Category: Gynecology · Uterine fibroids & gynecologic surgery
18 cm Uterine Fibroid and Surgery Alone With No One to Stay: How to Prepare, What to Pack, Post-op Medicines, the Injection Question and Travelling Home Upcountry
AI Overview / Quick Answer (BLUF)
Solo fibroid surgery can be safe when four things work together: planning ahead, telling the ward you are alone, nurse support for walking and basic care, and correcting anemia before surgery. After discharge, know the red flags: fever 38°C or higher, soaking a pad hourly, or breathlessness.
preparing for myomectomy for a very large uterine fibroid
when you have to go to hospital alone — a solo-patient plan, what to pack, post-op medicines, the “injection” question and travelling home to the provinces.
If a fibroid presses on your bowel or you are afraid of surgery, read
Fibroid pressing on the bowel: coping with fear of surgery;
if you also have a chocolate cyst or were offered a hysterectomy, read
Chocolate cyst + fibroid: alternatives to hysterectomy ·
Red flags ·
What to pack ·
The injection question
A real reader question: age 25, an 18 cm fibroid, surgery in Bangkok next month — and no one to stay with her
Direct answer: surgery alone is possible with planning — ward nurses cover basic care, but you need to prepare the rest yourself:
tell the hospital you are coming alone, correct anemia before surgery, plan the trip home or a stay near the hospital, and know the post-op red flags.
A 25-year-old reader in a fibroid and ovarian cyst support group shared that she has an 18 cm uterine fibroid and surgery booked next month at a Bangkok hospital.
She lives upcountry and has no one who can stay with her or care for her after the operation. She asked whether she can manage alone, what to prepare and pack,
how to look after herself afterwards, what medicines she will need, and whether everyone has to get a “contraceptive injection”.
(3) what to pack (4) medicines and recovery after surgery (5) the confusing “injection” question (6) travelling home upcountry.
Red flags — before and after surgery, what not to wait on
Direct answer: after surgery, sudden breathlessness, chest pain, fainting, or vaginal bleeding soaking 1 pad or more per hour for 2 hours in a row means call 1669 in Thailand (or your local emergency number) or go to the emergency room now. Fever of 38°C or higher, a red, hot or pus-draining wound, or a painful swollen calf means contact the hospital or get checked the same day.
Call 1669 or go to the emergency room now
- Sudden breathlessness, or chest pain when breathing in — possible blood clot in the lung (pulmonary embolism)
- Chest tightness, coughing up blood, or an unusually fast heartbeat with breathlessness
- Fainting or near-fainting, pale cold skin — possible internal bleeding
- Vaginal bleeding soaking 1 pad or more per hour for 2 hours in a row, or large clots
- Abdominal pain that keeps getting worse despite the pain medicine you were given, or a rigid, board-like abdomen
Contact the hospital or get checked the same day
- Fever of 38°C or higher, or shaking chills
- Wound that is increasingly red, hot or swollen, draining pus or foul fluid, or opening up
- A swollen, painful, warm calf or leg on one side — possible deep vein thrombosis
- Persistent vomiting; unable to eat or drink
- Increasing bloating with no gas and no bowel movement for several days
- Unable to pass urine, severe burning, or very little urine
- Foul-smelling vaginal discharge with pelvic pain or fever
While waiting for surgery: tell your doctor before the appointment
- Periods so heavy that you feel faint, have palpitations or get breathless easily — possible severe anemia
- Sudden severe pelvic pain with fever or vomiting
- Unable to urinate, constipation with no bowel movement for days, or one swollen leg — a large fibroid can press on the bladder, bowel or veins
1. Can you manage surgery alone? Yes, with planning — but it is not “100% easy”
Direct answer: many patients have surgery with no relative staying — nurses and nurse aides help with the call bell, getting out of bed, the first walk and hygiene,
but they are not at your bedside one-to-one all the time. The hardest part is usually not the ward but the first days after discharge and the long trip home.
