Is a Myomectomy a Major Surgery?

A myomectomy is surgery to remove fibroids.

Doctors don’t know why, but some women get fibroids. These are noncancerous tumors that grow on the outside, inside, or within the wall of the uterus. 

• Also called leiomyoma or myomas, fibroids vary in size. Some are as small as a seed. Others are big enough to change the shape of your uterus. 
• If you don’t have symptoms, you can live the rest of your life with fibroids. That’s what doctors call watchful waiting. 
• In some cases, though, fibroids can interfere with fertility and pregnancy. They can also cause heavy menstrual bleeding or periods that last more than a week. 
• There are many treatment methods, including medication, hysterectomy, and myomectomy.
• The main difference between myomectomy and hysterotomy is a myomectomy surgery allows the patient to have children.

Here is information that will help you understand how a myomectomy is used to treat them and what to expect after the surgery.

A myomectomy is a surgery to remove fibroids. Unlike a hysterectomy, it leaves your uterus intact. This might be an option for you if you plan to have children or have concerns about fibroids and infertility.

A myomectomy involves general anesthesia that relaxes your digestive tract muscles and the airway that keeps food from moving from your stomach to your lungs. This is why you fast by not eating or drinking before surgery. Talk to your doctor about exact timing and what to do about any medications you take daily.

There are three types of myomectomy: 

• Open or abdominal: Your surgeon removes fibroids through an abdominal cut near your bikini line. 
• Laparoscopic or robotic: During laparoscopic surgery, your surgeon makes many small incisions near your belly button. He uses them to put a small camera in your abdomen and use instruments to remove your fibroids. In robotic surgery, your surgeon uses a console to control the instruments.
• Hysteroscopic: Your surgeon inserts instruments through your vagina and cervix. Doctors often use this method for fibroids that jut into the lining of your uterus.

Your recovery depends on many factors, including what kind of myomectomy you had and how the surgery went. Your doctor can be more specific about prescriptions for pain medication, diet or activity restrictions, and recovery time. 

Use these general recovery estimates as a guide: 

• Open or abdominal: A few days in the hospital -- full recovery can take up to 6 weeks 
• Laparoscopic or robotic: One night in the hospital and 4 weeks at home
• Hysteroscopic: No hospital stay and 1 to 4 days at home

It’s common to spot or have vaginal bleeding in the days and weeks after a myomectomy.

Some women with fibroids have anemia from heavy blood loss. Surgery may cause more bleeding. Talk to your surgeon about ways to avoid a transfusion during your myomectomy. 

Other risks include scar tissue and childbirth complications. In rare cases, doctors mistake a cancerous tumor for a fibroid. If it breaks into small pieces during surgery, the cancer can spread.

After a myomectomy, most women return to a normal menstrual cycle without heavy or extended bleeding. It’s common to have success with pregnancy after your uterus has had 3 to 6 months to heal.

Sometimes they do. It happens most often in younger women during childbearing years. There’s also the possibility that some of your fibroids were so small your doctor couldn’t see them during surgery. Your doctor may also leave behind a piece of one. A hysterectomy -- surgery to remove your uterus -- is the only way to guarantee your fibroids won’t grow back.