Myomectomies are also often used as alternatives to hysterectomies. A hysterectomy is the surgical removal of the uterus. This, too, can remove fibroids and the symptoms they cause, but it is a more drastic approach and makes it impossible for the patient to become pregnant. A myomectomy allows the patient to remain fertile by preserving the uterus.
When is it recommended?
A myomectomy may be the right course of action for patients with fibroids within the uterus, causing any of the aforementioned problems, like pain, heavy periods, pressure symptoms and infertility. However, it is essential to note that not all fibroids are suitable for treatment with myomectomy. Your gynaecologist will have to assess your fibroids’ size, number, and location to determine whether a myomectomy is appropriate.
Laparoscopic or robotic myomectomy
Also known as keyhole myomectomy, this procedure involves using a device called a laparoscope, a small, lighted telescope. It is inserted into the body through a small incision around the belly button, providing the surgeon a clear view. Other small surgical instruments, which the surgeon controls either manually or with the aid of a robot, are then passed through the cut to remove the fibroids.
This is a minimally invasive form of myomectomy with relatively fast healing times and minimal surgical scarring. It allows patients to return to their regular routines with less delay than abdominal myomectomy.
However, it is not always suitable, depending on the patient’s size, location, and number of fibroids.
Hysteroscopic myomectomy
This procedure does not involve any incisions. Instead, a special surgical camera is passed through the vagina into the uterus to remove the fibroids from within. This form of myomectomy is only suitable for treating fibroids protruding into the uterine cavity, but it has the fastest recovery times. It is also typically the fastest procedure to complete.
Note that some fibroids may be too large to be removed in a single hysteroscopic procedure. Thus, you may need a second-stage procedure.
Myomectomy surgery – what to expect
In the sections below, we will outline what to expect before, during, and after a myomectomy, including preparation, the procedure itself, and post-procedure care.
FAQ
What are the risks and complications of the surgery?
Like all surgeries, a myomectomy does carry some risks, but most are uncommon and can be managed well with good care.
Some women may experience bleeding during or after surgery, and in rare cases, a blood transfusion might be needed. There’s also a small chance of infection or formation of scar tissue inside the uterus or abdomen. Extremely rarely, and if there’s uncontrolled bleeding, the need for a hysterectomy (removal of the uterus) has been described in the literature, but that’s not typical.
Most women recover well with the right support, and our medical team is there to guide you through each step, keeping your well-being at the heart of every decision.
Can I have a baby after a myomectomy?
Yes, you should still be able to get pregnant and have a baby after this procedure, as your uterus will be left intact.
Will I have a scar after the surgery?
It depends on the type of procedure carried out. Some types involve incisions, which will leave scars. The scars tend to heal very well.
Can fibroids come back after myomectomy?
Yes, more fibroids may form after the procedure. Certain individuals are at a higher risk of developing fibroids, such as those under 40. Older patients, closer to menopause, are less likely to face recurring fibroid issues. We recommend annual monitoring with an ultrasound scan after a myomectomy.