On the ward: who helps with what
- Nurses: pain medicine, wound checks, vital signs, IV line and urinary catheter care
- Nurse aides: help you get up, walk, go to the toilet, wash, and change pads
- You can always press the call bell — keep your phone, water and glasses within reach before you sleep
- What you must handle yourself: valuables, paperwork, buying extra supplies and contacting people outside
Tell the hospital when you book that you are coming alone
- Tell admissions and the ward when surgery is booked so they can plan your care and discharge in advance
- Ask about the hospital policy on who takes you home after anesthesia — some require an escort, others allow a taxi once the anesthetic has worn off
- Adult patients can usually sign their own surgical consent; ask whether a witness is needed and give a remote emergency contact, such as a relative or friend who will reliably answer the phone
Plan your discharge day
- Book a taxi or pick-up in advance; do not walk to public transport on discharge day
- One option is to stay a few days in budget accommodation near the hospital instead of travelling far straight away, until the first wound check (often around 1–2 weeks)
- Stock ready-to-eat food and water, and set up food and grocery delivery apps so you rarely need to go out at first
- Know the name and number of the hospital nearest your home upcountry in case symptoms appear after you return
Solo-patient plan (checklist before surgery day)
- Tell the ward you are alone + ask about the discharge escort policy
- Name 1–2 emergency contacts and save their numbers on your phone and on paper
- Get a blood test for anemia and start iron as prescribed
- Ask whether you need GnRH agonist injections before surgery
- Book your discharge ride + accommodation near the hospital if you will wait for the wound check
- Pack using the checklist table below
- Photograph your appointment card, discharge summary and medicine list on your phone
- Write down the red flags, the ward phone number and 1669, and keep them with you
2. Preparing your body for an 18 cm fibroid — blood, iron and the pre-op injection
Direct answer: an 18 cm fibroid is very large, and the single most important thing before surgery is your blood count — if you are anemic, correct it with iron first.
Some surgeons may offer GnRH agonist injections for about 3 months to shrink the fibroid and raise hemoglobin; this is not a contraceptive, and not everyone needs it.
Average reduction in uterine volume after pre-op GnRH agonist (Cochrane 2017)
Average rise in pre-operative hemoglobin versus no treatment
Chance of an occult uterine sarcoma at surgery for presumed benign fibroids
Sources: Lethaby 2017;
Pritts 2015 — study averages, not personal figures
Anemia and iron — the first thing to ask about
- Fibroids often cause heavy periods and iron-deficiency anemia, and removing a large fibroid can involve significant blood loss
- Ask for a complete blood count (CBC) and iron stores (ferritin) now, not the day before surgery
- Oral iron such as ferrous sulfate takes several weeks to raise hemoglobin — if time is short or you cannot tolerate it, your doctor may give intravenous (IV) iron
- An international consensus statement recommends detecting and treating anemia and iron deficiency before major surgery with expected blood loss (Muñoz 2017)
The pre-op GnRH agonist injection — the “jab” people often mention
- GnRH agonists (such as leuprorelin, goserelin, triptorelin) are given every 1 or 3 months and temporarily shut down ovarian estrogen so periods stop — they are hormone suppressants, not contraceptives
- A Cochrane review (38 trials, 3,623 women) found that compared with no treatment, uterine volume fell by about 175 mL on average and pre-op hemoglobin rose by about 0.88 g/dL; at hysterectomy they reduced transfusions (OR 0.54), and at myomectomy blood loss was about 22–157 mL lower, with no clear difference in transfusions (Lethaby 2017)
- The common side effects are menopause-like symptoms, especially hot flushes (OR 7.68); they are used short-term because long use thins bone
- Used only in selected patients, for example a very large fibroid the surgeon wants to shrink, or anemia that needs periods stopped to recover — the downside is that small fibroids may shrink and be missed, possibly increasing recurrence (Fauconnier 2000)
Questions to discuss with your surgeon before signing consent
- Approach: at this size an open abdominal myomectomy is typical; some centres can do it laparoscopically or robotically in selected cases — ask where and how long the incision will be
- Blood loss and transfusion: ask for blood grouping and cross-match, and which bleeding-reduction methods will be used, such as tranexamic acid (about 224 mL less blood loss during surgery on average, Baradwan 2022), vasopressin injected into the uterine muscle (fewer transfusions, OR 0.15) or a temporary tourniquet around the cervix (Kongnyuy 2014)
- Chance of an emergency hysterectomy: rare, but discuss it in advance and tell your surgeon clearly that you want to keep your uterus, so every option is tried before removing it
- Occult uterine sarcoma (leiomyosarcoma): very rare — about 1 in 2,000 across all studies and about 1 in 8,300 in prospective studies (Pritts 2015) — which is why uncontained power morcellation is avoided or done inside a closed bag, and tissue is always sent to pathology (NCI — uterine sarcoma)
- Ask after surgery: how deep the incisions were and whether the uterine cavity was entered — this affects how long to wait before pregnancy and how you should deliver in future
Timeline: from 3 months of preparation to 6 months after surgery
Direct answer: large-fibroid surgery is roughly a 9-month process — building up your blood beforehand, a few days in hospital, 4–6 weeks of recovery, and waiting for the uterine scar to heal before pregnancy.
