For many women, the discovery of uterine fibroids brings a multitude of feelings: fear, confusion, and concern about the future, especially when it comes to fertility. If you are facing such a diagnosis and are worried about your ability to conceive or carry a pregnancy to term, a myomectomy presents a hopeful path forward. This surgical procedure is specifically designed to remove fibroids while preserving the uterus, making it a preferred option for many women who wish to maintain their fertility. 1Fibroid does not perform myomectomy—we treat fibroids with uterine fibroid embolization (UFE) and refer patients who need surgery to experienced gynecologic surgeons—but in this blog we explain what myomectomy entails, its benefits, and what you can expect during and after the procedure so you can weigh all of your options.
Understanding Myomectomy
A myomectomy is a surgical procedure aimed at excising uterine fibroids—benign tumors that form in the muscular tissue of the uterus. Unlike a hysterectomy, which involves the removal of the entire uterus, a myomectomy selectively targets the fibroids, leaving the uterus intact. This focus on preservation is crucial for women who wish to become pregnant in the future.
Types of Myomectomy
The approach to myomectomy varies depending on the size, location, and number of fibroids, as well as the patient’s overall health and reproductive goals. There are three main types of myomectomy:
1. Abdominal Myomectomy: Also known as an open myomectomy, this procedure involves making a larger incision in the lower abdomen to access the uterus and remove fibroids. This method is generally used for larger fibroids or when there are multiple fibroids.
2. Laparoscopic Myomectomy: This minimally invasive approach uses several small incisions in the abdomen. A surgeon inserts a laparoscope (a thin tube fitted with a camera) and specialized instruments to remove the fibroids. This method typically leads to quicker recovery, less scarring, and less postoperative pain compared to an open myomectomy.
3. Hysteroscopic Myomectomy: For fibroids that are located inside the uterine cavity, a hysteroscopic myomectomy may be recommended. This procedure involves inserting a hysteroscope through the vagina and cervix into the uterus, requiring no incisions. It is ideal for submucosal fibroids (those that grow into the uterine cavity).
Benefits of Myomectomy for Fertility
- Fertility Preservation: The most significant benefit of a myomectomy for women of reproductive age is the preservation of the uterus, offering a chance to conceive naturally or through assisted reproductive technologies.
- Symptom Relief: By removing fibroids, a myomectomy can alleviate symptoms such as heavy menstrual bleeding, pelvic pain, and pressure symptoms, which can interfere with the quality of life.
- Possible Fertility Benefit : Fibroids have been linked to complications such as miscarriage, preterm labor, and delivery problems. Removing fibroids that distort the inside of the uterus may improve the chances of pregnancy, but for other fibroids the evidence that surgery improves fertility or pregnancy outcomes is still uncertain.
What to Expect During the Procedure
The specifics of a myomectomy procedure will depend on the type of surgery you are having. Generally, the surgery can last from one to several hours. Anesthesia is typically used, so you will not be awake during the procedure. After surgery, you will be monitored in a recovery room, and depending on the type of myomectomy, you may be discharged on the same day or may require a short hospital stay.
Recovery and Post-Procedure Care
Recovery time varies widely based on the type of myomectomy performed:
- Abdominal Myomectomy: Recovery can take four to six weeks. You’ll likely need to stay in the hospital for a few days post-surgery.
- Laparoscopic and Hysteroscopic Myomectomy: Recovery is generally quicker. Most women return to normal activities within two to four weeks after laparoscopic surgery, and often within a few days after hysteroscopic surgery.
During recovery, it’s important to follow your doctor’s instructions, which may include taking prescribed medications, avoiding lifting heavy objects, and abstaining from sexual intercourse for a specified period. Pain and light vaginal bleeding or discharge can be expected after the procedure.
Long-Term Considerations
While myomectomy is an effective treatment for fibroids, it is not a guarantee against recurrence. Fibroids can redevelop, and ongoing medical management may be necessary. If you are planning a future pregnancy, it’s crucial to discuss the timing with your healthcare provider. They may recommend waiting several months to a year after surgery to ensure the uterus has healed adequately before trying to conceive. Because there is a small risk of the uterine scar opening (uterine rupture) during a later pregnancy, your surgeon may also recommend a planned cesarean delivery, depending on how extensive the surgery was.
A Hopeful Option
Choosing a myomectomy for the treatment of fibroids is a significant decision, particularly for women who are considering future pregnancies. By removing fibroids while preserving the uterus, myomectomy offers a hopeful option for managing symptoms and preserving fertility. However, as with any surgical procedure, it comes with risks and considerations. It is essential to discuss all your options thoroughly with a qualified healthcare provider to make the most informed decision possible. Remember, you are not alone on this journey. With the right care, many women who undergo myomectomy go on to have successful pregnancies and regain control over their health and lives.
1Fibroid Is Here To Support You
If you are living with uterine fibroids and curious about your nonsurgical alternatives to fibroid treatment, consider 1Fibroid. 1Fibroid is based in New York, with locations in both Manhattan and Queens. We are committed to women’s care and offer nonsurgical options such as medication, hormone therapy, and minimally invasive UFE procedures; if myomectomy is the better choice for you, we will refer you to an experienced gynecologic surgeon. If you’re ready to live life without the symptoms of fibroids, call us today at 212-991-9991.
Sources
- Management of Symptomatic Uterine Leiomyomas. American College of Obstetricians and Gynecologists (Practice Bulletin No. 228), 2021.
- Surgical treatment of fibroids for subfertility. Cochrane Database Syst Rev, 2020.
- Minimally invasive surgical techniques versus open myomectomy for uterine fibroids. Cochrane Database Syst Rev, 2014.
- Trial of labor after myomectomy and uterine rupture: a systematic review. Acta Obstet Gynecol Scand, 2016.
- Uterine artery embolisation versus myomectomy for premenopausal women with uterine fibroids wishing to avoid hysterectomy: the FEMME RCT. Health Technol Assess, 2022.
- Uterine Fibroids. N Engl J Med, 2024.
- Hysteroscopy. American College of Obstetricians and Gynecologists.
- Uterine fibroids and uterine fibroid embolization (UFE) treatment. Society of Interventional Radiology.