Myomectomy

A Myomectomy is a surgical procedure to remove uterine fibroids, benign or non-cancerous growths on the uterus. Many women with uterine fibroids do not experience any symptoms. However some women may experience symptoms including heavy and prolonged menstrual bleeding, bleeding between periods, pelvic pain, infertility, lower back pain, pain during intercourse and urinary or bowel problems. Rarely may you have difficulty emptying your bladder, difficulty moving your bowels, anaemia due to heavy menstrual bleeding.

Myomectomy is the treatment of choice for women with fibroids who desire fertility. Myomectomy removes only the fibroids and leaves the uterus intact.

The surgical modality depends on the size and site of the fibroid. If the fibroid is mainly in the uterine cavity, it can be removed hysteroscopically by inserting a long thin camera through the cervix into the uterus. The fibroid is then cut away and removed through the cervix and vagina. If the fibroid is in the uterine body or outside the muscle layer, then it will need to be removed through the abdomen, either laparoscopically with a long thin camera through small incisions on the abdomen or an open operation (laparotomy) through a long incision on the abdomen.

Potential risks of the operation include infection, bleeding, blood transfusion, small risk of needing to perform hysterectomy (removal of uterus) due to uncontrolled bleeding, nearby organ injury and anaesthesia risks.

After a myomectomy, if fertility is desired, you should wait for at least 4 months for the uterus to heal before starting to try to fall pregnant. In some cases, labour may carry a significantly higher risk of uterine rupture and an elective caesarean section is advised for future pregnancies.