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Myomectomy FAQ

 

What is myomectomy?

Myomectomy is the surgical removal of fibroids without removing the uterus.

This can be performed through the abdominal wall, or if the fibroids are small by laparoscope (a small tube inserted near the belly button) or hysteroscope (a small tube is inserted through the vagina).

Myomectomy is normally only offered to women wishing to have children because most women will subsequently need to have a hysterectomy.

 

What does the operation involve?

Myomectomy is a longer operation than hysterectomy, often involving more bleeding.

There is considerable pain after the operation normally lasting from 3 to 10 days.

The operation is associated with heavy bleeding requiring blood transfusions. A high fever occurs in a large proportion (32%) of patients.

 

How long would I stay in hospital?

Normal hospital stay is 6 days to 2 weeks.

 

How long does it take to recover?

Myomectomy is very invasive surgery. There is danger of a hernia (protrusion of a portion of organ or tissue) if there is any lifting or stretching of the abdomen. For this reason women must not even lift a kettle or drive a car for at least 6 weeks.

Return to work is normally between 2 to 3 months, depending on the nature of the work.

 

What care will I need?

Most women will need considerable care at home for at least 6 weeks, because they will not be able to lift or stretch or drive. This means another member of the family will need to look after them.

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Side effects and safety

The most serious side effects arise because myomectomy is such an invasive procedure. Urinary tract infections (from the bladder to the kidneys) occur in 3.3% to 25% of women and wound infections in 25%.

Deep vein thrombosis (DVT) occurs in approximately 15-18% of patients having gynae surgery. This is a serious complication where a blood clot occurs usually in the leg due to the surgery and subsequent inactivity. This blood clot can move to the heart and lungs causing a potentially fatal pulmonary embolism.

The overall surgical complication rate is 1.8-25%.

 

Long term side effects

Although myomectomy is effective at removing the fibroids in the short-term most re-grow and require further treatment.

Adhesions, where surgically damaged tissues grow together and can cause severe pain occur in 55-100% of women.

If a pregnancy occurs, the baby will normally be delivered by Caesarean section.

 

Effect on fertility

Fertility is maintained and if fibroids were the cause of infertility or miscarriage the success rate for pregnancies is high.

 

Questions to ask your doctor

  • How long will I be in hospital?
  • How will I feel immediately after the procedure?
  • How much pain will I suffer?
  • How much support will I need at home?
  • How much time will my partner need to take off work to look after me?
  • What will I be able to do after the procedure?
  • When can I return to work?
  • What are the short-term side effects?
  • What are the long-term side effects?
  • What could go wrong?
  • Will it have any effect on my sex life?
  • Will I be able to become pregnant?
  • What is your success rate of women becoming pregnant after hysterectomy? 
  • How will it affect my periods and menopause?

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