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Information about uterine fibroids
Minimally Invasive Therapy Unit & Endoscopy Training Centre
University Department of Obstetrics and Gynaecology
Royal Free Hospital
Pond Street
Hampstead
London NW3 2QG, UK

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 haemorrhage, the risk is there. We may suggest prior treatment with a drug to shrink the fibroids and make them less vascular as this can make the surgery easier and reduce bleeding.

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
Hysteroscopic myomectomy
Laparoscopic myomectomy
Vaginal myomectomy

THIS SITE: Home ¦ What are fibroids ¦ Symptoms ¦ Diagnosis ¦ Treatment overview ¦ Medical treatment ¦ Myomectomy ¦ Hysterectomy ¦ Uterine artery embolisation ¦ Operation movies ¦ Fibroid Clinic
USEFUL INFORMATION: Other fibroid web sites ¦ Heavy periods ¦ Pelvic pain¦ Infertility ¦ Endometriosis ¦ Adhesions ¦ Polycystic ovaries
CONTACT: Appointment ¦ Find us ¦ Downloads ¦ Guestbook ¦ Comments or enquiry
USEFUL LINKS: One Stop Fertility Clinic ¦ Royal Free Hospital ¦ Gynaecology Workshops ¦ MRCOG & DRCOG Courses ¦ Royal College of Obstetricians and Gynaecologists ¦ The Hysterectomy Association ¦ Really Useful Software

MEDICAL NOTES
History

The first successful abdominal myomectomy was done in 1844 by Washington Atlee in the USA, and the following year he removed a prolapsed fibroid through the vagina. Abdominal myomectomy became a standard procedure of the gynaecologist's repertoire some years later.

Hysteroscopic myomectomy was first reported formally by Robert Neuwirth, another American, in 1976 (scissors) and 1978 (resectoscope).

At about the same time. Kurt Semm (Germany) developed the necessary instruments and techniques to excise fibroids laparoscopically.