Myomectomy Procedures

For women who want to become pregnant but need fibroid treatment, a doctor may recommend a myomectomy. This procedure will extract the fibroids from the uterus, while leaving the healthy uterine tissue. If you've been diagnosed with fibroids that require surgery, you may now be searching for information about procedure options. There are different methods for performing a myomectomy, including minimally invasive methods that require only small incisions or no incisions at all. You should discuss the various approaches with your doctor. Ultimately, your surgeon will determine which approach you'll need based on the size and location of the fibroids.

This procedure is not for everyone and only your surgeon can determine if it's the right treatment for you. While a myomectomy may improve your chances of pregnancy after surgery, it's not guaranteed to make you fertile.

Minimally Invasive and Open Myomectomy Procedures

The approaches for performing a myomectomy range from a traditional "open" procedure, where an incision in made into the abdominal wall, to minimally invasive approaches that may require no incision at all. Which approach is right for you will be determined by your surgeon based on the size and location of the fibroids to be removed. If your doctor determines that you are a candidate for a minimally invasive myomectomy (using small or no incisions), you may experience a shorter hospital stay, faster recovery, and less pain and scarring than you would if you have an open myomectomy.

Open myomectomy procedures are performed through a single incision in the abdomen. This approach may be required to remove large fibroids, many fibroids, or fibroids that have grown deep into the uterine wall.⁸⁷ There is a hospital stay of one to four days following the procedure, and recovery time usually requires four to six weeks.⁸⁷

Laparoscopic myomectomy procedures are performed through one or more small incisions in the abdomen. This approach may be used to remove one or two small fibroids that are growing on the outside of the uterus.⁸⁷ This may be performed as an outpatient procedure or may require a hospital stay of one day, and recovery usually requires one to two weeks^.87

Hysteroscopic myomectomy procedures are performed through the vagina and cervix, and require no incisions. The surgeon uses a device called a resectoscope, that allows to the surgeon to both see the inside of the uterus and to shave pieces from the fibroid.⁸⁸ This approach may be used to remove fibroids on the inner wall of the uterus that have not grown deep into the uterine wall.⁸⁷ This approach is performed as an outpatient procedure and recovery usually requires from a few days to two weeks.⁸⁷

Talking to your Surgeon about Myomectomy Procedures

Once you're referred to a surgeon, it is important to ask questions about your myomectomy procedure. Learn as much as you can about your surgeon, the surgery, and your own condition. Here are a few questions for you to get the conversation started.

• What about a minimally invasive procedure? Is that a viable option for me?
• Are my fibroids too big for a minimally invasive procedure?
• What are the differences in post-op recovery after open surgery versus a minimally invasive procedure?
• Can I keep my ovaries? My cervix?