Preserving Fertility and Relieving Symptoms: Myomectomy in Korea

Uterine fibroids (leiomyomas) are non-cancerous growths that develop in the uterus, affecting a significant number of women, especially during their reproductive years. While often asymptomatic, fibroids can cause debilitating symptoms like heavy menstrual bleeding, pelvic pain, pressure on surrounding organs, and even impact fertility. For women who wish to alleviate these symptoms while preserving their uterus and potential for future pregnancy, myomectomy is the preferred surgical solution.

South Korea, a global leader in advanced medical care, offers state-of-the-art myomectomy procedures performed by highly skilled gynecological surgeons, often utilizing minimally invasive techniques for faster recovery and better outcomes.



What is a Myomectomy?

A myomectomy is a surgical procedure specifically designed to remove uterine fibroids while leaving the uterus intact. This is a crucial distinction from a hysterectomy, which involves the complete removal of the uterus and is a permanent solution for fibroids but ends a woman's ability to carry a pregnancy.

Why is Myomectomy Performed?

Myomectomy is typically recommended for women experiencing symptomatic fibroids, particularly those who:

• Suffer from severe symptoms: Such as excessively heavy or prolonged menstrual bleeding leading to anemia, chronic pelvic pain or pressure, frequent urination, constipation, or painful intercourse.
• Wish to preserve their fertility: Fibroids can interfere with conception, cause recurrent miscarriages, or lead to complications during pregnancy. Removing them can improve chances of successful pregnancy.
• Have large or rapidly growing fibroids: Even if not immediately symptomatic, large fibroids can cause pressure or concern.
• Are seeking an alternative to hysterectomy: For women who do not want to remove their uterus.

Types of Myomectomy Procedures in Korea

Korean gynecological surgeons are adept at performing various types of myomectomy, selecting the most appropriate method based on the fibroid's size, number, and location (e.g., within the uterine wall, on the outer surface, or within the uterine cavity). The emphasis is often on minimally invasive approaches for improved patient outcomes.

1. Hysteroscopic Myomectomy:

• Best for: Submucosal fibroids (those that bulge into the uterine cavity).
• How it works: A thin, lighted telescope (hysteroscope) is inserted through the vagina and cervix into the uterus. No external incisions are made. Surgical instruments are passed through the hysteroscope to shave off or remove the fibroids.
• Benefits: Outpatient procedure (no hospital stay), shortest recovery time, no external scars.
• Recovery: Typically a few days to 1 week.

1. Laparoscopic Myomectomy (Minimally Invasive Surgery - MIS):

• Best for: Subserosal (on the outer surface) and intramural (within the uterine wall) fibroids, especially smaller to medium-sized ones or fewer in number.
• How it works: Several small incisions (typically 0.5-1 cm) are made in the abdomen. A laparoscope (a thin tube with a camera) and specialized surgical instruments are inserted. The fibroids are carefully cut out of the uterus, and the uterine muscle wall is precisely repaired with sutures. The fibroids are then removed through one of the small incisions, sometimes by using a morcellator to break them into smaller pieces.
• Benefits: Smaller scars, less pain, shorter hospital stay compared to open surgery, quicker recovery.
• Recovery: Generally 2-3 weeks before resuming normal activities. Hospital stay usually 1-3 days.

1. Robotic-Assisted Myomectomy:

• Best for: Complex cases, including larger or multiple intramural fibroids, or fibroids in challenging locations, where open surgery might have traditionally been necessary.
• How it works: Similar to laparoscopic surgery, small abdominal incisions are made. However, the surgeon controls robotic arms equipped with highly precise instruments and a 3D high-definition camera from a console. The robotic system offers enhanced dexterity, visualization, and precision, allowing for intricate suturing and dissection. Korea is a leader in robotic surgery, with many major university hospitals utilizing Da Vinci robotic systems.
• Benefits: Maximizes the advantages of minimally invasive surgery (small incisions, less pain, quicker recovery) with superior precision, especially for complex uterine repairs, which is critical for preserving future fertility.
• Recovery: Similar to laparoscopic myomectomy, typically 2-3 weeks. Hospital stay usually 1-3 days.

