How Fast Do You Recover After Fibroid Surgery?
According to John Hopkins Medicine, between 20% and 50% of women in their childbearing years have fibroids and approximately 77% of women will experience them at some time during their lives. Many of these fibroids go undiagnosed because they do not cause any symptoms however, there are many women who suffer painful symptoms that interrupt their lives.
When women seek treatment to relieve fibroid symptoms, they are most often given one of two surgical treatment options; a myomectomy or a hysterectomy. Every year in the United States 65,000 myomectomies are performed along with 600,000 hysterectomies. We have previously written about these procedures and the different techniques used, today we are going to look at the recovery time from fibroid surgery and what you can expect from each surgical procedure.
A myomectomy is a surgery that is done to remove fibroids one by one and is performed by an OB/GYN. There are a variety of techniques used to perform a myomectomy but they all can leave the uterus weak and compromised. It is almost always mandatory for a woman who becomes pregnant after a myomectomy to have a C-section. Some women experience uterine scarring which affects their fertility and many experience fibroid recurrence.
Myomectomy Fibroid Surgery Recovery
1. Open Myomectomy
Known also as an abdominal myomectomy, an open myomectomy requires an incision that is made above the pubic bone called a bikini cut. The fibroids are cut out by the surgeon and removed from the uterus and then the uterus is repaired and sewn together with several layers of sutures.
Many women experience the loss of blood during an open myomectomy and require a blood transfusion. Some “bank” their blood in advance for use if this occurs. Most patients need to spend at least two nights in the hospital before they are discharged to go home.
During a patient’s myomectomy fibroid surgery recovery time, their activities will be limited to ensure the incision and surgery site heal properly. Most patients need pain medication for a few weeks to help their discomfort. Patients also report feelings of “tightness” or “pulling” near their incision site for several weeks.
Changes in bowel movements are normal and using fiber supplements is recommended to help avoid constipation and straining. Baths and being submerged in water should be avoided for several weeks until the doctor gives the “all clear”.
Normally, patients must take off work for at least 2–4 weeks, and more if their job is labor intensive. They cannot lift anything heavier than a gallon of milk for 4-6 weeks so getting help with children, pets, and housework is recommended.
Patients should not engage in any strenuous activity until they are told by the surgeon that it is okay. Typically, abdominal myomectomy fibroid surgery recovery takes about 6 to 8 weeks.
2. Laparoscopic Myomectomy
The recovery from fibroid removal performed through a laparoscopic myomectomy is normally 4-6 weeks. Using this myomectomy procedure, the surgeon makes a series of small abdominal incisions and removes the fibroids using a laparoscope. The laparoscope is a small surgical instrument that has a special camera attached so the surgeon can view the procedure in real-time using a video monitor.
Depending on how many fibroids were removed, where they were located, and how long the surgery lasted, patients may be discharged to go home or they may need to stay in the hospital a night or two.
Patients are usually released with a prescription for pain medication to help ease their discomfort and aftercare directions including wound care and activity restrictions.
Abdominal pain, cramping, and swelling are normal after undergoing a laparoscopic myomectomy and many patients experience changes in bowel movements for a few days. Shoulder or back pain is also normal and is a side effect of the gas that is used during the surgery to open up the abdominal cavity.
It is also normal to experience a brown or red-brown vaginal discharge and some bleeding and spotting for several weeks after the surgery. The first few menstrual periods after surgery may be irregular, heavy, and more painful than normal.
Laparoscopic myomectomy fibroid surgery recovery time is much shorter than after an open myomectomy and is normally about 4 to 6 weeks.
3. Hysteroscopic Myomectomy
Only certain types of submucosal fibroids can be removed through a hysteroscopic myomectomy. They must be small enough and located inside the cavity of the uterus. If other fibroids are present within the wall of the uterus, these cannot be removed with this hysteroscopic approach and will be left behind. With this surgery, there are no abdominal incisions, and the procedure is done through the vagina using a special tool called a hysteroscope. The fibroids are removed with an electric-charged loop-type tool.
Recovery from hysteroscopic myomectomy fibroid surgery usually takes less than a week and normally does not cause a lot of postoperative pain. Most patients can return home a few hours after the procedure unless rare complications arise.
Patients may experience mild cramping after the procedure but this can normally be controlled with over-the-counter pain medications like acetaminophen. General fatigue for a few days is normal and some patients have side effects from the general anesthesia used during the surgery.
Most patients experience a small amount of vaginal bleeding for up to six weeks after the procedure. Most patients can return to work after a few days and should be fully recovered in a few weeks.
