Guide to Myomectomy (Uterine Fibroid Surgery)

Uterine fibroids are benign tissue growths that often develop in the uterus during a woman’s childbearing years. These growths can vary in size and number and does not always require treatment. However, some fibroids may cause symptoms and increase the risk of developing certain complications. In such cases, a myomectomy or uterine fibroid surgery may be necessary.

What Is Myomectomy and When Do You Need It?

A myomectomy is a surgical procedure that removes uterine fibroids while preserving the uterus. It is often recommended for patients experiencing symptoms of fibroids like irregular bleeding, heavy menstrual periods, pelvic pain, and iron-deficiency anaemia due to blood loss.

By keeping the uterus intact, myomectomy allows patients the chance to conceive in the future. This is in contrast to a hysterectomy, which involves removing the entire uterus.

Types of Myomectomy

There are three primary types of myomectomy and the most suitable procedure is determined by the number, size, and location of the uterine fibroids.

  • Open Myomectomy
    Open myomectomy involves a larger abdominal incision to access the uterus and remove fibroids. This procedure is best suited for large fibroids, multiple fibroids, or those deeply embedded within the uterine wall. As the most invasive approach, it carries a higher risk of complications and requires a longer recovery period.
  • Laparoscopic Myomectomy
    Laparoscopic myomectomy is a less invasive approach that utilises small incisions in the abdomen instead of a large incision. This is often recommended for fewer and smaller fibroids. A tiny, lighted camera is inserted to provide a clear view of the surgical site on a monitor. Specialised surgical instruments are then used to remove the fibroids.
  • Hysteroscopic Myomectomy
    Hysteroscopic myomectomy is the least invasive approach, requiring no incisions. This procedure is only suitable for fibroids that are located within the uterine lining. The surgeon will insert a hysteroscope through the vagina and cervix into the uterus, where the fibroids can be removed.

What to Expect

Preparing for Uterine Fibroid Surgery

Be sure to inform your surgeon of any medications and supplements that you are taking. Drugs like blood thinners may need to be temporarily stopped to reduce the risk of bleeding during surgery. A pre-operative examination will be performed to ensure that you are fit for fibroid surgery. You will also be asked to fast for about 6 to 8 hours before the procedure. Your fibroid specialist will also provide post-operative instructions to help you prepare for recovery.

Procedure Details

Uterine fibroid surgery is often performed under general anaesthesia. The specific duration, hospital stay and recovery period depends on the type of myomectomy, the number, size and location of fibroids, as well as the surgeon’s experience.

In terms of the type of myomectomy performed, here is a general guide of how long each one will take:

  • Open Myomectomy: This procedure usually takes around 2 hours and often requires 1-2 days hospitalisation for monitoring. Typically, complete recovery may take up to 6 weeks.
  • Laparoscopic Myomectomy: Typically lasting around 3 hours, this is usually an outpatient procedure or up to 1-day hospital stay. The recovery time is generally 2-3 weeks.
  • Hysteroscopic Myomectomy: This is the least invasive option, typically taking around 90 minutes. It is an outpatient procedure and patients usually recover within 48 hours.

Recovery From Fibroid Surgery

It is common to experience some discomfort after fibroids surgery. You will usually be given medications to help manage the pain. You may also experience vaginal bleeding for a few days to a few weeks. During this time, it is generally recommended to use sanitary pads instead of tampons to reduce the risk of infection.

Other post-operative instructions for a smoother recovery include:

  • Refrain from strenuous physical activity for the time being
  • Do not have sexual intercourse or insert anything in your vagina until you have recovered
  • Attend follow-up consultations to ensure that you are recovering properly

For more information about myomectomy (uterine fibroid surgery), please speak with your gynaecologist to determine if it is a suitable option for you.

Top