Myomectomy at Apollo Hospitals, Lucknow

Why Patients Choose Apollo Hospitals Lucknow for Myomectomy

• Part of the Apollo Hospitals group, founded in 1983 ? India's first corporate hospital chain, with more than four decades of clinical experience across 70-plus hospitals and a network that has treated patients from over 120 countries.
• Apollo Hospitals Lucknow is a multi-super-speciality tertiary care hospital serving Uttar Pradesh, with a dedicated Obstetrics & Gynaecology department that manages fibroids alongside on-site radiology, blood bank, critical care and anaesthesia support.
• A team of consultant gynaecologists and gynaecological surgeons whose combined clinical experience runs into several decades, supported by minimal-access surgery training. The exact number of consultants available for your case and their individual experience can be confirmed with the OPD desk when you book.
• Full range of myomectomy techniques under one roof ? open (abdominal) myomectomy, laparoscopic myomectomy and hysteroscopic myomectomy for submucosal fibroids ? so the technique is chosen to fit the fibroid, not the other way round.
• Modern imaging and operative technology, including high-resolution ultrasound and MRI for fibroid mapping, high-definition laparoscopy systems, advanced energy devices for haemostasis, and modular operation theatres with HEPA-filtered air.
• Fertility-conscious surgery: for women planning pregnancy, uterine repair technique, layered closure and adhesion-reduction measures are planned with future conception in mind, with access to fertility and high-risk obstetric opinion when needed.
• Integrated peri-operative support ? pre-anaesthetic clinic, anaemia correction before surgery, physiotherapy, dietetics and 24x7 intensive care backup if a patient needs escalation.
• Insurance and TPA desk on site to help with cashless pre-authorisation for major insurers, CGHS/ECHS-type panels where applicable, and documentation for reimbursement claims.
• Practical help for out-of-town patients, including consolidated investigation days and assistance with attendant arrangements for families travelling from districts across central and eastern Uttar Pradesh.

Overview

Myomectomy is a surgical procedure aimed at removing uterine fibroids while preserving the uterus. At Apollo Hospitals Lucknow, we pride ourselves on being one of the best hospitals for myomectomy, offering cutting-edge care and advanced technology to work towards the best possible outcomes for our patients. Our team of highly skilled surgeons and healthcare professionals is dedicated to providing personalised care, making us a trusted choice for women seeking treatment for fibroids. With a reputation for clinical rigour and a commitment to patient trust, Apollo Hospitals Lucknow aims to be your partner in health.

Uterine fibroids (leiomyomas) are among the most common gynaecological conditions in Indian women, frequently detected in the thirties and forties, and often picked up incidentally on ultrasound. Not every fibroid needs surgery. Myomectomy is considered when fibroids cause symptoms, when they are implicated in infertility or recurrent pregnancy loss, or when their size and position are creating pressure problems ? and when the woman wishes to keep her uterus.

Current Clinical Guidance We Follow

Decision-making at Apollo Hospitals Lucknow is aligned with contemporary Indian and international guidance rather than a single fixed protocol, because fibroid management is highly individualised.

