Overview of Myomectomy Procedure

Everything you need to know about the procedure and recovery time

Women of any age can get fibroids, but they are most common in women who are childbearing age. Fibroids are non-cancerous growths that can appear on your uterus. If left alone, they can grow and cause a lot of pain, discomfort and heavy periods.

Fortunately, there is a relatively simple procedure that can be performed to ideally alleviate symptoms related to discomfort and infertility. Your doctor may recommend a myomectomy to remove the fibroids and get you back on track with your fertility.

What is a myomectomy?

A myomectomy is a gynecological surgical procedure to remove fibroids. This surgery is necessary when fibroids are a direct cause of infertility or you plan to have biological children in the future.

During a myomectomy, the surgeon's goal is to remove the fibroids while keeping the uterus intact. This procedure is often used as an alternative to a hysterectomy, which involves removal of the uterus.

There are 3 primary methods used to perform a myomectomy:

1. Abdominal myomectomy, which involves a larger incision.

2. Robotic or laparoscopic myomectomy, involving several smaller incisions for a less invasive procedure without a large myomectomy scar.

3. Hysteroscopic myomectomy, which involves access through the vagina and cervix.

As with any surgical procedure, you may need to follow special instructions on medications you're taking before the surgery. General anesthesia is typical for all 3 types of surgery, although monitored anesthesia that doesn’t require a breathing tube might be used for a hysteroscopic procedure. Local or spinal anesthesia can be used in some cases as well.

When is a myomectomy procedure necessary?

Women with fibroids often experience bothersome symptoms that can make everyday life difficult. Pelvic pressure that becomes painful at times is one common sign, as well as more frequent urination. Heavy menstrual bleeding, along with more pain than normal, can be another symptom.

Fibroids can also interfere with a woman's fertility, possibly causing miscarriages. Although there are hormonal treatments that can shrink fibroids, they are usually intended to allow for less-invasive surgeries, rather than eliminate the need for surgery.

What are some possible complications?

Myomectomy complications are rare, but anyone undergoing this procedure should be aware of the potential risks and complications just the same. Some of the possible risks include:

  • Spreading a cancerous tumor if the fibroid is misdiagnosed
  • An impromptu hysterectomy instead due to abnormalities or bleeding
  • Damage to organs close to your uterus
  • Complications during pregnancy or childbirth, often making a C-section necessary
  • Uterine perforation
  • Adhesions, especially in abdominal surgery
  • Excessive blood loss
  • Infections that require antibiotic treatment
  • New fibroids, possibly in another location

Hysteroscopic and laparoscopic procedures are generally outpatient surgeries. When an abdominal myomectomy is performed, a 1-2 day stay in the hospital is typical. Patients will require someone to drive them home and watch for complications.

Pregnancy after a myomectomy

When infertility has been an issue, the procedure can help increase the chances of a successful pregnancy. However, pregnancy after myomectomy can come with an increased risk of complications. Having had past fibroids is a risk factor on its own.

Depending on where your surgeon had to make the incisions, you may have to deliver your children via C-section. Having a C-section instead of a vaginal delivery helps reduce the risk of a ruptured uterus during childbirth.

The myomectomy recovery process

Most doctors will prescribe pain medication following this procedure, as well as provide myomectomy recovery tips to help ensure that you heal better. There might be vaginal bleeding or spotting for a few weeks. The bleeding or spotting is normal.

You might also have some restrictions for a short time after the surgery. A hysteroscopic procedure has the shortest recovery time of 2-3 days. The laparoscopic surgery has a 2-4 week recovery time, and the abdominal option has the longest, lasting 4-6 weeks.

Take your doctor's advice about when to resume certain activities seriously. Sexual activity may require waiting for up to 6 weeks. Strenuous exercise or heavy lifting should be avoided until all incisions have healed.

If you have or suspect you're having issues related to fibroids, you will need to talk to an experienced OB/GYN to find out if a myomectomy might be right for you. If you live in North Florida, consider scheduling an appointment at All About Women Obstetrics and Gynecology to learn more about having this procedure done. Contact one of our experienced and caring professionals today.