What is Myomectomy? Purpose, Procedure & Recovery

A myomectomy is a surgical procedure that removes uterine fibroids while keeping your uterus intact. This surgery offers hope for women who want to preserve their fertility or simply keep their uterus while finding relief from fibroid symptoms.

Unlike a hysterectomy, which removes the entire uterus, myomectomy targets only the problematic fibroids. This makes it an attractive option for women who plan to have children in the future or prefer to maintain their reproductive anatomy.

What is myomectomy?

Myomectomy is a targeted surgical approach that removes fibroids from your uterus while preserving the organ itself. The word comes from "myo" meaning muscle and "ectomy" meaning removal, referring to the muscle tissue that makes up fibroids.

During this procedure, your surgeon carefully identifies and removes each fibroid while reconstructing the uterine wall. The goal is to eliminate symptoms while maintaining your uterus's structure and function for future pregnancies if desired.

This surgery can be performed through different approaches depending on the size, number, and location of your fibroids. Your surgeon will choose the method that offers the best results with the least invasive approach possible.

Why is myomectomy done?

Myomectomy becomes necessary when fibroids cause significant symptoms that interfere with your daily life and quality of living. The most common reason is heavy menstrual bleeding that doesn't respond to other treatments.

You might need this surgery if you experience severe pelvic pain, pressure, or cramping that affects your ability to work, exercise, or enjoy activities. Many women also choose myomectomy when fibroids cause frequent urination or difficulty emptying their bladder completely.

Fertility concerns often drive the decision for myomectomy. If fibroids are interfering with your ability to conceive or carry a pregnancy to term, removing them can improve your chances of successful conception and delivery.

Some women opt for myomectomy when fibroids cause noticeable abdominal swelling or when other treatments like medications or less invasive procedures haven't provided adequate relief.

What is the procedure for myomectomy?

The myomectomy procedure varies depending on which surgical approach your doctor recommends. There are three main types, each designed to access fibroids in different locations within your uterus.

Laparoscopic myomectomy uses small incisions in your abdomen and specialized instruments to remove fibroids. Your surgeon inserts a tiny camera called a laparoscope to guide the procedure while removing fibroids through these minimal openings.

Hysteroscopic myomectomy accesses fibroids through your vagina and cervix without any external incisions. This approach works best for fibroids that grow inside the uterine cavity and cause heavy bleeding.

Open myomectomy involves a larger abdominal incision, similar to a cesarean section. This method is typically reserved for large fibroids, multiple fibroids, or when previous surgeries have created scar tissue that makes minimally invasive approaches challenging.

During any myomectomy approach, your surgeon will carefully remove each fibroid while preserving healthy uterine tissue. The procedure typically takes one to three hours depending on the complexity of your case.

How to prepare for your myomectomy?

Preparation for myomectomy begins several weeks before your surgery date. Your doctor will likely prescribe medications to shrink your fibroids and reduce bleeding, making the surgery safer and more effective.

You'll need to stop taking certain medications that can increase bleeding risk, including aspirin, blood thinners, and some herbal supplements. Your healthcare team will provide a complete list of what to avoid and when to stop each medication.

Pre-surgical testing typically includes blood work to check your hemoglobin levels and overall health status. If you're anemic from heavy bleeding, your doctor might recommend iron supplements or other treatments to optimize your blood count before surgery.

The night before surgery, you'll need to stop eating and drinking at a specific time, usually around midnight. Your surgical team will give you exact instructions about when to begin fasting and any medications you should take the morning of surgery.

Plan for your recovery period by arranging help with household tasks, childcare, and transportation. Stock up on comfortable clothing, healthy foods, and any supplies your doctor recommends for post-surgical care.

How to read your myomectomy results?

After your myomectomy, your surgeon will provide details about what was found and removed during the procedure. This information helps you understand the extent of your fibroid problem and what to expect for recovery.

The pathology report will confirm that the removed tissue was indeed fibroids and not other types of growths. This report typically takes several days to complete but provides important reassurance about the nature of your condition.