3. Treatment options for an 18 cm fibroid in a 25-year-old who wants to keep her uterus
Direct answer: for a fibroid this size in someone who still wants children, the main option is open abdominal myomectomy;
some centres can operate laparoscopically in selected cases. Hysterectomy is not the first choice at 25, and uterine artery embolization is limited for very large fibroids and for women who want to conceive
(ACOG 2021).
Table: treatment options for an 18 cm uterine fibroid
For education — generic/class names only. The actual choice must be made with your operating gynecologist.
| Option | Advantages | Limitations / cautions | Fit for this case? |
|---|---|---|---|
| Open abdominal myomectomy | Keeps the uterus; removes the large fibroid and palpable small ones; the uterine wall can be repaired in several layers | Longer incision, more pain, hospital stay about 2–4 days, recovery 4–6 weeks, transfusion possible | Usually the main option for an 18 cm fibroid when fertility matters |
| Laparoscopic or robotic myomectomy | Less pain, less post-op fever (OR 0.44), shorter stay; recurrence no different from open surgery (Cochrane 2014) | Technically hard with very large fibroids; tissue must be removed in a contained bag; may convert to open surgery | Only in experienced centres and in cases the surgeon has selected |
| GnRH agonist for ~3 months, then surgery | Smaller fibroid, higher hemoglobin (+0.88 g/dL); may make surgery easier or the incision shorter | Hot flushes, longer wait for surgery, small fibroids may be missed, regrowth after stopping | Selected patients, such as anemia or a very large fibroid — not everyone |
| Hysterectomy | No recurrence; heavy periods end permanently | No future pregnancy; also major surgery | Not a first choice at 25 when wanting children — used in an emergency or if the patient chooses it |
| Uterine artery embolization (UAE) or other non-surgical options | No surgical incision, short stay, fewer transfusions | Repeat procedure within 2 years in about 15–32% versus about 7% after surgery; fertility outcomes may be worse than myomectomy (very low-quality evidence) (Cochrane 2014) | Limited for an 18 cm fibroid and for women wanting pregnancy |
Triage your pelvic symptoms while you wait for surgery
Heavy periods, pelvic pain, a growing abdomen, or frequent or difficult urination from pressure — how urgent is it?
Analyze your severity level and receive personalized guidance from our Advisory team.
This score grades pelvic symptoms; it does not diagnose disease or replace your pre- or post-operative check-ups — for emergencies, use the red-flag section above.
4. What to pack for hospital when you are going alone
Direct answer: focus on three groups — documents and money (ID card, treatment-rights papers, medicine list), things that keep you independent
(a 2–3 m charging cable, power bank, bottle with a straw) and clothes that do not press on the wound (front-opening tops, high-waisted underwear, sanitary pads) — no need to overpack.