• FOGSI (Federation of Obstetric and Gynaecological Societies of India) Good Clinical Practice Recommendations on the management of abnormal uterine bleeding and on fibroids emphasise structured evaluation using the FIGO PALM-COEIN classification for abnormal uterine bleeding, and the FIGO 0?8 fibroid subclassification (updated in 2018 and retained in the FIGO 2022 revision) to record exactly where each fibroid sits. This matters directly: FIGO type 0, 1 and 2 fibroids are usually approached hysteroscopically, while types 3?6 are usually approached laparoscopically or by open surgery.
• Uterine preservation is now the default discussion for symptomatic fibroids in women who have not completed their family, and increasingly also for women who simply do not want a hysterectomy. Guidance from FOGSI and from the Indian Association of Gynaecological Endoscopists (IAGE) supports minimal-access myomectomy where the surgeon's skill and the fibroid's size and number make it safe.
• Two recommendations that changed in recent years:
  1. Power morcellation caution. Following the US FDA's updated safety communications (2014, reinforced in 2020), unconfined power morcellation of fibroid tissue is discouraged because of the small risk of disseminating an unsuspected sarcoma. Contained (in-bag) tissue extraction or mini-laparotomy extraction is now preferred, and this is discussed as part of consent.
  2. Ulipristal acetate is no longer routinely used for pre-operative fibroid shrinkage in most settings after European Medicines Agency restrictions (2020) over rare but serious liver injury. GnRH analogues remain an option for short-term pre-operative use in selected cases, mainly to correct anaemia and reduce fibroid volume, and are not used as a substitute for definitive treatment.
• Anaemia correction before surgery. Indian guidance, including the Anaemia Mukt Bharat framework and FOGSI's iron-deficiency anaemia recommendations, supports actively treating iron deficiency before elective gynaecological surgery ? with oral iron, or intravenous iron where haemoglobin is low or oral iron is not tolerated. Given how common iron-deficiency anaemia is in Indian women with heavy periods, this is one of the most useful things done before a myomectomy.
• NICE guideline NG88 (Heavy menstrual bleeding, 2018, updated 2021) and ACOG Practice Bulletin No. 228 (2021, Management of Symptomatic Uterine Leiomyomas) are used as supporting international references, particularly on medical alternatives and on counselling about recurrence.

Where the evidence is genuinely uncertain ? for example the exact degree of fertility benefit from removing intramural fibroids that do not distort the cavity ? this is stated openly during counselling rather than overstated.

Why Myomectomy is Necessary

Uterine fibroids are non-cancerous growths that can cause a variety of symptoms, including heavy menstrual bleeding, pelvic pain, and pressure on surrounding organs. For many women, these symptoms can significantly impact their quality of life. Myomectomy is often necessary when fibroids lead to severe discomfort, fertility issues, or other complications.

The benefits of myomectomy include:

• Symptom Relief: By removing fibroids, patients often experience a significant reduction in symptoms, leading to improved quality of life.
• Fertility Preservation: For women wishing to conceive, myomectomy can enhance fertility by removing fibroids that may interfere with implantation or pregnancy.
• Uterine Preservation: Unlike hysterectomy, myomectomy allows women to retain their uterus, which is particularly important for those who wish to have children in the future.

At Apollo Hospitals Lucknow, our expert team evaluates each patient's unique situation to determine the necessity of myomectomy, ensuring that you receive the most appropriate care tailored to your needs.

Risks of Delay

Delaying myomectomy can lead to several complications that may worsen over time. As fibroids grow, they can cause increased pain, heavier bleeding, and other complications such as anaemia due to blood loss. In some cases, untreated fibroids can lead to more severe health issues, including infertility or complications during pregnancy.

Timely intervention is important. At Apollo Hospitals Lucknow, we emphasise the value of addressing fibroid-related symptoms promptly. Our experienced team is here to guide you through the decision-making process, ensuring that you understand the risks of delay and the benefits of timely treatment.

It is equally honest to say the opposite where it applies: small, symptom-free fibroids often need only periodic observation, and surgery is not urgent simply because a fibroid exists on a scan.

Benefits of Myomectomy

Undergoing myomectomy at Apollo Hospitals Lucknow offers several potential benefits, including:

• Improved Quality of Life: Many patients report significant relief from symptoms such as heavy bleeding and pelvic pain, allowing them to return to their daily activities with greater ease.
• Enhanced Fertility: For women looking to conceive, myomectomy may improve the chances of pregnancy by removing fibroids that obstruct or distort the uterine cavity.
• Minimally Invasive Options: Our hospital uses advanced surgical techniques, including laparoscopic myomectomy, which can result in less pain, shorter recovery times, and minimal scarring.
• Personalised Care: Our dedicated team provides individualised treatment plans, so that each patient receives the care that best suits her needs.

At Apollo Hospitals Lucknow, we are committed to careful, evidence-based surgery, while being clear that no operation can guarantee a particular result.

