Myomectomy

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What is myomectomy?

Myomectomy is the surgical removal of fibroids from the uterus. It allows the uterus to be left in place and, for some women, makes pregnancy more likely than before. Myomectomy is the preferred fibroid treatment for women who want to become pregnant. After myomectomy, your chances of pregnancy may be improved, but are not guaranteed.

When is it used?

Myomectomy preserves the uterus while treating fibroids. It may be a reasonable treatment option if you have:

• Anemia that is not relieved by treatment with medicine.
• Pain or pressure that is not relieved by treatment with medicine.
• A fibroid that has changed the wall of the uterus. This can sometimes cause infertility or repeat miscarriages.

What are the benefits of this procedure?

Myomectomy decreases pelvic pain and bleeding from fibroids.

Pregnancy

Myomectomy is the only fibroid treatment that may improve your chances of having a baby. It is known to help with a certain kind of fibroid called a submucosal fibroid. But it does not seem to improve pregnancy chances with any other kind of fibroid.

Some studies suggest that myomectomy may also lower the risk of miscarriages among women with fibroids but there are not yet good enough studies to know for sure.

What are the risks associated with this procedure?

• Damage to a vein or artery that could cause serious bleeding
• Making a hole in my bladder that could cause a tract (fistula) between my vagina and bladder
• That I may have difficulty emptying my bladder
• That I may develop bulging in my rectum (rectocele) or my vagina (vaginal vault eversion)
• Damage to my ureters, the tubes that carry urine from my kidneys to my bladder
• That I may develop infection in my incision or in my pelvis
• That my doctor may not be able to completely remove all of the fibroids and another operation could be necessary to do so in the future, or that over time new fibroids may grow requiring future surgery.
• That I may need a cesarean section in future pregnancy and be at risk for uterine rupture in subsequent pregnancy resulting in the death of my child.

How do I prepare for myomectomy?

Follow your health care provider’s instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery. Also, your wounds will heal much better if you do not smoke after surgery.

Follow any other instructions your provider gives you. If you are to have general anesthesia, eat a light meal, such as soup or salad the night before surgery. Do not eat or drink after midnight.  You should not even drink coffee, tea, or water. Your physician may also recommend a bowel prep.

What happens after the procedure?

The length of time you may spend in the hospital varies, and hysteroscopy is an outpatient procedure. Laparoscopy may be an outpatient procedure or may require a stay of 1 day. Laparotomy requires an average stay of 1 to 4 days. Recovery time depends on the method used for the myomectomy:

Hysteroscopy requires from a few days to 2 weeks to recover; Laparoscopy requires 1 to 2 weeks; and Laparotomy requires 4 to 6 weeks. Plan for your care and recovery after the operation. Allow for time to rest. Try to find other people to help you with your day-to-day duties.

When should I call Greenville OB/GYN

Call our emergency number at any time if:

• You have a fever over 100 F (37.8 C).

Call during regular office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.