Your surgeon will describe the size, number, and location of fibroids that were removed. This information helps predict how much symptom relief you can expect and whether additional treatment might be needed in the future.

Recovery success is measured by symptom improvement over the following months. Most women notice significant reduction in heavy bleeding within the first few menstrual cycles after surgery.

How to optimize your recovery after myomectomy?

Recovery after myomectomy requires patience and careful attention to your body's healing process. The timeline varies depending on which surgical approach was used and your individual healing capacity.

For laparoscopic procedures, most women return to normal activities within two to three weeks. Open myomectomy typically requires four to six weeks of recovery time, with lifting restrictions and gradual return to full activity.

Pain management during recovery usually involves prescription medications for the first few days, followed by over-the-counter options as discomfort decreases. Your surgical team will provide specific guidelines for managing pain safely and effectively.

Follow-up appointments are crucial for monitoring your healing progress and addressing any concerns. Your doctor will check your incision sites, discuss your recovery experience, and determine when you can resume normal activities including exercise and sexual activity.

What are the risk factors for needing myomectomy?

Several factors increase your likelihood of developing fibroids severe enough to require myomectomy. Age plays a significant role, with fibroids most commonly affecting women in their 30s and 40s.

Family history strongly influences fibroid development. If your mother or sisters have had fibroids, you're more likely to develop them too. This genetic component can't be changed but helps explain why some women are more susceptible.

Race and ethnicity affect fibroid risk, with African American women experiencing higher rates of fibroids and more severe symptoms. These fibroids also tend to develop at younger ages and grow larger than in other populations.

Lifestyle factors that may increase fibroid risk include obesity, high blood pressure, and diets low in fruits and vegetables. However, these factors are less predictive than genetics and demographics.

Early menstruation (before age 12) and never having been pregnant also correlate with higher fibroid risk. Hormonal factors throughout your reproductive years influence fibroid growth and symptom severity.

What are the possible complications of myomectomy?

Like any surgical procedure, myomectomy carries certain risks that you should understand before making your decision. Most women experience smooth recoveries, but being aware of potential complications helps you make an informed choice.

Bleeding during or after surgery is the most common concern with myomectomy. Heavy bleeding during the procedure sometimes requires blood transfusion, though this occurs in less than 1% of cases. Post-operative bleeding is usually manageable with proper care.

Infection can develop at incision sites or within the pelvis, though this is relatively uncommon with proper surgical technique and post-operative care. Signs of infection include fever, increased pain, or unusual discharge from incision sites.

Scar tissue formation inside the pelvis or uterus can potentially affect future fertility, though this risk is generally low. Your surgeon takes precautions to minimize scarring, but some degree of internal healing always occurs after surgery.

Rare complications include damage to nearby organs like the bladder or bowel, especially during complex procedures involving large or numerous fibroids. These complications occur in less than 1% of myomectomy procedures.

Some women experience temporary changes in menstrual patterns or fertility after myomectomy, though these usually resolve within a few months as healing progresses.

When should I see a doctor after myomectomy?

Knowing when to contact your healthcare provider after myomectomy can help ensure proper healing and catch any complications early. Most post-surgical concerns are normal parts of recovery, but some symptoms require prompt attention.

Contact your doctor immediately if you experience heavy bleeding that soaks through a pad every hour for several hours. Some bleeding is normal after surgery, but excessive bleeding may indicate a complication requiring treatment.

Fever above 101°F (38.3°C) or chills can signal infection and should be reported to your surgical team promptly. Early treatment of post-operative infections leads to better outcomes and faster recovery.

Severe or worsening pain that doesn't improve with prescribed medications may indicate complications like infection or internal bleeding. Don't hesitate to call if pain becomes unmanageable or significantly worsens.

Signs of infection at incision sites include increased redness, warmth, swelling, or pus-like discharge. These symptoms warrant prompt medical evaluation and possible antibiotic treatment.

Difficulty urinating, persistent nausea and vomiting, or sudden shortness of breath are also reasons to contact your healthcare provider immediately after myomectomy.