Preparation and Recovery

Preparing for myomectomy involves several important steps to help ensure a smooth surgical experience.

Preparation Tips

• Consultation: Schedule a thorough consultation with our specialists to discuss your symptoms, medical history, and treatment options.
• Preoperative Testing: You may need blood tests, imaging studies, or other evaluations to assess your health and the size and location of the fibroids.
• Medication Management: Inform your doctor about any medications you are taking, as some may need to be adjusted or paused before surgery.
• Dietary Considerations: Follow any dietary guidelines provided by your healthcare team, which may include fasting before the procedure.

Recovery Tips

• Follow Postoperative Instructions: Adhere to the care instructions provided by your surgeon, including wound care and activity restrictions.
• Pain Management: Use prescribed pain medications as directed to manage discomfort during recovery.
• Gradual Return to Activities: Start with light activities and gradually increase your level of activity as you heal. Avoid heavy lifting and strenuous exercise for several weeks.
• Attend Follow-Up Appointments: Regular follow-up visits are essential to monitor your recovery and address any concerns.

At Apollo Hospitals Lucknow, our team supports you throughout your recovery journey with the care and guidance you need.

Timing of Surgery and the Pre-Procedure Phase

Myomectomy is almost always a planned, elective operation. That planning window is used productively rather than simply waited out.

When surgery is usually scheduled

• In the first half of the cycle, typically soon after the period ends, when the endometrium is thin. This is particularly relevant for hysteroscopic myomectomy, where a thin lining improves visibility.
• After anaemia is corrected, because operating on a woman with a haemoglobin of 7?8 g/dL increases the chance of needing transfusion.
• Deferred, not cancelled, if there is an active urinary or vaginal infection, uncontrolled blood pressure or diabetes, or a recent respiratory infection.
• Urgently reviewed if there is a rapidly enlarging mass after menopause, or bleeding heavy enough to cause fainting or require transfusion.

The pre-procedure phase, step by step

1. Consultation and examination ? symptom history, menstrual chart, obstetric and fertility plans, abdominal and pelvic examination.
2. Imaging ? transvaginal or transabdominal ultrasound for most patients; MRI pelvis when fibroids are numerous, very large, or when the distinction from adenomyosis matters; saline infusion sonography or hysteroscopy when a submucosal fibroid is suspected.
3. Blood work ? haemoglobin, complete blood count, iron studies, blood group and cross-match, thyroid function, blood sugar, kidney and liver function, and viral markers as per hospital protocol.
4. Endometrial assessment ? for women above 40 or with irregular bleeding, an endometrial biopsy or sampling may be advised to rule out other causes of bleeding.
5. Anaemia correction ? oral iron for six to eight weeks, or intravenous iron if the haemoglobin is low or surgery is sooner. Tranexamic acid or hormonal treatment may be used temporarily to reduce bleeding meanwhile.
6. Pre-anaesthetic check-up (PAC) ? usually a few days before admission; ECG and chest X-ray if indicated; review of blood thinners, diabetes medication and blood pressure drugs.
7. Consent and counselling ? including the possibility, discussed honestly beforehand, that in rare cases of uncontrollable bleeding or unexpected findings the surgeon may need to convert to hysterectomy. This is uncommon but must be part of informed consent.

Technique Options and Alternatives Compared

The right approach depends on fibroid size, number, FIGO type, your fertility plans and your general health. This table is for orientation; your surgeon will explain what applies to you.

Procedures Sometimes Performed at the Same Sitting

Fibroids often coexist with other pelvic conditions. Where relevant, the following may be planned in the same anaesthesia, after discussion and consent:

• Diagnostic hysteroscopy to check the cavity and remove polyps or divide a septum.
• Diagnostic laparoscopy with chromopertubation to assess tubal patency in women being investigated for infertility.
• Adhesiolysis where previous surgery, infection or endometriosis has caused adhesions.
• Treatment of endometriosis or ovarian cyst removal if found during surgery.
• Endometrial sampling where abnormal bleeding needs histological assessment.
• Ovarian cystectomy for a simple cyst detected pre-operatively.
• Adhesion-barrier placement in selected fertility-focused cases, where the surgeon judges it useful; the evidence for improved pregnancy rates remains limited.

