What Is a Myomectomy?
It is often a treatment option in people who have uterine fibroids and:
What Is the Recovery Time for a Myomectomy (Fibroid Removal)?
After a myomectomy, there may be abdominal swelling. Recovery time depends on the procedure used to remove the fibroids:
How Is a Myomectomy Performed?
There are several different methods used to perform a myomectomy, and the choice of procedure will depend on the size, number, and location of the fibroids.
- Hysteroscopic myomectomy
- Only used for submucosal fibroids that grow just beneath the inner lining of the uterus
- An outpatient surgical procedure
- Patients lie on their back with feet in gynecology stirrups
- A speculum is placed in the vagina and a long, slender “telescope” is placed through the cervix into the uterine cavity
- The uterine cavity is filled with fluid to lift apart the walls
- Instruments passed through the hysteroscope shave off the submucosal fibroids
- Patients are able to go home following the procedure after several hours of observation in the recovery room
- Cramping and light bleeding may occur after the procedure
- Recovery usually involves one to four days of resting at home and there are no scars
- Laparoscopic myomectomy
- Not all fibroids can be removed by a laparoscopic myomectomy
- Large, numerous, or deeply embedded fibroids may require abdominal myomectomy
- Four one-centimeter incisions are made in the lower abdomen: one at the belly button, one below the bikini line (near the pubic hair), and one near each hip
- The abdominal cavity is filled with carbon dioxide gas and a laparoscope (a thin, lighted telescope) is placed through an incision, so doctors can see the ovaries, fallopian tubes and uterus
- Long instruments, inserted through the other incisions, remove the fibroids and the uterine muscle is sewn back together
- The gas is then released and the skin incisions are closed
- Laparoscopic myomectomy may require one night in the hospital and two to four weeks of home recovery
- There will be small scars on the skin where the incisions were made
- Abdominal myomectomy (also called an “open” myomectomy)
- A major surgery
- An incision called a “bikini cut” is made through the lower abdomen and the fibroids are removed from the wall of the uterus
- The uterine muscle is sewn back together with several layers of stiches
- Abdominal myomectomy usually requires two nights in the hospital and can take four to six weeks to recover at home
- The procedure will leave a four-inch horizontal scar near the pubic hair or “bikini” line
What Are Risks of a Myomectomy?
Like any surgical procedure, myomectomy carries some risks, though they are rare. Risks of myomectomy may include:
- An infection after surgery of the uterus, fallopian tubes, or ovaries (pelvic infection)
- Scar tissue in the uterine muscle
- Injuries to internal organs
- Uterus may be weaker after surgery
- Infertility (rare)
- Injuries to the bladder or bowel, such as a bowel obstruction (rare)
- Uterine scars that can break open (rupture) in late pregnancy or during delivery (rare)
- Those who have an abdominal myomectomy doctor are usually advised to have a Caesarean section (C-section) for the delivery of future pregnancies to reduce the chance that the uterus could open apart during labor
- A hysterectomy may be required during a myomectomy if removing the fibroid causes heavy bleeding that cannot be stopped without doing a hysterectomy (rare)
New fibroids may also develop in about 10 to 50 percent of women, resulting in recurrent symptoms and additional procedures. Larger and more numerous fibroids are most likely to recur.