Surgery to remove molar tissue from the womb

A molar pregnancy occurs when the fertilisation of the egg by the sperm goes wrong and leads to the growth of abnormal cells or clusters of water filled sacs inside the womb. It is a type of gestational trophoblastic disease (GTD). 

You have surgery to confirm the diagnosis of a molar pregnancy and to remove the molar tissue.

Before the operation

You might have some tests such as blood tests, a heart trace (ECG) and a chest x-ray.

A member of the surgical team will tell you about the operation you are going to have and what to expect afterwards.

Your nurse will check your:

• weight
• blood pressure
• pulse
• temperature

Your nurse might give you a tablet or an injection to help you relax. This will be an hour or so before you go to the operating theatre. This makes your mouth feel dry but you can rinse your mouth with water to keep it moist.

How you have it

You have the operation under general anaesthetic. The anaesthetist puts a small tube into a vein in your arm (cannula) and injects the general anaesthetic. This sends you into a deep sleep. When you wake up, the operation will be over.

Once you are asleep, the surgeon opens up (dilates) the entrance to the womb (cervix) and uses gentle suction to remove as much of the molar tissue as possible. You have an ultrasound at the same time, so the surgeon can see the abnormal tissue.

The surgeon might then use a small instrument called a curette to scrape the lining of the womb and clear away any remaining molar tissue.

After your operation

You stay in hospital for at least a few hours or overnight. 

You will have some bleeding for up to 2 weeks and it might be heavy and red at first. Let your doctor or specialist nurse know if the bleeding doesn't ease off or if it gets heavier.

For 2 weeks after the operation you should avoid:

• having sex
• using tampons
• using very scented soaps

This is to avoid the risk of infection.

Follow up tests after your surgery

For most women, the surgery removes most of the molar tissue and usually the remaining cells die off on their own. So no more treatment is needed. But sometimes the few cells remaining in the womb, or elsewhere in the body, carry on growing after the surgery.

You need to have regular follow up to make sure you have no signs of remaining molar tissue after your surgery. Molar tissue produces a hormone called hCG. So you have regular blood or urine tests to check the levels of hCG.

If the hCG levels stay high or they go up, it is called persistent trophoblastic disease or PTD.

You might need to have a course of chemotherapy.

About 10 to 15 out of every 100 women (10 to 15%) who have a complete molar pregnancy will need treatment with chemotherapy as well as their operation.

About 1 out of every 100 women (1%) with a partial molar pregnancy will need chemotherapy. 

How you might feel

It’s not easy to deal with a molar pregnancy and you might have very strong emotions that feel overwhelming. Your nurse or midwife will support you and offer some options for counselling and support.