Myomectomy (Surgical Treatment)

Myomectomy – Fibroid Removal

This is fibroid removal surgery leaves the uterus intact. Myomectomies are often offered to women of childbearing age who wish to keep that option open. Women who undergo myomectomy report improvement in menstrual bleeding from fibroids and fibroid pain symptoms. But fibroids treated in this manner often re-grow. The younger you are and the more fibroids you have, the more likely you will be to experience fibroid-regrowth, after myomectomy. Uterine scarring from this surgery may also impair conception and complicate delivery.

Myomectomies Fall Into 3 Basic Categories:

Abdominal Myomectomy

An open incision, major surgery, using a 4 to 5 inch cut at the bikini line (just above the pubic area). Abdominal and uterine muscles are sliced to allow access to the fibroids, then stitched back together after the fibroid removal surgery. Blood loss during this surgery is common, so a blood transfusion may be required. Hospital stay involves a minimum of 2 nights. Home recovery is generally 4 to 6 weeks. Uterine scars from the procedure may complicate conception. Should you become pregnant post-procedure, it’s likely your obstetrician will recommend Caesarean (C-section) to avoid issues with surgically-weakened uterine walls.

Laparoscopic ​Myomectomy

When fibroids are small, few in number and not deeply embedded in the uterine wall, this type of myomectomy is often suggested. Four incisions, slightly over a ½ inch long, are made in the belly button, bikini line and near the right and left hip. The abdominal cavity is inflated with carbon dioxide gas. A laparoscope (a tube with a lighted camera) is guided through one of the incisions, allowing the fibroid doctor to see ovaries, fallopian tubes, and uterus. Surgical tools are introduced through the other incisions and used for fibroid removal. After fibroids are removed, the gas is released, the uterine wall is stitched and the incisions are closed. A hospital stay is required and recovery is roughly 2 to 4 weeks.

Hysteroscopic Myomectomy

This is an out-patient fibroid removal surgery (no hospital stay) that is only performed to treat submucosal fibroids. Submucosal fibroids grow directly out from the uterine wall and into the uterine cavity, like a fetus. Hysteroscopic myomectomy is not suitable for intramural fibroids (fibroids fully inside the uterine wall) or subserosal fibroids (inside the uterine wall and growing away from the uterine cavity). Hysteroscopic myomectomy is similar to a D & C (dilation & curettage). A speculum opens the vagina and instruments are guided past the cervix and into the uterus. The fluid is used to expand the uterus and any visible fibroids are scraped off the uterine wall. Post-procedure, you will be under observation for a few hours. Recovery takes a few days.

Benefits & Drawbacks

Unlike a hysterectomy, a myomectomy does not remove the uterus, just the fibroids. This is an obvious advantage for someone who wants to have children. However, complications associated with myomectomy include blood loss (a frequent problem when large fibroids are removed), uterine scarring (which impairs fertility) and a fairly significant incidence of regrowth (about 30% or higher, depending on your age).

If you are showing signs of fibroid symptoms and think you have fibroids, schedule an appointment for a professional diagnosis. One of our fibroid surgeons will talk to you about your symptoms and perform a pelvic exam. We may order further testing including an imaging procedure such as an ultrasound. If fibroids are diagnosed we will discuss the best fibroid treatment for you. Here at the Fibroid Treatment Collective, we offer free consultations in-office or over the phone. Feel free to contact us for more information. To learn more about fibroids, visit our homepage.