What is Myomectomy Surgery?

Myomectomy surgery is a specialized procedure performed to remove uterine fibroids while preserving the uterus. It is one of the most common surgical treatments for women experiencing fibroid-related symptoms such as heavy menstrual bleeding, pelvic pain, or reproductive issues. Unlike hysterectomy, which removes the entire uterus, myomectomy focuses only on the fibroids. This allows women to retain their fertility and hormonal balance, making it an ideal option for those who wish to conceive in the future.

What is Myomectomy Surgery?

Uterine fibroids, also known as leiomyomas, are noncancerous growths that develop in or on the uterus. These tumors vary in size and can be located within the uterine wall, on the outer surface, or inside the uterine cavity. While some women may not notice any symptoms, others experience significant discomfort, including prolonged periods, lower abdominal pressure, frequent urination, or pain during intercourse. When these symptoms affect quality of life or fertility, surgical intervention such as a myomectomy may be necessary.

When is Myomectomy Recommended?

Myomectomy is usually recommended when fibroids cause severe symptoms that do not respond to medication or non-invasive treatments. Women who want to maintain the possibility of pregnancy often choose myomectomy over more drastic surgical options. The size, location, and number of fibroids play a critical role in determining whether this surgery is the right approach.

For instance, fibroids that distort the shape of the uterus or block the fallopian tubes can interfere with conception. In such cases, removing the fibroids can improve fertility outcomes. Additionally, if fibroids lead to anemia from excessive bleeding or persistent pelvic discomfort, a myomectomy can offer much-needed relief.

Types of Myomectomy Surgery

There are several techniques used in performing a myomectomy, and the choice depends on the individual case, the surgeon’s expertise, and the fibroids’ characteristics.

1. Abdominal Myomectomy :- This is a traditional open surgery where the surgeon makes an incision in the lower abdomen to access the uterus and remove the fibroids. It is most suitable for women with large or numerous fibroids and allows direct visibility of the uterus. Though the recovery time is longer compared to other techniques, it offers a comprehensive removal option in complex cases.
2. Laparoscopic Myomectomy :- Laparoscopic myomectomy is a minimally invasive technique that involves small incisions in the abdomen. The surgeon uses a camera and specialized instruments to remove the fibroids. This approach typically results in less postoperative pain, minimal scarring, and a faster recovery. It is an effective option for women with fewer and moderately sized fibroids.
3. Hysteroscopic Myomectomy :- This technique is used when fibroids are located within the uterine cavity. A thin, lighted instrument called a hysteroscope is inserted through the vagina and cervix to reach the uterus. There are no external incisions, and the procedure is usually performed on an outpatient basis. Recovery is quick, and many women return to normal activities within a few days.

How the Procedure Works

Before the surgery, a thorough evaluation is conducted, including pelvic ultrasound or MRI, to assess the size and position of the fibroids. Preoperative medical treatments might be prescribed to reduce fibroid size and minimize blood loss during surgery.

During the procedure, the patient is placed under anesthesia. The surgeon then selects the most appropriate approach based on the surgical plan. Fibroids are carefully removed from the uterine wall, and the uterus is reconstructed using dissolvable sutures. The goal is to preserve the uterus’s function while eliminating the source of the symptoms.

Depending on the complexity of the surgery and the type of myomectomy, the procedure can last from one to three hours. Patients undergoing open abdominal myomectomy typically stay in the hospital for one to three days, while those undergoing laparoscopic or hysteroscopic procedures may be discharged the same day or after one night.

Recovery and Postoperative Care

Recovery time varies depending on the surgical technique. For abdominal myomectomy, complete recovery may take four to six weeks. Laparoscopic procedures generally require two to four weeks, and hysteroscopic recovery is often complete within a week.

During recovery, patients are advised to avoid strenuous activities, heavy lifting, and sexual intercourse until cleared by the doctor. Pain and discomfort are managed with medications, and follow-up appointments help monitor healing and prevent complications.

It is normal to experience some spotting or vaginal discharge after surgery. Patients are also encouraged to maintain a healthy diet, drink plenty of fluids, and gradually resume physical activity to support healing.

Benefits of Myomectomy

Myomectomy offers multiple benefits, particularly for women who wish to preserve their fertility. It significantly reduces or eliminates fibroid symptoms, improves quality of life, and increases the likelihood of successful pregnancy in some cases. Since the uterus is preserved, hormonal balance is maintained, and there is no early onset of menopause as seen with a hysterectomy.

Another advantage is the tailored approach. Surgeons can remove only the problematic fibroids while leaving healthy uterine tissue intact. This precision minimizes complications and helps maintain reproductive potential.

Risks and Considerations

As with any surgical procedure, myomectomy carries certain risks. These may include excessive bleeding, infection, damage to surrounding organs, or the need for blood transfusion. In rare cases, a hysterectomy might be required during surgery if complications arise.

There is also a chance that fibroids can return after surgery, especially in younger women. To minimize recurrence, some doctors recommend lifestyle changes or hormonal management post-surgery.

Women planning to conceive after a myomectomy should discuss timing with their doctor. Pregnancy is generally safe following the procedure, but in some cases, a cesarean section may be recommended for delivery, depending on the extent of the uterine repair.

Conclusion

Myomectomy surgery is a highly effective solution for women dealing with fibroids who want to preserve their uterus and fertility. With advancements in surgical techniques, the procedure is now safer, less invasive, and offers quicker recovery than ever before. If you are experiencing symptoms related to uterine fibroids, consulting a gynecologist can help determine whether myomectomy is the right choice for your health and future plans.