Patient Education | Myomectomy

If you suffer from fibroids, your doctor may recommend a myomectomy. This procedure involves removing the fibroids while preserving the uterus. It can be performed several different ways depending on the size, number and location of your fibroids.

Also known as an "open" myomectomy, an abdominal myomectomy is a major surgical procedure. It involves making an incision through the skin on the lower abdomen, known as a "bikini cut," and removing the fibroids from the wall of the uterus. The uterine muscle is sewn back together using several layers of stitches.

You will be asleep during the procedure. Blood loss during the surgery may require a blood transfusion. Some women store their blood before the operation in order to receive their own blood rather than blood from the blood bank. You will probably spend two nights in the hospital. Recovery takes about 4-6 weeks at home before you can resume your normal activities. After the procedure, you will have a four-inch horizontal scar near your pubic hair or "bikini" line.

After a myomectomy, your doctor may recommend a Caesarean section (C-section) for the delivery of future pregnancies. This is to reduce the chance that your uterus could open apart during labor. The need for C-section will depend on how deeply the fibroids were embedded in the wall of the uterus at the time of surgical removal.

It is also important to note that new fibroids may develop, resulting in recurrent symptoms and additional procedures.

Like any surgical procedure, an abdominal myomectomy does have some risks, though rare. About five percent of women develop an infection after surgery that is treated with antibiotics in the hospital for as many as five days. About five percent of women develop a wound infection. Although the wound infection is treated at home, frequent visits to the doctor's office for up to six weeks is required.

Only certain fibroids can be removed by a laparoscopic myomectomy. If the fibroids are large, numerous or deeply embedded in the uterus, then an abdominal myomectomy may be necessary.

You will be asleep during the procedure, which is performed in the operating room. First, four one centimeter incisions are made in the lower abdomen: one at the navel (belly button), one below the "bikini" line (near the pubic hair) and one near each hip. The abdominal cavity is then filled with carbon dioxide gas. A thin, lighted telescope -- called a laparoscope -- is placed through an incision, allowing doctors to see the ovaries, fallopian tubes and uterus. Long instruments, inserted through the other incisions, are used to remove the fibroids. The uterine muscle is sewn back together. At the end of the procedure, the gas is released and the skin incisions are closed. Sometimes during the operation, it is necessary to switch from a laparoscopic myomectomy to an abdominal myomectomy. After the procedure, you will have small scars on your skin where the incisions were made.

A laparoscopic myomectomy requires one night in the hospital. Recovery usually takes two to four weeks at home before you are able to resume your normal activities.

Like any surgical procedure, a laparoscopic myomectomy does have some risks, though rare. Complications may include injuries to internal organs and bleeding. Also, your uterus may be weaker after surgery. Therefore, women planning to become pregnant in the future are usually encouraged to have an open, abdominal myomectomy.

It is also important to note that new fibroids may develop, resulting in recurrent symptoms and additional procedures.

Only women with submucosal fibroids are eligible for a hysteroscopic myomectomy. Fibroids located within the uterine wall cannot be removed with this technique.

This is an outpatient surgical procedure, during which most patients are usually asleep. During the procedure, you will lie on your back with your feet held in gynecology stirrups. A speculum is placed in the vagina. A long, slender "telescope" is placed through the cervix into the uterine cavity. Fluid is introduced into the uterine cavity to lift apart the walls. Instruments passed through the hysteroscope are used to shave off the submucosal fibroids. Afterwards, you will be able to go home after several hours of observation in the recovery room.

You may experience cramping and light bleeding after the procedure. Typical recovery involves one to four days of resting at home. You will not have any scars on your skin after the procedure.

Reviewed by health care specialists at UCSF Medical Center.
Last updated September 20, 2007

This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.