Myomectomy

Myomectomy is a surgical procedures which involves removing the fibroids but leaving behind the uterus. It can be done a number of ways, depending on the number, size and position of the fibroids. For instance, someone with a single small fibroid which is situation in the cavity of the uterus can undergo hysteroscopic myomectomy, which is a relatively fast and straightforward procedure that can be done as day case surgery. Women with a few small to medium fibroids situated deeper in the muscle of the uterus, and especially on the outside, may be suitable for laparoscopic myomectomy, which should also be followed by a relatively short hospital stay and quick recovery. Vaginal myomectomy may also be possible in this situation. However, if your fibroids are numerous and/or large, then abdominal myomectomy may well be the only option if you wish to retain your uterus.

What ever you choose or is appropriate in your case, myomectomy does involve surgery and therefore surgical risk. The most important complication specific to myomectomy is haemorrhage (bleeding), which may necessitate a blood transfusion, and in rare cases even hysterectomy. Although the chance of requiring a hysterectomy is very small, as it is only done in extreme cases of life-threatening, the risk is there. We, for instance, routinely use tourniquets at open and some laparoscopic myomectomies to temporarily occlude the uterine blood supply during surgery thereby greatly reducing intra-operative bleeding. We sometimes also suggest prior treatment with a drug to shrink the fibroids and stop your periods while you waiting for surgery (e.g. if you have very large fibroids or are anaemic).

In theory, pregnancy is still possible after myomectomy (unlike after hysterectomy); you may be advised to have a Caesarean delivery after extensive surgery. Conversely, as it is sometimes difficult to remove all fibroids, particularly those which are small, there is a chance that the problem may recur and you may therefore need further treatment in years to come.

Click on the links below for further information:

	Abdominal myomectomy		Laparoscopic myomectomy
	Hysteroscopic myomectomy		Vaginal myomectomy

Go Back