Myomectomy is a procedure to remove uterine fibroids, which are noncancerous growths that can lead to problems in the uterus, while leaving the uterus in tact. In some cases, hormone therapies can be used to shrink the fibroids, which allows a minimally invasive surgical procedure.
Why is Myomectomy performed?
- Heavy menstrual bleeding
- Pelvic pressure
- Fibroids affecting fertility and/or ability to bear children
What are the risks of Myomectomy?
- Excessive bleeding
- Scar tissue
- Reoccurence of fibroids
- Childbirth complications
What happens in a Myomectomy?
There are three ways to perform the procedure:
- Abdominal Myomectomy
The surgeon makes an incision in the abdomen to access the uterus and remove the fibroids. Depending on specific cases and conditions, the incision either runs vertically from below the navel to above the pubic bone or horizontally approximately one inch above the pubic bone. Another incision is made in the uterus and the fibroids are grasped with instruments and removed. A hospital stay of two to three days is likely, with recovery in four to six weeks.
- Laparoscopic Myomectomy
The surgeon makes a small incision near the navel and introduces carbon dioxide to lift the abdominal wall and create more space for the procedure. A tube called a trocar is inserted into the incision, and a tiny video camera called a laparoscope is placed in the tube. More small incisions are made to introduce the instruments surgeons use to perform the removal of the fibroids. The fibroids also could be removed through an incision in the vagina. A hospital stay usually is not necessary, with recovery in a few days to two weeks.
- Hysteroscopic Myomectomy
This procedure primarily is used when fibroids bluge into the uterine cavity - they are called submucosal fibroids. The surgeon inserts a resectoscope, a small, lighted cutting instrument, through the vagina and cervix to access the uterus. A tube connected to the resectoscope releases a liquid to expand the uterine cavity. Using the resectoscope, the surgeon cuts away parts of the fibroid to even it out with the uterine cavity surface, and the removed tissue is flushed out along with the liquid. A hospital stay usually is not necessary, with recovery in a few days to two weeks.