"What really happens during a myomectomy?"
- drelyananoordin
- 3 days ago
- 2 min read
Have you ever wondered what really happens during a myomectomy? Let me walk you through it.
What is a Myomectomy?
A myomectomy is a surgery performed to remove fibroids from the uterus (womb) while preserving the uterus itself.
Fibroids are non-cancerous growths that can develop in the uterus. Some women may not have symptoms, while others may experience:
Heavy menstrual bleeding
Painful periods
Pelvic pressure or bloating
Frequent urination
Difficulty getting pregnant
A myomectomy may be recommended if fibroids are causing symptoms or affecting fertility.
In this patient, a myomectomy was performed because she had heavy menstrual bleeding that led to anaemia. She had undergone medical treatment for almost a year without significant improvement, and ultimately chose to have the fibroid removed to relieve her symptoms.
What happens during the surgery?
During the procedure, the surgeon will:
Locate the fibroids
Remove the fibroids from the uterus
Repair the uterine muscle carefully with stitches
The aim is to relieve symptoms while keeping the uterus intact, especially for women who wish to have children in the future.
How is myomectomy performed?
There are different ways to perform a myomectomy:
1. Laparoscopic Myomectomy (Keyhole Surgery)
Small cuts are made on the abdomen, and a camera is used to perform the surgery.
Advantages:
Smaller scars
Less pain
Faster recovery
This is usually suitable for selected fibroids depending on size, number, and location.
2. Open Myomectomy (Laparotomy)
A larger cut is made on the abdomen to remove the fibroids directly.
This may be needed if:
Fibroids are very large
There are many fibroids
The surgery is expected to be complex
Recovery is usually longer compared to keyhole surgery.
Read more about laparoscopy vs laparotomy here.
What are the risks of myomectomy?
Although myomectomy is commonly performed and generally safe, all surgeries carry some risks.
Common risks
Pain after surgery
Bleeding
Bruising or wound infection
Important surgical risks
Heavy bleeding during surgery, which may occasionally require blood transfusion
Injury to nearby organs such as the bladder, bowel, or ureter
Scar tissue (adhesion) formation inside the pelvis
Infection involving the wound or uterus
Risks related to fertility and future pregnancy
The uterus will have a scar after surgery
Some women may be advised to undergo Caesarean delivery in future pregnancies depending on the depth and location of fibroid removal
Fibroids can sometimes grow back in the future
Rare but serious risks
Need to convert from laparoscopic surgery to open surgery if the procedure is difficult or unsafe to continue laparoscopically
Very rarely, severe bleeding may require removal of the uterus (hysterectomy) to save the patient’s life
Anaesthesia-related complications
Blood clots in the legs or lungs
Recovery after surgery
Recovery depends on the type of surgery:
Laparoscopic myomectomy: usually 2–4 weeks
Open myomectomy: usually 4–6 weeks
Patients are generally advised to avoid heavy lifting and strenuous activities during recovery.
In summary
A myomectomy removes fibroids while preserving the uterus. It can help improve symptoms such as heavy bleeding, pain, and fertility issues. Most women recover well after surgery, but it is important to understand the potential risks and discuss them thoroughly with your doctor before the procedure.
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