A myomectomy is a procedure that can removefibroidsand preservethe uterus. Sometimes this type of surgery can be a safe and effective alternative toa hysterectomy, which is the surgical removal of the uterus.
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Preparation
Before having a myomectomy, you may need preoperative preparation, which often includes treatment with Lupron Depot (leuprolide acetate) for about three months preceding the procedure.Lupron inhibits estrogen production, causing the fibroids to shrink in size. During this time,menstruationusually ceases.
There are some pros and cons to pretreatment with Lupron:
A successful myomectomy should provide complete relief from all of the symptoms associated with fibroid tumors. However, fibroids often grow back, necessitating the need for a hysterectomy later on.
You can safely have a repeat myomectomy, but each time, there is an increased risk of pelvic adhesions, which is a type of post-surgical scar tissue that can cause symptoms.
Associated Risks
Complications are rare when a myomectomy is performed properly, but it is important to be aware of the possible risks if you are considering having this procedure.
Possible complications include:
It is possible that the surgery would need to be converted to a hysterectomy during the procedure. Some complications may require surgical treatment.
Pregnancy is still possible after a myomectomy, and some women who become pregnant following a myomectomy might need to have a cesarean section due to a potential weakening in the uterine wall.
General Procedure
Before the surgery, anesthesia is started and a catheter is inserted into the bladder to keep it empty during the procedure.
Another catheter is inserted into the uterus and a dye is injected to stain the uterine cavity; this staining helps with visualization to determine the location of the fibroids.
During your procedure:
The dye also runs into thefallopian tubesand can help determine whether they are blocked or open. Repairs to the fallopian tubes can also be made during this procedure.
All women undergoing a minimally invasive myomectomy technique should be aware of the possible need to convert to a traditional open abdominal procedure or a hysterectomy while the myomectomy is in progress.
Types of Myomectomy
There are several different myomectomy techniques. This surgery can access the fibroids vaginally or abdominally, using a variety of different methods. The type of myomectomy that you would have depends on many factors, such as the size and location of your fibroid tumors.
Conventional Myomectomy
This is the most commonly performed type of myomectomy. A traditional myomectomy requires a 5-7 inch abdominal incision, less than 24 hours of hospitalization, and six to eight weeks for recovery.
Laparoscopic Myomectomy
During this procedure, a small incision is made, usually in the navel, and surgery is performed using a smalllaparoscopethat is inserted into the uterus through the abdominal wall. This type of myomectomy offers the fastest recovery time.
Laparoscopic Minilap Myomectomy
This is a procedure that includes a small traditional abdominal incision to remove the fibroids. This type of procedure can be used for any size fibroid. Because the incision is only 4-5 cm, recovery is quicker than from a conventional myomectomy.
Laparoscopic Myomectomy With Colpotomy
Trans-Cervical Myomectomy
This is performed during ahysteroscopywith the aid of a resectoscope to treat submucosal fibroids. Other types of myomectomy may be performed during this procedure if intramural or subserosal fibroids are present.
More than 99% of fibroids are benign, but there is a rare possibility of cancer.After it is removed, your fibroid may be sent for pathological evaluation to determine whether it is cancerous.
What to Ask Your Healthcare Provider
Your healthcare provider should explain all possible fibroid treatment options before you make your decision.
Some questions you might want to ask:
Overview of Fibroids Surgery
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Library of Medicine. DailyMed.LUPRON DEPOT- leuprolide acetate kit[drug label].De La Cruz MS, Buchanan EM.Uterine fibroids: diagnosis and treatment.Am Fam Physician. 2017;95(2):100-107.Alharbi AA, Alshadadi F, Alobisi A, et al.Intraoperative and postoperative complications following open, laparoscopic, and hysteroscopic myomectomies in Saudi Arabia.Cureus. 2020;12(3):e7154. doi:10.7759/cureus.7154Mallick R, Odejinmi F.Pushing the boundaries of laparoscopic myomectomy: a comparative analysis of peri-operative outcomes in 323 women undergoing laparoscopic myomectomy in a tertiary referral centre.Gynecol Surg. 2017;14(1):22. doi:10.1186/s10397-017-1025-1Parker WH, Pritts EA, Olive DL.What is the future of open intraperitoneal power-morcellation of fibroids?.Clin Obstet Gynecol. 2016;59(1):73-84. doi:10.1097/GRF.0000000000000166Ghezzi F, Casarin J, De Francesco G, et al.Transvaginal contained tissue extraction after laparoscopic myomectomy: a cohort study.BJOG. 2018;125(3):367-373. doi:10.1111/1471-0528.14720Ciebiera M, Łoziński T, Wojtyła C, Rawski W, Jakiel G.Complications in modern hysteroscopic myomectomy.Ginekol Pol. 2018;89(7):398-404. doi:10.5603/GP.a2018.0068Stanford Health Care.Fibroids.Additional ReadingTanos V, Berry KE, Frist M, Campo R, DeWilde RL.Prevention and management of complications in laparoscopic myomectomy.Biomed Res Int. 2018;2018:8250952. doi:10.1155/2018/8250952