Phase-by-Phase Recovery

Timelines below are typical, not guaranteed, and are usually faster for hysteroscopic and laparoscopic surgery than for open myomectomy.

Criteria for Returning to Normal Activity, Work and Exercise

Return is judged by how you are functioning, not only by the calendar.

• Pain: controlled on simple oral painkillers, or none needed.
• Wound: dry, closed, no discharge, no spreading redness.
• Walking: able to walk 20?30 minutes on level ground without needing to stop.
• Stairs: able to climb one flight without holding the abdomen.
• Bowel and bladder: normal, without straining.
• Lifting: can lift and carry 5 kg comfortably before attempting more; heavy lifting, generally beyond 8?10 kg, usually waits until six weeks or later after open surgery.
• Driving: only when you can brake hard without hesitating because of pain, and are off sedating painkillers ? often about two weeks after laparoscopy and four weeks after open surgery.
• Two-wheeler pillion or riding: usually later than car travel, because of vibration and pothole jolts.
• Yoga and gym: breathing practice and gentle stretching early; core work, deep squats, inversions and weight training only after review.
• Intercourse: typically after four to six weeks, and after any hysteroscopic procedure once bleeding has stopped and your doctor agrees.

Preventing and Monitoring Recurrence

Myomectomy removes the fibroids that are present; it does not remove the tendency to form new ones. Recurrence is genuinely common ? published series report new fibroids on imaging in a substantial minority of women within five years, more often when many fibroids were removed, when the woman is younger, and when pregnancy does not follow. Not all recurrences cause symptoms or need repeat surgery.

• Follow-up ultrasound as advised ? often at six to twelve months, then periodically.
• Keep a symptom diary of period heaviness, clot passage, number of pads used, and pain, so change is noticed early.
• Maintain haemoglobin with iron-rich food and supplements if advised; ongoing heavy bleeding should not be normalised.
• Weight and metabolic health ? obesity and insulin resistance are associated with fibroid growth; regular activity and a diet lower in refined carbohydrates are sensible general advice.
• Vitamin D deficiency is widespread in India and has been linked in observational studies with fibroid burden. Correcting a documented deficiency is reasonable, though it is not proven to prevent recurrence.
• Do not delay planned pregnancy unnecessarily if childbearing was the reason for surgery ? discuss the optimal window with your surgeon.
• Options if fibroids recur: medical control of bleeding, an LNG-IUS in suitable cases, repeat myomectomy, uterine artery embolisation, or hysterectomy once family is complete.

Special Considerations: Younger Women, Older Women and Post-Menopausal Patients

Adolescents and very young women

Fibroids are uncommon before the twenties. When a young woman does have a fibroid causing heavy bleeding, the priorities are preserving the uterus, minimising uterine wall damage, and ruling out other causes of bleeding such as a bleeding disorder. Surgery is kept as conservative as possible.

Women in their twenties and thirties planning pregnancy

The surgical plan is built around fertility: careful multilayer closure, minimal use of energy near the endometrium, and adhesion prevention. You should expect a discussion about the safe interval before conception and about mode of delivery, since a deep myomectomy scar may lead your obstetrician to recommend a planned caesarean.

Women in their forties

Both myomectomy and hysterectomy are reasonable, and the choice is preference-led. Some women prefer to manage symptoms medically for a few years, since fibroids often stabilise or shrink after menopause. Endometrial assessment is more important in this group before assuming fibroids are the sole cause of bleeding.

Post-menopausal women

A fibroid that grows or bleeds after menopause needs careful evaluation, because the small possibility of a uterine sarcoma must be excluded. Myomectomy is rarely the preferred operation here; the discussion usually shifts to definitive surgery with tissue diagnosis.

