What is a myomectomy surgery?
A myomectomy is a procedure to remove uterine fibroids (also known as leiomyomas) from your uterus. Fibroids are growths made up of connective tissue and muscle cells. They can appear inside or outside your uterus. They’re almost always not cancerous (benign). You can have one or many fibroids, and they can vary in size. During a myomectomy, your surgeon removes the fibroids but preserves the tissues in your uterus so that you can become pregnant in the future.
Myomectomy is an alternative to a hysterectomy, which removes your uterus, cervix and fibroids.
What does myomectomy treat?
Your healthcare provider may recommend myomectomy surgery if you have uterine fibroids that are causing:
- Pelvic pain.
- Irregular bleeding or bleeding between periods.
- Heavy menstrual bleeding.
- Not being able to fully empty your bladder.
Myomectomy surgery is a good option if you wish to become pregnant in the future and want to preserve your fertility.
What are my treatment options if I have fibroids?
Uterine fibroids are extremely common, and some don’t require any treatment. Your treatment depends on a few factors:
- Your symptoms.
- The size, location and number of fibroids.
- Your preferences (desire to become pregnant in the future or have a menstrual period).
Surgery isn’t the only treatment option. Medication may also be an option for treating uterine fibroids. Taking medication may reduce the symptoms of fibroids and shrink their size. Other treatment options include uterine artery embolization or radiofrequency ablation. Your provider will recommend the best treatment option based on your health history and preferences.
What’s the difference between a myomectomy and a hysterectomy?
The main difference between the two procedures is that a myomectomy removes only the fibroids, leaving your uterus in place. Your menstrual period will return, and you can get pregnant in the future. A hysterectomy removes the fibroids and your uterus. People who undergo a hysterectomy can no longer become pregnant and won’t get their menstrual period.
What is the recovery like after myomectomy?
Recovery depends on the type of procedure you have. It also depends on whether any problems arise. You can expect some pain for the first few days. Your provider will give you medication for pain. They’ll also encourage you to move your legs or take small walks after surgery to prevent blood clots.
With an open myomectomy, full recovery before getting back to your normal activities can take up to six weeks.
After a laparoscopic myomectomy, you may go home the same day. Recovery at home is about two to four weeks.
If the procedure is done hysteroscopically (through your vagina without incisions), full recovery can be just a matter of days.
Things to expect as you recover from myomectomy
Your surgeon will talk to you about when you can return to your normal activities. It’s important to follow these instructions to allow yourself to recover. How long you need to modify your activities depends on the type of surgery you had. You can expect to need more time to recover if you had an open abdominal myomectomy.
Some of the things you can expect include:
- Vaginal bleeding and discharge for a few weeks.
- Don’t lift anything heavier than 5 to 10 pounds for the first week after surgery. You may need to wait longer if you have an open abdominal surgery.
- No sexual intercourse for six weeks. Nothing should go inside your vagina during your recovery.
- Gradually increase your activity level. Don’t abruptly jump back into your normal activities. Start slowly and monitor how you feel.
How many days of rest do I need after the procedure?
No matter what type of myomectomy you have, you can expect to need at least a few days of rest afterward. How much rest and recovery time you need depends on the type of surgery you have. If possible, arrange for someone to help you around the house for the first one to three days after surgery. Talk to your provider about when you can return to your normal activities and follow their recommendations.
Can fibroids come back after myomectomy?
New fibroids may grow after a myomectomy. Younger people (under age 40) with many fibroids are at greater risk of getting more fibroids in the future. People who are near menopause or have just a few fibroids have less of a chance of recurring fibroids.
Can you have a baby after a myomectomy?
Yes, you can still get pregnant after a myomectomy. Discuss your desire for pregnancy with your surgeon ahead of time so they’re aware of your goals. You may be at increased risk for a C-section due to the potential complications of a vaginal delivery.
What is your period like after myomectomy?
Most people experience a lighter and more regular period after myomectomy. Talk to your provider about what you can expect when your menstrual period returns after surgery.
Does your body change after myomectomy?
There shouldn’t be any noticeable changes to your body after myomectomy other than finding relief from the symptoms fibroids are causing. Since your uterus is still functioning normally, you won’t enter menopause and should resume your period shortly after surgery.
Will I have a scar from myomectomy?
Yes, you’ll have a small scar from a myomectomy. The only time you wouldn’t have a scar is if you have a hysteroscopic myomectomy. If you have an open myomectomy, your scar will be below your underwear line. Scars from laparoscopic myomectomy will be smaller and closer to your belly button. They may be noticeable if you wear a two-piece bathing suit or short shirt. Most scars fade over time. Contact your provider if your scar is painful or feels sensitive.
When To Call the Doctor
When should I see my healthcare provider?
If you have a myomectomy to remove fibroids, contact your provider if you experience any of the following symptoms:
- Heavy bleeding.
- Fever, chills or other flu-like symptoms.
- Pain that’s not manageable with medication.
- Chest pains or trouble breathing.
- Red, swollen legs or cramping in your legs.
