Myomectomy

Uterine fibroids (also known as myomas or leiomyomas) are benign tumors of the uterus.

A myomectomy is the surgical removal of fibroids. Myomectomy can be performed in many ways: abdominally (with a big incision) or with minimally invasive techniques that minimize incisions. Learn more about each option below:

· Laparoscopic myomectomy (1 – 4 small incisions)

· Robotic-assisted laparoscopic myomectomy (1 – 4 small incisions)

· Hysteroscopic myomectomy (no incisions)

The best method of myomectomy depends on the person, how many fibroids are present, where they are located in the uterus, and of course, your individual goals. Sometimes more than one method of myomectomy is required during the same surgery.

The benefit of minimally invasive surgery is that there is less pain, recovery is faster, and risk of complications like infection is lower.

The most important benefit of myomectomy is that the procedure allows for uterine preservation. 

In addition, some women pursuing pregnancy are advised by their OB/GYN or reproductive endocrinology and infertility specialist to have fibroids removed before attempting in vitro fertilization. 

Because fibroids are hormonally sensitive, they can recur later in life after surgery. There is up to a 30% chance of recurrence of fibroids requiring treatment or additional surgery in the future.

Compared to hysterectomy, in general, myomectomy is a more complex surgery. This is because after the fibroids are removed from the uterus, the uterus must be reconstructed, which needs time and care. For this reason, the risk of needing a blood transfusion after myomectomy is higher than for women having hysterectomy – up to 10%. Your risk of bleeding and possibly needing a blood transfusion depends on the number and type of fibroids you have. That being said, skilled technique and excellent preparation is key to preventing complications, and we will thoroughly discuss your treatment strategy before planning surgery.

One unique thing to consider after myomectomy is the impact on future pregnancy. Depending on the extent of the myomectomy and type of fibroid removed, a C-section may be recommended in future pregnancy.