1. Abdominal Myomectomy (Open Myomectomy):

• Best for: Very large fibroids, numerous fibroids, or fibroids in highly complex locations that cannot be safely or effectively removed with minimally invasive techniques.
• How it works: Involves a single, larger incision (typically 4-7 inches) in the lower abdomen (horizontal or vertical, similar to a C-section incision). The surgeon directly visualizes and removes the fibroids.
• Benefits: Allows for manual palpation and removal of all fibroids, especially deep or hard-to-reach ones.
• Recovery: Longer recovery period, typically 4-6 weeks for full return to normal activities. Hospital stay usually 3-5 days.

The Myomectomy Process in Korea

Korean hospitals are known for their efficiency and patient-centered approach, particularly for international patients.

1. Initial Consultation & Diagnosis: You will undergo a comprehensive consultation with a gynecologist. This will include a review of your medical history, physical examination, and advanced imaging such as ultrasound and/or MRI to accurately map the size, number, and location of your fibroids.
2. Pre-operative Preparation: Once the surgical plan is determined, you'll receive detailed instructions for preparation, including fasting, medication adjustments, and potentially pre-surgical treatments (e.g., GnRH-a therapy to temporarily shrink fibroids). You'll also have consultations with the anesthesiologist.
3. The Surgery: Performed under general anesthesia. The duration varies significantly based on the number and size of fibroids and the surgical approach (e.g., 1-3 hours for laparoscopic/robotic, potentially longer for complex open cases).
4. Hospital Stay: Varies by surgical type (as noted above). Korean hospitals prioritize comfort and efficient recovery.

Recovery and Aftercare

Recovery timelines vary greatly by the surgical method:

• Hysteroscopic: Minimal pain, light spotting, back to normal activities in days.
• Laparoscopic/Robotic: Moderate pain (managed with medication), swelling, and bruising at incision sites. Light activity within a few days. Resume normal activities in 2-3 weeks.
• Abdominal (Open): More significant pain requiring stronger medication. Restricted activities for longer. Full recovery 4-6 weeks.

General Post-Operative Guidelines:

• Pain Management: Follow your doctor's instructions for pain medication.
• Activity: Gradually increase activity. Avoid heavy lifting (over 10 lbs) and strenuous exercise for 4-6 weeks.
• Sexual Activity: Avoid sexual intercourse, tampon use, and douching for at least 6 weeks (or as advised by your surgeon) to allow the uterus to heal completely.
• Driving: Avoid driving for at least 1-2 weeks after minimally invasive surgery, and 3-4 weeks after open surgery.
• Follow-up: Crucial follow-up appointments to monitor healing and discuss future plans, especially for fertility.

Benefits and Risks of Myomectomy

Benefits:

• Uterus Preservation: The primary benefit, allowing for future pregnancies.
• Symptom Relief: Significant reduction or elimination of heavy bleeding, pain, and pressure.
• Improved Fertility: For women whose fibroids were impacting their ability to conceive.
• Avoids Menopause: Unlike hysterectomy with ovary removal, myomectomy does not induce surgical menopause.

Risks:

• General Surgical Risks: Bleeding (potentially requiring blood transfusion), infection, anesthesia complications, injury to nearby organs (rare).
• Scar Tissue (Adhesions): Can form internally, potentially causing pain or affecting fertility, though less common with minimally invasive methods.
• Uterine Rupture: A rare but serious risk in subsequent pregnancies, especially after removal of deep fibroids, due to the uterine wall being surgically altered. Many doctors recommend C-section for future deliveries.
• Fibroid Recurrence: Myomectomy removes existing fibroids but doesn't prevent new ones from growing. The recurrence rate varies (up to 50% within 5-10 years) depending on factors like age, number/size of fibroids removed, and genetics.
• Incomplete Removal: Very small or numerous fibroids might not all be detected or safely removed.
• Possibility of Hysterectomy: In rare cases of uncontrollable bleeding during surgery, a hysterectomy might be necessary.