Hysterectomy Fibroid Surgery Recovery
When a woman undergoes a hysterectomy, the surgeon removes her uterus. Like myomectomies, there are different techniques for hysterectomy. A hysterectomy is done using general anesthesia and usually requires a stay in the hospital.
During a hysterectomy, part of the uterus may be removed, or the whole uterus as well as the ovaries, cervix, and fallopian tubes. A woman cannot become pregnant after having a hysterectomy and if she is pre-menopausal, surgery can increase her risk of heart disease, stroke, and other health-related issues.
1. Abdominal Hysterectomy
The recovery time for fibroid removal is the longest when an abdominal hysterectomy is performed. Most doctors use this technique unless special circumstances make it necessary.
During an abdominal hysterectomy, a 5-7 inch incision is made above the pubic bone (in the same location as a c-section scar). For women with a very enlarged uterus, an even longer vertical incision may be needed, extending from above the pubic bone to the area of the belly button. The uterus will be removed, and sometimes other reproductive organs as well. Most women must remain in the hospital for three to four days before being released to recover at home.
Most patients need prescription pain medication and are fatigued for a few weeks after an abdominal hysterectomy. Many normal household tasks must be avoided and lifting is restricted. If you have small children you will need help for several weeks. The doctor will encourage some walking but no strenuous activity for several weeks. Full recovery normally takes six to eight weeks.
2. Laparoscopic Hysterectomy
Using a laparoscope to perform a hysterectomy makes recovery from fibroid removal a bit easier and also lowers the risk of complications. This technique requires a surgeon with specific training and may not be possible if the uterus and/or fibroids are particularly large. The surgeon makes four to five small incisions on the abdomen and the surgical tools are inserted through these incisions to remove the uterus. The laparoscopy is usually inserted through the belly button and has a light and a camera so it helps guide the surgeon during the procedure.
Most patients require pain medication for about a week after a laparoscopic hysterectomy and feel severely fatigued for several days. During the procedure, gas is pumped into the abdomen to help give the surgeon room to work and increased visibility. Some of this gas gets trapped and has to work its way out during the patient’s recovery and can cause back or shoulder pain for a few days. This gas can also cause the stomach to appear bloated for several weeks after the surgery.
The surgeon will provide post-operative instructions on how to take care of your incision sites when you can bathe, return to work, avoid lifting, and when you can resume your normal activities. Usually, it takes about four to six weeks to recover from laparoscopic hysterectomy surgery.
3. Vaginal Hysterectomy
Recovering from a vaginal hysterectomy does not take as long as the other forms of hysterectomy because there are no incisions made in the abdomen. The uterus is removed through the vagina after the surgeon detaches it from the other reproductive organs and the supporting connective tissues.
Patients sometimes spend a night in the hospital or they may be released the same day depending on the circumstances. The doctor will prescribe pain medication that can be taken for the first few days to help with discomfort. Patients are encouraged to get a lot of rest and not to lift anything heavy. Vaginal blood and discharge are normal for a few weeks and normal activities can be resumed after about six weeks.
Vaginal hysterectomies are not always possible and factors such as the size and location of fibroids may require a different technique.
Non-Surgical Fibroid Removal Recovery
Uterine Fibroid Embolization (UFE)
The shortest and easiest recovery from fibroid removal is associated with uterine fibroid embolization (UFE) which is a procedure that can remove all fibroids without surgery. The uterus is not compromised or removed and patients can still become pregnant after UFE. There are no incisions or stitches and patients return home to recover the same day as the procedure with just a band-aid.
The first few hours of uterine fibroid embolization recovery are the most uncomfortable for most patients. Cramping, nausea, and mild to moderate pain can be controlled with over-the-counter medications but often only last a few days. Some women also experience a mild fever but it is no reason for concern.
Patients will be fatigued and need to take it easy for about a week with the exception of taking a short walk each day. Many patients return to work after only a few days. Normally after a week patients are feeling much better, and typically between 8 days and two weeks into their uterine fibroid embolization recovery, they can resume all their normal activities.
If you have been diagnosed with uterine fibroids and want to learn more about eliminating your fibroids without losing your uterus or experiencing a long fibroid removal surgery recovery time, contact The Atlanta Fibroid Center today. John Lipman, MD, FSIR is one of the Nation’s leading experts on the UFE procedure and has helped thousands of women become fibroid free and improve their quality of life. Set up an appointment today to learn more about UFE and how it might help you!