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Myomectomy refers to the removal of fibroids from the uterus. After this procedure, women typically have a normally functioning uterus and can become pregnant in the future.
What is Myomectomy?
Myomectomy is a procedure done to remove fibroids from the uterus.
Fibroids are growths made of connective tissue and muscle cells. These growths can appear as one or more fibroids that grow in the muscle of the uterus or even in another part of the pelvis.
They are generally not cancerous. During a myomectomy, the fibroids are removed, and the uterus is repaired. After this procedure, you typically have a normally functioning uterus.
In some cases, the treatment for fibroids may involve a hysterectomy (a procedure to remove the entire uterus). Unlike myomectomy, women who undergo a hysterectomy will no longer menstruate or be able to become pregnant.
What Are My Options if I Have Fibroids?
Fibroids are very common, and most fibroids do not require treatment.
There are many treatment options for women with fibroids. Your healthcare provider will recommend the best procedure based on the following factors:
- Size, location, and number of fibroids
- Your preferences (such as your desire to preserve your uterus for future pregnancies or other reasons)
What Questions Should I Ask My Doctor Before Fibroid Treatment?
There are a few questions you should consider before undergoing fibroid treatment. The answers to these questions will help your doctor determine the best treatment type for you.
- Are the fibroids causing any symptoms?
- Do you want to become pregnant?
- Do you want to continue menstruating?
- Do you prefer non-surgical options?
What Is the Difference Between Myomectomy and Hysterectomy?
Myomectomy removes the fibroids while leaving the uterus in place. This procedure will allow you to have future pregnancies. Your normal menstrual cycles will return, and your bleeding will be lighter than before the fibroids were removed. There is a possibility of new fibroids developing. Therefore, post-surgery follow-up is important.
The surgery itself usually takes longer than a hysterectomy and can result in more blood loss compared to a myomectomy.
Hysterectomy is typically chosen by women who have completed their childbearing and no longer wish to menstruate. The options surrounding a hysterectomy include whether to remove the cervix or ovaries. The method of hysterectomy can be vaginal, abdominal, or laparoscopic (using small incisions in the abdomen with a minimally invasive technique).
Frequently Asked Questions About Myomectomy
What Happens When I Choose Myomectomy?
Once you and your doctor decide that myomectomy is the right procedure for you, there are still options to consider. These decisions depend on various factors, including:
- Size of the fibroids
- Number of fibroids
- Location of the fibroids within the uterus
- Surgeon’s experience
Are There Different Types of Myomectomy?
There are three main types of myomectomy:
- Open myomectomy
- Minimally invasive laparoscopic myomectomy
- Hysteroscopic myomectomy
What Is Open Myomectomy?
Also known as abdominal myomectomy, open myomectomy is performed with an incision in the abdomen. The incision may be vertical or horizontal, similar to a bikini cut. This type of procedure may be the best option for extremely large fibroids, but often it can also be done in a minimally invasive way. Recovery from open myomectomy is similar to recovery from other major surgeries.
Possible complications of open myomectomy include:
- Bleeding
- Infection
- Damage to other organs
- Anesthetic (painkiller drugs used during surgery) issues
These complications are rare, and your healthcare team will take every effort to avoid these problems.
What Is Minimally Invasive Myomectomy?
There are several types of minimally invasive options for myomectomy. These surgeries usually have faster recovery times and are easier on your body.
- Standard laparoscopic myomectomy: For this procedure, a small, lighted telescope is inserted through the belly button. Several small incisions are made in the abdomen to insert special instruments to help remove the fibroids. The fibroids themselves are sometimes removed through the vagina or small openings in the abdomen. Some surgeons use a special machine (a robot) to precisely control the movement of the instruments during these surgeries.
- Single-port myomectomy: In this surgery, only one opening near the belly button is used for all the instruments. This results in a slightly larger incision at the belly button, but there are no other openings in the abdominal wall.
- Hysteroscopic myomectomy: This procedure does not require any incisions. When the fibroids are located in the right place inside the uterus, a camera with a special attachment can be placed from the vagina into the uterus to remove the fibroids.
All of these minimally invasive approaches have similar results and complications.
What Are the Complications of Fibroid Treatments?
All surgeries carry the potential for complications. Non-surgical treatment options are available for fibroids. Non-surgical treatments may include:
- Medications (typically birth control pills that affect the menstrual cycle)
- IUD (intrauterine device) that contains hormones for birth control and reduces bleeding
What Are Some of the Risks of Myomectomy?
Though rare, you could develop an infection after myomectomy. If this occurs, antibiotics will be given to you. Fever is quite common after myomectomy, but this is usually related to tissue changes rather than infection.
You may experience severe bleeding with myomectomy, and in such cases, a blood transfusion may be required.
If you become pregnant after myomectomy and the fibroids have spread to a large part of the uterine wall, a cesarean delivery may be necessary.
What is the recovery like after myomectomy?
This depends on the type of procedure. It also depends on whether any complications arise.
With open myomectomy, full recovery may take up to six weeks before you can return to your normal activities. After laparoscopic myomectomy, you may stay in the hospital for one night and then return home. Home recovery typically lasts around two to four weeks. If the procedure is performed hysteroscopically (through the vagina with no incisions), complete recovery occurs in just a few days.
Can fibroids return after myomectomy?
New fibroids may grow after myomectomy. Younger women with many fibroids are at a higher risk of developing more fibroids compared to women who are closer to menopause and have fewer fibroids.
