What is myomectomy?
A myomectomy is a surgical procedure to remove fibroids in your uterus that usually form during your childbearing years. The fibroids, called leiomyomas, are noncancerous growths, but create unwanted symptoms such as heavy menstrual bleeding and pelvic pain, and can even inhibit pregnancy.
Who should get a myomectomy?
When the fibroids in your uterus begin to cause symptoms that affect your daily life, your doctor may recommend that you undergo a myomectomy. It’s also the only fibroid treatment that may improve your chances of having a baby (although it doesn’t guarantee it). Your OB/GYN specialist recommends this procedure if:
- You plan to bear children
- Your doctor suspects the fibroids might be interfering with your fertility
- You want to keep your uterus (as a hysterectomy requires removing the entire uterus)
Outside of fertility reasons, women can also undergo myomectomy if they have:
- Anemia that wasn’t successfully treated by medicine
- Pain or pressure unrelieved by use of medicine
- A fibroid that’s changed the wall of the uterus, which can potentially cause infertility
What does a myomectomy procedure look like?
There are three surgical methods for a myomectomy:
Hysteroscopy
This procedure involves inserting a viewing instrument through the vagina and into the uterus. This process can remove the fibroids on your inner uterine wall, but not the ones that have grown deep into the wall.
Laparoscopy
This involves a viewing instrument and at least one incision in the abdomen. It’s used to remove one or two fibroids that are growing outside of the uterus.
Laparotomy
Involves a larger incision in the abdomen, and is reserved for removing several fibroids, large fibroids, or those that have grown deep into the uterine wall.
What are risks of undergoing a myomectomy?
Myomectomy has low complication rates, but as with any surgery, certain risks are involved:
- Excessive blood loss
- Scar tissue
- Infection of the uterus, fallopian tubes, or ovaries
- Pregnancy or childbirth complications
- Rare chance of injuries to the bladder or bowel
- Rare chance of uterine scars rupturing in late pregnancy or delivery
- Rare chance of a hysterectomy
- Rare chance of spreading a cancerous tumor
The doctor may recommend specific measures to minimize these risks before undergoing surgery, such as:
- Iron supplements or vitamins
- Hormonal treatment
- Therapy to shrink fibroids
