Myomectomy: A Complete Guide to Fibroid Removal Surgery
Uterine fibroids are quite common, especially in women during their reproductive years, and can affect health and daily life in many ways. While many fibroids cause no symptoms, some can lead to heavy bleeding, severe cramps, pelvic pain, and fertility challenges. For women who wish to preserve their uterus and fertility, myomectomy is often the treatment of choice.
In this guide, we’ll dive deep into what a myomectomy is, why it’s performed, the different surgical approaches, recovery, and what you should know before undergoing this procedure.
What is Myomectomy?
A myomectomy is a surgery that removes fibroids from the uterus while keeping the uterus intact, making it a great option for women who want to preserve fertility. Unlike a hysterectomy, where the uterus is removed entirely, a myomectomy focuses on removing only the fibroids, making it a preferred option for women who wish to maintain their fertility or simply keep their uterus.
Why is Myomectomy Performed?
Not all fibroids require treatment. However, a myomectomy may be recommended when fibroids cause:
> Heavy or prolonged menstrual bleeding
> Pelvic pressure or pain
> Frequent urination due to bladder pressure
> Constipation or bowel issues from rectal pressure
> Infertility or repeated miscarriages linked to fibroids
> Enlarged abdomen affecting comfort and lifestyle
By removing fibroids while keeping the uterus intact, myomectomy helps restore quality of life and improve reproductive outcomes.
Types of Myomectomy
There are several approaches to performing a myomectomy, depending on the size, number, and location of fibroids.
1. Abdominal Myomectomy (Open Surgery)
> How it’s done: A surgical incision is made in the lower abdomen to access the uterus and remove fibroids.
> Best for: Large or multiple fibroids.
> Pros: Effective for complex cases.
> Cons: Longer recovery (4–6 weeks), visible scar.
2. Laparoscopic Myomectomy (Minimally Invasive)
> How it’s done: Small incisions and a laparoscope (camera) are used to remove fibroids.
> Best for: Small to medium fibroids.
> Pros: Less pain, shorter hospital stay, quicker recovery.
> Cons: Not the best choice if fibroids are very large or if there are too many.
3. Robotic-Assisted Myomectomy
> How it’s done: Similar to laparoscopy but with robotic arms for more precision.
> Best for: Medium to large fibroids in difficult locations.
> Pros: Enhanced precision, minimal blood loss, faster healing.
> Cons: Higher cost, limited availability.
4. Hysteroscopic Myomectomy
> How it’s done: A hysteroscope is inserted through the vagina and cervix into the uterus to remove fibroids inside the uterine cavity.
> Best for: Submucosal fibroids (inside the uterine lining).
> Pros: No abdominal incision, quick recovery.
> Cons: Only suitable for certain types of fibroids.
Benefits of Myomectomy
Choosing a myomectomy offers several advantages, especially for women seeking to maintain reproductive potential:
> Preserves the uterus – unlike hysterectomy.
> Improves fertility outcomes – by removing fibroids that interfere with implantation or pregnancy.
> Relieves symptoms – like painful cramps and heavy menstrual bleeding.
> Improves quality of life – less discomfort, improved sexual health, and reduced pressure symptoms.
Risks and Complications of Myomectomy
As with any surgery, a myomectomy carries some risks. Potential complications include:
> Excessive bleeding
> Scar tissue formation (adhesions)
> Infection
> Damage to surrounding organs
> Rare need for hysterectomy if bleeding is uncontrollable
> Fibroids may return over time, even after having surgery
Discussing risks with your surgeon helps you prepare for possible outcomes and make informed decisions.
Preparing for a Myomectomy
Before undergoing a myomectomy, your doctor may suggest:
> Imaging tests (ultrasound or MRI) to map fibroid size and location.
> Blood tests to rule out anemia or issues with blood clotting
> Medicines such as GnRH shots may shrink fibroids before surgery.
> Pre-surgery counseling to discuss fertility goals and expectations.
Recovery After Myomectomy
Recovery varies depending on the type of myomectomy performed:
> Abdominal Myomectomy: 4–6 weeks recovery, restricted physical activity.
> Laparoscopic or Robotic Myomectomy: 2–4 weeks recovery, quicker return to normal activities.
> Hysteroscopic Myomectomy: 1–2 weeks recovery, minimal downtime.
During recovery, doctors often recommend:
> Avoiding heavy lifting or strenuous exercise
> Managing pain with prescribed medications
> Eating a balanced diet to support healing
> Attending follow-up visits to monitor recovery
Myomectomy and Fertility
One of the main reasons women choose a myomectomy is to improve fertility. By removing fibroids that distort the uterine cavity or block fallopian tubes, the chances of conception increase.
> Pregnancy is usually safe after myomectomy, but doctors may recommend waiting 3–6 months before trying to conceive.
> In some cases, a cesarean delivery may be advised due to the risk of uterine rupture during labor.
Alternatives to Myomectomy
While myomectomy is a highly effective treatment, it is not the only option. Depending on individual needs, alternatives include:
> Hysterectomy – complete removal of the uterus (for women not seeking fertility).
> Uterine artery embolization (UAE) – shrinks fibroids by cutting off their blood supply.
> Medications – to manage symptoms but not permanently remove fibroids.
> MRI-guided focused ultrasound – non-invasive fibroid treatment option.
Final Thoughts
A myomectomy is an excellent treatment for women suffering from fibroid-related symptoms who still wish to preserve their fertility or avoid a hysterectomy. With advances in minimally invasive techniques, recovery is faster and risks are lower than ever before.
Making the Right Choice
Choosing between vaginal birth vs c section depends on several factors:
1. Medical Necessity: In some cases, a C section is unavoidable to ensure the safety of mother and baby.
2. Doctor’s Advice: A gynecologist’s guidance based on the pregnancy’s progression is essential.
Prenatal education classes can also help expectant mothers understand the process, manage expectations, and prepare for either delivery method.
Final Thoughts
Both vaginal birth and C sections have their advantages and challenges. While vaginal birth is natural and promotes faster recovery, C sections are sometimes necessary for medical reasons and can save lives. Understanding the differences, benefits, and risks associated with vaginal birth vs c section empowers women to make informed decisions for a safe and healthy delivery experience.
At the end of the day, the safest choice is the one that keeps both mom and baby healthy. Open communication with your doctor and a supportive birth plan can make the journey smoother, no matter the delivery method.