Table: packing checklist for a patient with no one to stay
No product brands — choose whatever is convenient for you
| Item | Why it matters when you are alone | Tip |
|---|---|---|
| ID card + treatment-rights / referral documents + insurance | No one can run home to fetch paperwork for you | Keep them in one waterproof folder and photograph them on your phone |
| Current medicine list, allergies, previous blood and ultrasound results | You can answer staff questions even while drowsy from medication | Write it on one sheet and keep it in your bag |
| Cash and cards | Taxi fares, food and extra supplies | Carry a moderate amount; use the hospital’s valuables system |
| Phone + 2–3 m charging cable + power bank | Sockets are often far from the bed, and getting up is hard at first | Fully charge the power bank before going to theatre |
| Loose front-opening clothes | No lifting arms overhead or straining the abdomen | Wear them on discharge day and for the journey |
| Loose high-waisted underwear | The waistband sits above the incision instead of rubbing it | Pack 4–5 pairs of breathable cotton |
| Sanitary pads | Light vaginal bleeding after surgery is common | Day and night types; they also help you judge how much you bleed |
| Tissues and wet wipes | Freshen up yourself while showering is still awkward | Small packs kept beside the bed |
| Water bottle with a straw + lip balm | Drink without sitting fully upright; lips dry out from fasting and anesthesia | Start sipping only when the nurse says you may |
| Flat, non-slip, slip-on shoes | Walk on your own without bending to tie laces; fewer falls | Rubber non-slip sole, no heel |
| Eye mask and earplugs | Wards are noisy and lit all night; sleep helps recovery | Small items that make a big difference |
| Small pillow | Hug it against the wound when coughing, sneezing or sitting up, and use it as a cushion under the seatbelt when travelling | Useful in the vehicle and at your accommodation |
| Abdominal binder | Some people find it supports the wound when walking | Use it only if your surgeon approves |
| Long-handled grabber (optional) | Pick things up from the floor without bending | Handy when recovering alone at your accommodation or home |
Adult diapers are generally not needed — at first you usually have a urinary catheter, and after it is removed sanitary pads are enough. There is no need to buy expensive equipment.
5. After surgery: usual medicines, wound care and the recovery timeline
Direct answer: after open abdominal surgery most people stay about 2–4 days, walk from day 0–1, and avoid lifting more than about 5 kg and strenuous exercise for about 4–6 weeks.
The main medicines are pain relief, anti-nausea medicine, a laxative, and iron if you are anemic — antibiotics are usually a single dose around the time of surgery; a course at home is not routine.
Table: recovery timeline and medicines after open myomectomy
Approximate timings — everyone differs; follow your surgeon’s instructions
| Period | What to expect | Medicines and care | What to avoid |
|---|---|---|---|
| Day of surgery (day 0) | Wound pain, drowsiness from anesthesia, IV line and urinary catheter | Scheduled pain relief, anti-nausea medicine, a single antibiotic dose around surgery; sit up or stand by the bed when the nurse says so | Getting up alone for the first time without pressing the call bell |
| Day 1–3 (in hospital) | Catheter usually out within about 24 hours; eating again; walking on the ward; light vaginal bleeding is possible | Paracetamol ± an NSAID such as ibuprofen if suitable ± a short opioid course; laxative; compression stockings; some receive LMWH injections such as enoxaparin | Lying still all day; suppressing coughs (hug a pillow against the wound and cough) |
| Week 1–2 (accommodation or home) | Pain gradually eases; tiring easily; first wound check often at about 1–2 weeks | Pain relief as needed, iron if anemic, laxative while on opioids; several short walks a day | Driving (about 2 weeks or while on opioids), heavy lifting, baths or swimming until the wound heals |
| Week 3–6 | Back to desk work at about 3–4 weeks, physical work at about 6 weeks | Increase activity step by step; repeat blood count if anemic | Lifting more than about 5 kg and strenuous exercise until about 4–6 weeks; sex until your surgeon says it is fine |
| 3–6 months | The uterine scar is healing and remodelling; periods are often lighter if the fibroid was the cause | Reliable contraception for the interval your surgeon advises; follow up pathology and ultrasound | Becoming pregnant before your surgeon gives the go-ahead |
Medicines commonly given after surgery (generic names)
- Pain relief: paracetamol as the base, plus an NSAID such as ibuprofen if there is no contraindication (kidney disease, stomach ulcer), and a short course of an opioid for severe pain
- Anti-nausea medicine: in the first period after anesthesia or while taking opioids
- Laxative or stool softener: prevents constipation from painkillers and straining that hurts the wound
- Iron: continued if you have anemia, guided by blood tests
- Antibiotics: generally a single dose before or around the time of surgery to prevent wound infection — a course of antibiotics at home is not routine unless your surgeon prescribes one for a specific reason (ACOG 2018)
- Blood-clot prevention injections: besides early walking and compression stockings, some patients after major open pelvic surgery receive under-the-skin LMWH injections such as enoxaparin, as decided by the surgeon — ACCP guidance recommends LMWH for patients at high clot risk (about 6% without prevention) who are not at high bleeding risk (Gould 2012). This is another “injection” patients may get
Looking after the wound yourself
- Follow your surgeon’s instructions — most people can shower after 24–48 hours with a waterproof dressing, then pat dry
- Check the wound daily with a mirror or compare photos: increasing redness, heat, swelling, pus or opening = contact the hospital
- Light vaginal bleeding or blood-stained discharge can last days to weeks; use pads, not tampons
Enhanced recovery after surgery (ERAS) principles
The ERAS Society gynecologic guideline (Nelson 2019)
emphasizes early eating after surgery, early walking, early catheter removal and multimodal pain control to reduce opioid use — for a patient on her own, these principles help you get back to self-care sooner.
