Uterine Fibroids

A myomectomy is a surgery used in the treatment of uterine fibroids. In it, your surgeon will take out the fibroids while leaving your uterus so that you can get pregnant. A myomectomy is a more invasive procedure than a hysterectomy. It’s not recommended for women who no longer are able to have children.

Most fibroids are small and don’t have symptoms. However, many women with fibroids have a lot of pain and bleeding. These can interfere with their daily lives, so they ask their doctor for treatment. Symptoms are directly related to the number, size and location of the tumors.

Fibroid symptoms are typically classified into three categories:

• Heavy menstrual bleeding
• Bulk related symptoms including pelvic pressure and pain
• Reproductive dysfunction or infertility

Fibroids can grow in the muscle of the uterus, in the cavity or on the outside. Fibroids that are in the muscle, require an incision in the uterus for removal. The incision can be deep in the muscle, and will require repair and a longer healing time. In addition, the fibroids need to be removed through the abdominal wall in a myomectomy, which increases the size of the incisions and leads to increased pain.

There are some fibroids that protrude into the uterine cavity called submucosal fibroids. This type of fibroid can be removed via a D&C with a morcellation device. This type of procedure doesn’t require an incision into the uterus and is a lower risk surgery compared to an open procedure through the abdominal wall.

This is important to understand, as many women believe a myomectomy is a less painful procedure than a hysterectomy.

Your health care provider may recommend a pelvic ultrasound to diagnose and evaluate your fibroids.

If preserving fertility is possible, a myomectomy is appropriate. If fertility is no longer an option, and fibroids are recurring, a hysterectomy may be a better solution. Some physicians may also recommend a procedure called a uterine fibroid embolization.