Women with other health conditions

Diabetes, hypertension, thyroid disease, obesity, anaemia and previous abdominal surgery all influence the choice of route and the pre-operative workup. These are addressed in the pre-anaesthetic clinic rather than on the day of surgery.

If You Choose Not to Have Surgery

Declining or deferring surgery is a legitimate choice, and it should be an informed one. Realistic possibilities include:

• Symptoms stay the same or improve ? common with small fibroids, and likely as menopause approaches.
• Symptoms worsen gradually ? heavier or longer periods, worsening fatigue, iron-deficiency anaemia, backache, urinary frequency, constipation.
• Anaemia becomes the dominant problem, sometimes needing intravenous iron or transfusion, which affects work, energy and immunity.
• Fertility timeline shifts ? if a cavity-distorting fibroid is left in place, conception and successful implantation may be harder, and time matters if you are already in your late thirties.
• Pregnancy complications ? larger fibroids are associated with pain in pregnancy, malpresentation, preterm birth and postpartum bleeding, though many women with fibroids have entirely uncomplicated pregnancies.
• A bigger operation later ? a fibroid that could have been removed laparoscopically may later need open surgery, or hysterectomy may become the only practical option.

If you choose observation, agree a plan: a review interval, a target haemoglobin, and clear thresholds at which you will reconsider surgery.

What Influences the Cost of Myomectomy

No figures are quoted here. Costs vary by patient, and the hospital billing and insurance desk will give you a written estimate after your surgeon has decided the plan.

Insurance and Cashless Treatment in India

Myomectomy for symptomatic fibroids is generally treated as a medically necessary inpatient surgery and is covered by most Indian health insurance policies, subject to your specific terms. Points worth checking before you fix a date:

• Waiting periods. Most indemnity policies apply a specific-disease waiting period, commonly 24 months (sometimes 12 or 36 months depending on the product), to uterine fibroids, hysterectomy, and related gynaecological surgery. If your policy is newer than that period, the claim may be declined. Confirm the exact clause with your insurer in writing.
• Pre-existing disease clause. If fibroids were diagnosed before you bought the policy, the pre-existing disease waiting period ? typically 36 months under current IRDAI norms, and up to 48 months in older policies ? will apply.
• Planned versus accident cover. Myomectomy is planned surgery, not an accident claim. Personal accident policies and accident-only riders will not pay for it. Only your hospitalisation or mediclaim policy applies.
• Cashless versus reimbursement. For cashless, the hospital's insurance desk sends a pre-authorisation request to your insurer or TPA with the surgeon's plan and estimate. Approval usually takes a couple of working days for planned surgery, so start early ? ideally at the time you book the date.
• Network status. Confirm that Apollo Hospitals Lucknow is in your insurer's or TPA's network for cashless. If it is not, you can still be treated and file for reimbursement.
• Room-rent and proportionate deduction. If you choose a room above your eligible category, many policies apply a proportionate deduction across the entire bill, not just the room charge. Ask about this before selecting a room.
• Co-payment and sub-limits. Senior-citizen plans and some corporate policies carry co-pay clauses or per-surgery sub-limits.
• Non-payable items. Gloves, certain consumables, attendant food, and administrative charges are often excluded and must be settled by you.
• Government and panel schemes. Coverage under Ayushman Bharat PM-JAY, CGHS, ECHS, state schemes or corporate panels depends on empanelment and package rules. Whether these apply at this hospital for your procedure must be confirmed with the insurance desk before admission.
• Documents to carry: policy or e-card, photo ID (Aadhaar or PAN), previous prescriptions and scan reports, and the employer letter if it is a corporate policy.

Planning Your Admission and What to Bring

Before admission

• Complete the pre-anaesthetic check-up and submit all reports.
• Confirm fasting instructions ? usually no solid food for six to eight hours and clear fluids stopped a couple of hours before, as directed.
• Ask specifically about blood thinners, aspirin, diabetes medicines and any herbal or Ayurvedic supplements. Many need to be stopped several days ahead.
• Arrange at least one adult attendant who can stay overnight.
• Plan househ