6. Does everyone need a “contraceptive injection” or hormone shot? No — and four things often get mixed up
Direct answer: not everyone. In fibroid patient groups, “the injection” usually refers to different things —
a pre-op GnRH agonist injection (selected patients), hormone suppression after surgery (not routine), contraception while the uterine scar heals (any reliable method), and blood-clot prevention injections (some patients).
- Pre-op injection (GnRH agonist): temporarily suppresses estrogen to shrink the fibroid and build up blood — used in selected patients, not a contraceptive
- Hormones after surgery: after a complete myomectomy, ongoing hormone suppression is not routine; it may be considered if you also have endometriosis or adenomyosis
- Contraception after surgery: many surgeons advise avoiding pregnancy for about 3–6 months (depending on incision depth and whether the cavity was entered) so the uterine scar can heal — use any reliable method, such as the pill, an IUD, an implant, condoms or an injection; it does not have to be an injection
- Blood-clot prevention injections (LMWH): some patients get these after major pelvic surgery — they are anticoagulants and have nothing to do with hormones
How long should you wait before trying to conceive?
A systematic review found insufficient data to set a clear minimum interval. Among 1,016 women with data, about one-third were advised to wait 3–6 months
and another third 6–12 months (Margueritte 2021) — ask your surgeon, who knows how deep your incisions were.
Pregnancy after myomectomy: uterine rupture and mode of delivery
- Uterine rupture is under 1%: about 0.6% of pregnancies after myomectomy (11 of 1,825) and 0.47% in women who tried labor, mostly occurring before labor began (Gambacorti-Passerini 2016)
- If the incision was deep or entered the uterine cavity, a cesarean may be advised — keep your operation summary for your future obstetrician
- Fibroids can grow back over the years: about 10% have symptoms again within 5 years after open myomectomy (Fauconnier 2000), and in women with a large uterus 12% needed repeat surgery, on average 7.9 years later (Kramer 2021)
7. Travelling home upcountry safely after surgery
Direct answer: a long bus or van ride home is fine once your doctor discharges you, but major surgery within the past month puts you in the highest-risk group for travel-related blood clots,
so get up and walk every 1–2 hours, move your calves often, and ask your doctor about well-fitted below-knee compression stockings for journeys over 3 hours (Watson 2011).
- Do not drive yourself for about 2 weeks, or for as long as you are taking opioid painkillers
- An option many people use: stay near the hospital until the first wound check, then make the long trip — it avoids having to come back to Bangkok
- Bus or van: choose an aisle seat near the toilet, get up at every stop or every 1–2 hours, and flex your ankles and tighten your calves while seated
- Drink a reasonable amount of water — harmless and helpful for constipation, though evidence that it directly prevents clots is weak
- Place a small pillow between the wound and the seatbelt, and hug it over bumps
- Keep your discharge summary, all medicines, appointment card and the ward phone number in your carry-on bag, not in the luggage hold
- Travel-related clots can occur up to about 8 weeks after a journey — if a calf swells and hurts or you become breathless after arriving, go to your local hospital straight away
Frequently asked questions (FAQ)
Can I have fibroid surgery alone with no family to stay with me?
