Myomectomy is the surgical removal of fibroids while leaving the uterus in place. Because a woman keeps her uterus, she may still be able to have children. If a woman does become pregnant after a myomectomy, the baby may need to be delivered by cesarean birth. Sometimes, though, a myomectomy causes internal scarring that can lead to infertility.
Fibroids do not regrow after surgery, but new fibroids may develop. If they do, more surgery may be needed.
Myomectomy may be done in a number of ways:
- Laparoscopy
- Robotic assisted laparoscopy
- Hysteroscopy
- Laparotomy
The method used depends on the location and size of the fibroids. In laparotomy, an incision (cut) is made in the abdomen. The fibroids are removed through the incision. In laparoscopy, a laparoscope is used to view the inside of the pelvis. Other tools are inserted through another small incision to remove the fibroids.
Hysteroscopy can be used to remove fibroids that protrude into the cavity of the uterus. A resectoscope is inserted through the hysteroscope. The resectoscope destroys fibroids with electricity or a laser beam. Although it cannot remove fibroids deep in the walls of the uterus, it often can control the bleeding these fibroids cause. In most cases, an overnight stay in the hospital is not necessary.
Myomectomy has risks, including bleeding and infection. Hysteroscopy may cause other problems related to the use of fluid during the procedure. Your doctor can explain all of the risks to you.
