women on the couch with her daughter researching what is a myoectomy surgery

What is a myomectomy?

A myomectomy is a surgery that removes fibroids from your uterus. Uterine fibroids are noncancerous growths made of muscle and tissue. They’re common and can grow in different areas of the uterus. Some are tiny, while others can grow much larger.

Unlike a hysterectomy—which removes your entire uterus—a myomectomy only removes the fibroids. Your uterus stays in place, so you may still be able to get pregnant after the procedure. It’s often a good option for people who want to treat fibroid symptoms but still hope to have children in the future.

There are different types of myomectomy surgeries. Your doctor will recommend the best approach based on where the fibroids are, how many there are, and how big they are.

Why might I need myomectomy surgery?

A myomectomy may be suggested by your doctor if you have uterine fibroids causing issues such as:

  • Pelvic discomfort
  • Irregular bleeding or bleeding between periods
  • Heavy menstrual bleeding (menorrhagia)
  • Trouble emptying your bladder
  • Infertility concerns related to fibroids

Myomectomy can also be a good choice if you're hoping to get pregnant in the future. The surgery removes the fibroids but keeps your uterus intact, which can help improve your chances of a healthy pregnancy.

Your doctor will help determine if myomectomy is the right option based on the size, location and number of fibroids, as well as your overall health and fertility goals.

How to prepare for myomectomy surgery

Your healthcare provider will give you all the instructions you need to prepare for surgery. This includes when to stop eating and drinking and whether you need to stop taking certain medications.

Your provider will also explain what to expect after surgery, including how long you’ll need to stay in the hospital or surgical center and any lifestyle changes you may need to make during recovery.

Be sure to ask your provider any questions you have before surgery, so you feel fully prepared and know what to expect.

The myomectomy procedure

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A myomectomy can be performed in different ways. Depending on the size, number and location of your fibroids, you may have the option of an abdominal, laparoscopic or hysteroscopic myomectomy. Your doctor will explain the details of the process based on the type of procedure you're having. Here’s what you can expect before, during and after the surgery.

Before the procedure

You’ll arrive at the hospital at the time given to you by your surgical team. Once you are checked in, you’ll be taken back to the surgery area, where you’ll receive anesthesia.

Abdominal, robotic and laparoscopic myomectomies usually involve general anesthesia, which will make you unconscious during the surgery. Hysteroscopic myomectomies may involve general anesthesia or sedation, which puts you to sleep but doesn’t require breathing assistance as general anesthesia does.

During the procedure

The type of myomectomy you have will determine how the procedure is done.

  • Abdominal myomectomy: Your surgeon will make a single, large incision in the lower part of your belly. This is sometimes called a “bikini cut,” and it may be horizontal or vertical. Your surgeon will remove the fibroids and then sew your incision back together using stitches.
  • Laparoscopic myomectomy: Your surgeon will make a few small incisions. Through one incision, they’ll insert a laparoscope, a long, thin tube outfitted with a light and a camera that lets the surgeon see your uterus and fibroids. Through the other incisions, they’ll insert special surgical tools that can remove the fibroids. Finally, the small incisions are sewn back together.
  • Robotic myomectomy: Your surgeon sits at a computer console that includes a high-definition camera and small surgical instruments. They will make a few small incisions and use the camera to see inside your uterus. They’ll also use the computer to control robotic arms that remove your fibroids. Once the procedure is over, they’ll sew the incisions back together.
  • Hysteroscopic myomectomy: First, your surgeon will insert a hysteroscope into your vagina. This tool contains a camera that lets them see your uterus, and it injects a saline solution that helps them see the area more clearly. Next, your surgeon will use a resectoscope, a device that delivers electricity to fibroids, or a morcellator, a tool that cuts the fibroid into pieces. This procedure doesn’t require incisions, so you won’t have stitches afterward.

After the procedure

Once the surgery is complete, you'll be moved to a recovery room, where the anesthesia will wear off, and you'll be monitored. Depending on the type of myomectomy you had, you may stay in the hospital for a short period, either overnight or for a few days, or you may be discharged and allowed to go home the same day.

Your doctor will provide pain medication and give you specific instructions about rest and activities to avoid during your recovery.

What are the risks of a myomectomy?

Like any surgery, myomectomy carries some risks, though they are rare. Potential risks include:

  • Infection
  • Excessive bleeding
  • Blood clots
  • Damage to nearby organs
  • Scar tissue that could block the fallopian tubes or cause fertility issues
  • New fibroids that may require another removal procedure
doctor discussing Myoectomy recovery with a patient

Myomectomy recovery

Recovery time can vary depending on the type of myomectomy procedure you had and whether any complications arise. It's normal to experience some pain during the first few days after surgery, but your doctor will provide medication to help manage it. They may also encourage you to move your legs or take short walks to reduce the risk of blood clots.

The full recovery time will depend on the procedure you had:

  • Abdominal myomectomy: 4 to 6 weeks
  • Laparoscopic and robotic myomectomies: 2 to 3 weeks
  • Hysteroscopic myomectomy: 1 to 2 days

If you had an abdominal, laparoscopic or robotic myomectomy, you may need to take several weeks off work. Your doctor will guide you on when it’s safe to return to normal activities and how to best support your healing process.

Your doctor will also schedule follow-up appointments to monitor your recovery and ensure you’re healing properly. It’s important to follow their instructions closely to help make your recovery as smooth and quick as possible.

Frequently asked questions

  • How fast do fibroids grow back after myomectomy?

    The time it takes for fibroids to grow back after a myomectomy varies widely, and fibroids don’t always return. Getting pregnant after myomectomy may reduce the chances of fibroids returning, and women who have only one, compared to multiple, fibroids are at a lower risk of fibroids growing back.

  • How long after myomectomy can I get pregnant?

    Doctors generally recommend waiting three to six months after myomectomy before trying to conceive. If you’d like to have a baby after surgery, talk to your doctor or surgeon for recommendations specific to the procedure you’re having. A little over 50% of women are able to get pregnant within 15 months of a myomectomy.

  • Is myomectomy a major surgery?

    Some types of myomectomy are considered major surgeries. An abdominal myomectomy requires making a large incision in your abdomen and can require many weeks of recovery. A hysteroscopic myomectomy, however, requires no incisions and only a few days of recovery. It is not considered major surgery.

  • How long does it take the uterus to heal after myomectomy?

    Healing time for your uterus after a myomectomy depends on the type of surgery. It can take a few weeks to a few months. Abdominal surgery takes the longest, while hysteroscopic recovery is usually quickest. Your doctor will let you know what to expect based on your procedure.

  • Why is my first period after myomectomy heavy?

    Your first period after a myomectomy may be heavier because your uterus is still healing. Changes to the uterine lining during surgery can affect your cycle, leading to more bleeding. This is usually temporary, but talk to your doctor if it’s very heavy or lasts too long.

  • How long does a myomectomy take?

    Myomectomy surgery usually takes between 30 minutes and four hours. The exact time depends on the type of procedure and how many fibroids need to be removed. Your doctor will walk you through what to expect based on your specific situation.

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