Yes, with planning. Nurses and nurse aides help with the call bell, getting up, walking and hygiene, but they are not at your bedside all the time. Tell the ward when you book that you are coming alone, ask about the hospital policy on who takes you home after anesthesia and on an emergency contact, ask to see the hospital social worker if needed, and book your ride or a room near the hospital in advance.
How should I prepare for surgery on an 18 cm fibroid?
The most important step is a blood test for anemia and correcting it with oral or intravenous iron, because a fibroid this large can bleed a lot. Ask your surgeon about having blood cross-matched, about drugs that reduce bleeding during surgery such as tranexamic acid or vasopressin, and whether you need GnRH agonist injections for about 3 months beforehand to shrink the fibroid.
Is the injection people talk about before surgery a contraceptive?
No. It usually means a GnRH agonist injection such as leuprorelin, goserelin or triptorelin, which temporarily switches off estrogen. A Cochrane review found it reduced uterine volume by about 175 mL on average and raised pre-operative hemoglobin by about 0.88 g/dL, but caused more hot flushes. It is used only in selected patients; not everyone needs it.
What medicines will I take after surgery, and do I need antibiotics at home?
Common medicines are pain relief such as paracetamol, an NSAID such as ibuprofen if it suits you, and a short course of an opioid, plus an anti-nausea drug, a laxative or stool softener, and iron if you are anemic. Antibiotics are usually given as a single dose around the time of surgery. A course of antibiotics at home is not routine unless your surgeon prescribes it.
Does everyone need a contraceptive or hormone injection after surgery?
No. Hormone suppression after a complete myomectomy is not routine; it may be considered if you also have endometriosis or adenomyosis. Contraception is about avoiding pregnancy while the uterine scar heals, which many surgeons advise for about 3 to 6 months, using any reliable method, not necessarily an injection. Some patients also get blood-thinning LMWH injections, which is a separate matter.
How long will I stay in hospital, and when can I go back to work?
After open abdominal surgery most people stay about 2 to 4 days. You start walking on the day of surgery or the next day, and the urinary catheter is usually removed within about 24 hours. Light activity is fine within 2 weeks. Avoid lifting more than about 5 kg and strenuous exercise for about 4 to 6 weeks. Desk work usually resumes in about 3 to 4 weeks and physical work in about 6 weeks.
Can I take a long bus or van ride home upcountry after surgery?
Yes, once your doctor discharges you. Many people stay near the hospital until the first wound check at about 1 to 2 weeks. On the journey, get up and walk every 1 to 2 hours, move your ankles and calves often, drink water, and put a small pillow between the wound and the seatbelt. Carry your discharge summary, medicines and the hospital phone number. Do not drive yourself for about 2 weeks or while taking opioids.
Can I still get pregnant after a myomectomy, and could my uterus rupture?
Most women can. A systematic review found uterine rupture in about 0.6% of pregnancies after myomectomy and 0.47% in women who tried labor. If the incision was deep or entered the uterine cavity, a cesarean may be advised. Fibroids can grow back over the years; about 10% have symptoms again within 5 years after open surgery.
Scientific mechanism
Hormone-driven growth: a fibroid is a benign smooth-muscle tumour whose cells carry abundant estrogen and progesterone receptors.
Estrogen increases progesterone receptors, while progesterone drives cell proliferation and the build-up of a large fibrous extracellular matrix, so fibroids can grow throughout the reproductive years
and usually stop after menopause (Bulun 2013;
Stewart 2015).
Why a GnRH agonist shrinks the fibroid: the drug stimulates pituitary GnRH receptors continuously; after a brief flare, the receptors down-regulate,
LH and FSH fall, the ovaries stop making estrogen, and a temporary hypoestrogenic state follows — the fibroid shrinks and periods stop, allowing hemoglobin to recover.
When the drug stops, hormones return and the fibroid can regrow, so it is a preparation for surgery, not a cure (Lethaby 2017).
