Myomectomy is the surgical removal of fibroids. It leaves the uterus intact. This can be done by different approaches, depending on the size, location and number of fibroids.
Hysteroscopic myomectomy is the removal of one or more fibroids, typically up to 3-4 cm in size (mostly within the uterus) using a hysteroscope inserted through the cervix into the uterus.
Laparoscopic myomectomy removes fibroids (typically up to 6 cm in size depending on location) on the outside of the uterus. The fibroids are removed through small incisions in the abdominal wall using a lighted fiber-optic tube.
Abdominal myomectomy is an open surgery that requires an incision on the abdomen. It's needed if there are fibroids within the uterine wall or on the outer surface of the uterus, or if the fibroids are very large.
Pros and Cons of Myomectomy
Pros: This procedure may relieve pain, discomfort, heavy bleeding and bloating. It also preserves the uterus, so it's commonly performed on younger women who may want to have children. However, conceiving may still be difficult.
Cons: The surgery is less successful if there are many fibroids because it might not be possible to completely remove all of them. Patients may have significant bleeding during surgery and might need a blood transfusion or a hysterectomy (this is uncommon).
Since this is a major surgery, there are other risks associated with anesthesia and being in a hospital.
The fibroids also may recur. The uterine wall may be weaker after a myomectomy, so if you become pregnant, careful follow-up with your doctor is mandatory.
Recovery Time: Varies depending on the method of surgery:
- Hysteroscopy typically requires less than a week of recovery time
- Laparoscopy typically requires 1-3 weeks of recovery time
- Abdominal myomectomy typically requires 4-8 weeks of recovery time