
- This surgery is done to remove uterine fibroids and eliminate the symptoms they cause without having to remove the entire uterus. It is often chosen by women who wish to preserve their fertility, but it is not always an option for those with large or numerous fibroids.
There are different techniques used to perform a myomectomy, including an abdominal (open), which involves creating an incision very similar to that used during a C-section, or laparoscopic, which utilizes several smaller abdominal incisions, or vaginal, which is completed from within so there are no external incisions.
Recovery
- C-Section
- Recovering from a cesarean section can take anywhere from 6 to 8 weeks or longer depending on the patient’s circumstances. It usually involves a stay in the hospital of at least 3 or 4 days.
- Myomectomy
- Recovery time after this surgery can vary depending on the type of myomectomy technique used. An abdominal myomectomy usually requires a minimum of 4 to 6 weeks of recovery or longer, while laparoscopic and hysteroscopic myomectomies often have shorter recovery times of up to around 4 weeks. Depending on the technique used, a hospital stay of anywhere from 2 to 4 days is usually necessary.
Risks
- C-Section
- Infection, blood loss, blood clots, complications from anesthesia, and potential complications in future pregnancies.
- Myomectomy
- Infection, blood loss, scar tissue formation, potential damage to the uterus or surrounding organs, an emergency hysterectomy if severe bleeding occurs. Long-term complications can include fertility issues, pregnancy complications, including uterine rupture, and fibroid recurrence.
Is A Myomectomy More Painful Than A C-Section?
Both myomectomy surgery and a C-section can create postoperative pain. A myomectomy can be performed laparoscopically, vaginally, or as an open procedure, while a C-section can only be done “open” or using a long incision. Recovering from a myomectomy that was performed laparoscopically or vaginally would not be as painful as a C-section, but the pain following an open abdominal myomectomy vs. C-section would be more comparable but not entirely the same.
During both a C-section and open myomectomy, the patient is under some type of anesthesia that prevents them from feeling any pain. So pain only becomes an issue once they wake up and start their recovery process. Determining if a myomectomy is more painful than a C-section is not straightforward because each person has their own pain tolerance level, which can be further influenced by their specific circumstances.
Both surgeries require making a long incision along the bikini line just above the pubic bone and cutting through both the abdominal muscles and through the muscular uterine wall. Recovering from either of these surgeries is one of the toughest experiences a woman can go through.
Pain After A C-Section
Some patients experience moderate pain after C-section surgery for between three and four days, especially around their incision site. Often, pain can be managed with prescription medications for the first several days, followed by over-the-counter medications afterward. It is important to consult with your doctor if you are breastfeeding before taking any type of medication;
Pain surrounding the incision site is normal and expected after surgery and can take at least two weeks to dissipate. It is also common to experience cramping for a few weeks after delivering a baby, which can exacerbate the pain they experience while recovering from a C-section.
Here are some excerpts from women who had C-sections talking about their pain levels. You will see from the following statements that women can have very different experiences with pain after a C-section.
“The pain on days two through four was almost unbearable, but then I started feeling better, and at around 2 weeks, I almost felt normal except when I coughed or sneezed. Those first few days are the worst pain I have ever felt.”
“For me, days 2 and 3 were the hardest, with pain peaking at day 3, then it gradually got better and better after that.“
“I have had 2 C-sections and really didn’t have much pain after either of them.”
“After my emergency c-section, I had to take Percocet for about a week, but then Motrin 1-2 times a day worked to ease my discomfort.”
Pain After Open Myomectomy
An open myomectomy can cause abdominal pain and discomfort for at least 7–10 days after surgery, and many patients reported having to take medication to help manage the pain for several weeks. In addition to the pain surrounding the external incision, there is also pain coming from the locations within the uterus that had to be cut apart while removing the fibroids. The abdominal cavity is filled with gas during the surgery to provide the surgeon space to work so they can see what they are doing. The residual trapped gas can be quite painful and can last several days to clear;
One woman took to social media to talk about her level of pain after an open myomectomy and said, “The pain is excruciatingly unbearable” and “Walking is brutal and seems impossible; every time I try to get up, I get close to passing out from pain.”.
Another woman sharing her myomectomy story wrote, “This is day 20 in my recovery, and I am still taking medication for pain every 12 hours. Coughing and sneezing is unbearable, but I can move around pretty much pain-free but get winded easily and have to sit down. I had 2 laparoscopic myomectomies before this one, which were not pain free, but this open myomectomy is the most pain I have ever felt.”
Is A Previous Myomectomy Indication For A C-Section?
Depending on the extent of your myomectomy, many OB/GYNs will require you to deliver your baby during a scheduled C-section to prevent uterine rupture. During a myomectomy, your uterus is cut in several places to remove the fibroid growths, and then these holes are stitched back together. This can leave places within your uterine wall that are weak and may not be able to withstand the pressure of childbirth.
One case study reported that a 39-year-old woman who was 32 weeks pregnant was having severe abdominal pain but no contractions, and her blood pressure had become dangerously low. An emergency C-section was performed, and it was discovered that her myomectomy scars had ruptured.
Can You Remove Fibroids During A C-Section?
Yes, it is possible to remove fibroids during a C-section, and this combination surgery is called a cesarean myomectomy. Doctors most often prefer to handle fibroids during a separate procedure, but there are some pros and cons of myomectomy during a cesarean section.
Cons
- It can increase the risk of losing too much blood leading to an unwanted hysterectomy, a blood transfusion, or severe anemia. (The blood supply to the uterine artery is increased during pregnancy.);
- It can increase the surgery time past that of a regular cesarean section, especially if more than one myoma is being removed;
- It can prolong your stay in the hospital.
Pros
- It can avoid additional surgery if the fibroids are easily accessible;
- It may reduce risks to the baby if the fibroids are obstructing a safe delivery;
- It can help prevent complications in future pregnancies, such as anemia, infertility, pain, and abnormal uterine bleeding.
What Can Be Done About Uterine Fibroids Besides Surgery?
If you have been diagnosed with uterine fibroids and your doctor has recommended myomectomy surgery, please contact the Atlanta Fibroid Center and speak to one of our knowledgeable professionals today. There is another option for fibroid treatment that does not require any surgery or removing or compromising your uterus in any way.
Uterine fibroid embolization (UFE) is a procedure that is done in our comfortable outpatient center and takes less than an hour. When performed by a specially trained interventional radiologist with several years of experience and numerous successful UFE procedures, it is low-risk but highly effective. Unlike a myomectomy, the procedure can treat all types of fibroids no matter where they are located.
The procedure uses tiny particles to block the fibroid’s blood supply, which causes them to shrink and die. As they reduce in size, the symptoms they cause are neutralized, which can significantly improve your quality of life. It takes most women between 5 and 7 days to recover, and while some report a few painful days, Dr. Lipman will prescribe some medication to help ease your discomfort during this time. Compared to a myomectomy, the UFE procedure and recovery are less painful, easier, and shorter. Another huge benefit of UFE is that the treated fibroids will never grow back, which is not true after a myomectomy.
Set up a consultation today to find out more about how UFE works and how the Atlanta Fibroid Center can help you become fibroid-free.