Healing of the myometrial scar: after the fibroid is removed, the uterine wall is repaired in layers. The wound goes through inflammation, new tissue formation and a remodelling phase that lasts months.
A deep incision, or one that entered the cavity, must withstand considerable stretch in pregnancy — the reason surgeons advise an interval before conceiving and sometimes recommend cesarean delivery.
Why clots are a risk after pelvic surgery: all three parts of Virchow’s triad are present — slow blood flow in pelvic and leg veins from immobility
(and, before surgery, a large fibroid pressing on veins), vessel-wall injury from the operation, and a post-operative hypercoagulable state. Long sitting on a bus adds venous pooling in the legs.
Walking and calf contractions use the “calf-muscle pump” to push blood back to the heart, which is the basic prevention; LMWH injections are for higher-risk patients (Gould 2012).
Summarized and reviewed by Asst. Prof. Dr. Norawit Raatpiboon
Academic citations (E-E-A-T)
- Lethaby A, Puscasiu L, Vollenhoven B. Preoperative medical therapy before surgery for uterine fibroids. Cochrane Database Syst Rev 2017 (PMID 29139105)
- Nelson G et al. Guidelines for perioperative care in gynecologic/oncology: ERAS Society recommendations — 2019 update. Int J Gynecol Cancer 2019 (PMID 30877144)
- Bulun SE. Uterine fibroids. N Engl J Med 2013 (PMID 24088094)
- Stewart EA. Clinical practice. Uterine fibroids. N Engl J Med 2015 (PMID 25901428)
- ACOG. Management of Symptomatic Uterine Leiomyomas: Practice Bulletin No. 228. Obstet Gynecol 2021 (PMID 34011888)
- Bhave Chittawar P et al. Minimally invasive surgical techniques versus open myomectomy for uterine fibroids. Cochrane Database Syst Rev 2014 (PMID 25331441)
- Gupta JK et al. Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database Syst Rev 2014 (PMID 25541260)
- Kongnyuy EJ, Wiysonge CS. Interventions to reduce haemorrhage during myomectomy for fibroids. Cochrane Database Syst Rev 2014 (PMID 25125317)
- Baradwan S et al. Prophylactic tranexamic acid during myomectomy: a systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol 2022 (PMID 35839714)
- Pritts EA et al. The prevalence of occult leiomyosarcoma at surgery for presumed uterine fibroids: a meta-analysis. Gynecol Surg 2015 (PMID 26283890)
- Gambacorti-Passerini Z et al. Trial of labor after myomectomy and uterine rupture: a systematic review. Acta Obstet Gynecol Scand 2016 (PMID 27154306)
- Margueritte F et al. Time to conceive after myomectomy: should we advise a minimum time interval? A systematic review. Reprod Biomed Online 2021 (PMID 34353724)
- Fauconnier A et al. Recurrence of leiomyomata after myomectomy. Hum Reprod Update 2000 (PMID 11129693)
- Kramer KJ et al. Reoperation rates for recurrence of fibroids after abdominal myomectomy in women with large uterus. PLoS One 2021 (PMID 34882735)
- Gould MK et al. Prevention of VTE in nonorthopedic surgical patients: ACCP Evidence-Based Clinical Practice Guidelines, 9th ed. Chest 2012 (PMID 22315263)
- Watson HG, Baglin TP. Guidelines on travel-related venous thrombosis. Br J Haematol 2011 (PMID 21083651)
- Muñoz M et al. International consensus statement on the peri-operative management of anaemia and iron deficiency. Anaesthesia 2017 (PMID 27996086)
- ACOG Practice Bulletin No. 195: Prevention of Infection After Gynecologic Procedures. Obstet Gynecol 2018 (PMID 29794678)
- MedlinePlus (NIH) — Uterine fibroids · Uterine artery embolization · Deep vein thrombosis · NCI — Uterine sarcoma
Medical disclaimer
This article provides general education about preparing for fibroid surgery, post-operative care and travelling home.
It is not a diagnosis, a prescription, or personal surgical advice — medicines, doses, recovery times and the interval before pregnancy must follow the surgeon who treats you directly.
Figures come from population studies. In an emergency, call 1669 in Thailand or your local emergency number, or go to the emergency room now.