Fertility After Myomectomy

For many women, myomectomy significantly improves their chances of getting pregnant and carrying to term. Doctors typically recommend waiting 3-6 months after surgery before attempting conception to allow the uterus to fully heal. If you plan to get pregnant, discuss this thoroughly with your surgeon, as they may recommend a C-section for delivery to prevent uterine rupture.

Cost of Myomectomy in Korea

The cost of myomectomy in Korea is generally more affordable than in many Western countries while maintaining high standards of medical care. Prices vary based on the hospital's reputation, the surgeon's expertise, the type of myomectomy performed, and the complexity (size/number of fibroids).

As of July 2025 (approximate ranges for international patients without Korean National Health Insurance):

• Hysteroscopic Myomectomy: ₩3,000,000 to ₩6,000,000 KRW (approximately $2,200 to $4,400 USD).
• Laparoscopic Myomectomy: ₩5,000,000 to ₩10,000,000 KRW (approximately $3,700 to $7,500 USD).
• Robotic-Assisted Myomectomy: ₩12,000,000 to ₩20,000,000 KRW (approximately $9,000 to $15,000 USD).
• Abdominal (Open) Myomectomy: ₩6,000,000 to ₩12,000,000 KRW (approximately $4,400 to $9,000 USD).

These costs generally include the surgeon's fee, anesthesia, and a standard hospital stay. Pre-operative tests (MRI, blood work), consultations, and any extended hospital stays or specific medications would be additional. It's crucial to obtain a detailed, itemized quote directly from your chosen clinic during your consultation.

Finding a Foreigner-Friendly Hospital in Korea

South Korea's medical tourism infrastructure is well-developed, and many large university hospitals in Seoul have dedicated international patient centers to assist foreign visitors.

Recommended Hospitals for Myomectomy in Seoul for Foreigners (with OB/GYN departments known for fibroid treatment):

• Severance Hospital (Yonsei University Health System): Excellent international patient services, highly experienced gynecological department, strong in robotic and laparoscopic surgeries.
• Asan Medical Center: One of the largest and most technologically advanced hospitals in Korea, with a leading OB/GYN department and an established international clinic.
• Samsung Medical Center: Known for its high-quality care and advanced medical equipment, offering comprehensive gynecological services.
• Seoul National University Hospital (SNUH) / SNU Bundang Hospital: Leading academic medical centers with expertise in complex gynecological surgeries.
• Catholic University of Korea Seoul St. Mary's Hospital: Has a dedicated Fibroid Center and is known for its high volume of robotic myomectomies.
• Ewha Womans University Medical Center: A prominent women's hospital with a long history, offering a range of gynecological surgeries.
• CHA University CHA Gangnam Medical Center: Renowned for women's health, particularly fertility, and offers advanced gynecological surgery.

Tips for Foreign Patients:

• International Patient Centers: Always contact the hospital's International Patient Center first. They provide services like appointment scheduling, translation (English, Chinese, Japanese, etc.), billing assistance, and guidance through the entire process.
• Language Support: Confirm the availability of English-speaking doctors within the OB/GYN department.
• Medical Records: Bring all relevant past medical records, imaging (ultrasound, MRI reports), and test results from your home country.
• Insurance: Understand your insurance coverage. If you have Korean National Health Insurance (NHIS), check what portion of the procedure is covered. If you have private international insurance, confirm direct billing options.

A Path to Health and Fertility Preservation

Myomectomy in Korea offers an excellent option for women suffering from fibroids who wish to preserve their uterus and fertility. With its combination of cutting-edge technology, highly skilled surgeons, and patient-focused care, South Korea is a premier destination for this important procedure. A thorough consultation with a trusted gynecologist is the essential first step toward making an informed decision about your health and future.

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