Myomectomy

A myomectomy is surgery to remove one or more uterine fibroids while preserving the uterus. Fibroids are non-cancerous growths in the muscle or lining of the uterus. The operation may be hysteroscopic, laparoscopic, robotic-assisted or open, depending on the fibroids’ number, size and position. The route affects the incision, hospital stay and recovery. Your surgeon will explain whether the aim is to improve bleeding, pressure, pain or fertility-related concerns.

Recovery depends mainly on the surgical route. After hysteroscopic surgery, cramps and light bleeding may last for a short period. Keyhole surgery usually causes abdominal soreness and tiredness while the small incisions heal. Open surgery involves a larger abdominal wound and a longer return to normal activity. Avoid lifting and strenuous exercise as advised, keep the wound clean and attend follow-up. Seek help for fever, increasing pain, heavy bleeding or wound redness.

Possible complications include bleeding, infection, blood clots, injury to the bladder or bowel, and reactions to anaesthesia. Scar tissue can form inside or around the uterus. In some cases, an operation planned as a myomectomy needs a different approach to control bleeding. Fibroids can also be found in places that make removal difficult. Ask how the route, fibroid position and your health history change the risks and warning signs.

Removing a fibroid can reduce bleeding, pressure or pain caused by that fibroid, but symptoms may have another cause or more than one fibroid may be involved. New fibroids can develop later because the uterus remains in place. If pregnancy is a goal, ask about healing time, the depth of the uterine incision and whether future birth planning needs specialist advice. Your follow-up plan should match your symptoms and reproductive plans.

The operation preserves the uterus but does not remove every possible cause of heavy periods or pelvic pain. Imaging helps map the fibroids before surgery. The route is selected according to location and surgical findings. Ask whether tissue will be sent for laboratory examination and when you should expect the result.

It may be offered when fibroids cause troublesome heavy periods, pelvic pain, pressure, anaemia-related symptoms, difficulty conceiving or pregnancy-related concerns. The decision considers your symptoms, scan findings, age, medical history and whether preserving the uterus matters to you. Read about Uterine Fibroids, Heavy Periods and Pelvic Pain to put the discussion in context.

You review medicines, anaesthesia and the planned route before surgery. The surgeon reaches the fibroid, separates it from surrounding uterine muscle and removes it. The uterine wall is repaired when needed, and the removed tissue is taken for examination. Afterward, the team monitors pain, bleeding, urination and movement before discharge or continued hospital care.

Cramps, tiredness and vaginal bleeding can occur after surgery. Increase walking gently, protect the incision and use pain relief as prescribed. Return to work, exercise and sexual activity only within the timeframe given for your route and healing. Contact the team if bleeding becomes heavy, pain escalates, you develop fever or you feel short of breath.

Ask about bleeding control, infection prevention, scar tissue, injury to nearby organs, the chance of needing a different operation and how fibroid recurrence could affect future care. If you may want a pregnancy, discuss uterine healing, contraception during recovery and when to seek pre-pregnancy advice.

Depending on symptoms and goals, options may include medicines, a radiofrequency fibroid ablation device, uterine artery embolisation, or hysterectomy. Observation can be reasonable when symptoms are mild. Each option differs in how it affects the uterus, fertility, recovery and the chance of future fibroid symptoms. Ask for a comparison tailored to your scan and priorities.

Choose a gynaecologist experienced with the surgical route proposed for your fibroids. Bring scan reports, bleeding details, pain triggers, medicines and pregnancy plans. Ask who performs the procedure, how complications are handled, what follow-up includes and whom to contact outside clinic hours.