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Library of Medicine. DailyMed.LUPRON DEPOT- leuprolide acetate kit[drug label].De La Cruz MS, Buchanan EM.Uterine fibroids: diagnosis and treatment.Am Fam Physician. 2017;95(2):100-107.Alharbi AA, Alshadadi F, Alobisi A, et al.Intraoperative and postoperative complications following open, laparoscopic, and hysteroscopic myomectomies in Saudi Arabia.Cureus. 2020;12(3):e7154. doi:10.7759/cureus.7154Mallick R, Odejinmi F.Pushing the boundaries of laparoscopic myomectomy: a comparative analysis of peri-operative outcomes in 323 women undergoing laparoscopic myomectomy in a tertiary referral centre.Gynecol Surg. 2017;14(1):22. doi:10.1186/s10397-017-1025-1Parker WH, Pritts EA, Olive DL.What is the future of open intraperitoneal power-morcellation of fibroids?.Clin Obstet Gynecol. 2016;59(1):73-84. doi:10.1097/GRF.0000000000000166Ghezzi F, Casarin J, De Francesco G, et al.Transvaginal contained tissue extraction after laparoscopic myomectomy: a cohort study.BJOG. 2018;125(3):367-373. doi:10.1111/1471-0528.14720Ciebiera M, Łoziński T, Wojtyła C, Rawski W, Jakiel G.Complications in modern hysteroscopic myomectomy.Ginekol Pol. 2018;89(7):398-404. doi:10.5603/GP.a2018.0068Stanford Health Care.Fibroids.Additional ReadingTanos V, Berry KE, Frist M, Campo R, DeWilde RL.Prevention and management of complications in laparoscopic myomectomy.Biomed Res Int. 2018;2018:8250952. doi:10.1155/2018/8250952
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Library of Medicine. DailyMed.LUPRON DEPOT- leuprolide acetate kit[drug label].De La Cruz MS, Buchanan EM.Uterine fibroids: diagnosis and treatment.Am Fam Physician. 2017;95(2):100-107.Alharbi AA, Alshadadi F, Alobisi A, et al.Intraoperative and postoperative complications following open, laparoscopic, and hysteroscopic myomectomies in Saudi Arabia.Cureus. 2020;12(3):e7154. doi:10.7759/cureus.7154Mallick R, Odejinmi F.Pushing the boundaries of laparoscopic myomectomy: a comparative analysis of peri-operative outcomes in 323 women undergoing laparoscopic myomectomy in a tertiary referral centre.Gynecol Surg. 2017;14(1):22. doi:10.1186/s10397-017-1025-1Parker WH, Pritts EA, Olive DL.What is the future of open intraperitoneal power-morcellation of fibroids?.Clin Obstet Gynecol. 2016;59(1):73-84. doi:10.1097/GRF.0000000000000166Ghezzi F, Casarin J, De Francesco G, et al.Transvaginal contained tissue extraction after laparoscopic myomectomy: a cohort study.BJOG. 2018;125(3):367-373. doi:10.1111/1471-0528.14720Ciebiera M, Łoziński T, Wojtyła C, Rawski W, Jakiel G.Complications in modern hysteroscopic myomectomy.Ginekol Pol. 2018;89(7):398-404. doi:10.5603/GP.a2018.0068Stanford Health Care.Fibroids.
National Library of Medicine. DailyMed.LUPRON DEPOT- leuprolide acetate kit[drug label].
De La Cruz MS, Buchanan EM.Uterine fibroids: diagnosis and treatment.Am Fam Physician. 2017;95(2):100-107.
Alharbi AA, Alshadadi F, Alobisi A, et al.Intraoperative and postoperative complications following open, laparoscopic, and hysteroscopic myomectomies in Saudi Arabia.Cureus. 2020;12(3):e7154. doi:10.7759/cureus.7154
Mallick R, Odejinmi F.Pushing the boundaries of laparoscopic myomectomy: a comparative analysis of peri-operative outcomes in 323 women undergoing laparoscopic myomectomy in a tertiary referral centre.Gynecol Surg. 2017;14(1):22. doi:10.1186/s10397-017-1025-1
Parker WH, Pritts EA, Olive DL.What is the future of open intraperitoneal power-morcellation of fibroids?.Clin Obstet Gynecol. 2016;59(1):73-84. doi:10.1097/GRF.0000000000000166
Ghezzi F, Casarin J, De Francesco G, et al.Transvaginal contained tissue extraction after laparoscopic myomectomy: a cohort study.BJOG. 2018;125(3):367-373. doi:10.1111/1471-0528.14720
Ciebiera M, Łoziński T, Wojtyła C, Rawski W, Jakiel G.Complications in modern hysteroscopic myomectomy.Ginekol Pol. 2018;89(7):398-404. doi:10.5603/GP.a2018.0068
Stanford Health Care.Fibroids.
Tanos V, Berry KE, Frist M, Campo R, DeWilde RL.Prevention and management of complications in laparoscopic myomectomy.Biomed Res Int. 2018;2018:8250952. doi:10.1155/2018/8250952
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