What it is
A myomectomy takes the fibroids out and leaves the uterus behind. It is the choice when you want to keep the option of pregnancy.
Where the fibroids sit decides the route. Ones inside the cavity come out through the cervix with a camera. Ones in the wall need small cuts in the belly, or one larger cut.
Fibroids can grow back. A uterus that made one can make another, so this is not always a one-time operation.
Why it is done
- Heavy periods coming from a fibroid
- Pressure, bloating, or a belly that looks pregnant
- Needing to urinate often because a fibroid presses on the bladder
- A constant ache low down, or pain with sex
- Trouble getting pregnant, or repeated miscarriage, with a fibroid in the cavity
- You want the fibroid gone and the uterus kept
What happens, step by step
- 1
Mapping the fibroids
An ultrasound, and sometimes an MRI, shows how many there are and where.
- 2
Choosing the route
Their position decides it: through the cervix, through keyholes, or open.
- 3
Anesthesia
General for the routes through the belly. Through the cervix, sedation is often enough.
- 4
Taking them out
Each fibroid is cut out of the muscle, and the muscle is stitched closed.
- 5
Going home
Home the same day for the smaller routes, a night or two after an open one.
- 6
Healing check
Seen at two weeks, and told when the uterus is strong enough for pregnancy.
Questions people ask
- Will I still be able to get pregnant?
- That is the point of the operation. Dr. Mueller will tell you how long to wait and whether the scar means delivering by C-section.
- Do fibroids grow back?
- They can. Removing the ones there today does not stop the uterus from making new ones.
- Will I need a C-section afterward?
- Often yes, if the cut went through the full thickness of the muscle. If the fibroid came out through the cervix, no.
- Is recovery worse than a hysterectomy?
- It is similar. There is more bleeding during a myomectomy, because the uterus stays and every cut in it has to be stitched.
- How big does a fibroid have to be?
- Size alone does not decide it. What it is doing to you does.