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Myomectomy is the surgical removal of fibroids from the uterus. It allows the uterus to be left in place and, for some women, makes pregnancy more likely than before. Myomectomy is the preferred fibroid treatment for women who want to become pregnant. After myomectomy, your chances of pregnancy may be improved but are not guaranteed.
Before myomectomy, shrinking fibroids with gonadotropin-releasing hormone analogue (GnRH-a) therapy may reduce blood loss from the surgery. GnRH-a therapy lowers the amount of estrogen your body makes. If you have bleeding from a fibroid, GnRH-a therapy can also improve anemia before surgery by stopping uterine bleeding for several months.
Surgical methods for myomectomy include:
The method used depends on the:
The length of time you may spend in the hospital varies.
Recovery time depends on the method used for the myomectomy:
Myomectomy preserves the uterus while treating fibroids. It may be a reasonable treatment option if you have:
Myomectomy decreases pelvic pain and bleeding from fibroids.
Myomectomy is the only fibroid treatment that may improve your chances of having a baby. It is known to help with a certain kind of fibroid called a submucosal fibroid. But it does not seem to improve pregnancy chances with any other kind of fibroid.2
After myomectomy, a cesarean section may be needed for delivery. This depends in part on where and how big the myomectomy incision is.
Fibroids return after surgery in 10 to 50 out of 100 women, depending on the original fibroid problem. Fibroids that were larger and more numerous are most likely to recur.3 Talk to your doctor about whether your type of fibroid is likely to grow back.
Risks may include the following:
When trying to get pregnant after myomectomy. Because fibroids can grow back, it is best to try to conceive as soon after a myomectomy as is safely possible and your recovery from surgery is complete.
When incisions have been made into the uterine wall to remove fibroids, future pregnancy may be affected. Sometimes placenta problems develop, such as placenta abruptio or placenta accreta. During labor, the uterus may not function normally, which can make a cesarean delivery necessary.
In rare cases, a hysterectomy is needed when the surgery reveals that the uterus is too overgrown with fibroids for a safe myomectomy.
- American College of Obstetricians and Gynecologists (2008, reaffirmed 2012). Alternatives to hysterectomy in the management of leiomyomas. ACOG Practice Bulletin No. 96. Obstetrics and Gynecology, 112(2, Part 1): 387–399.
- Parker WH (2012). Uterine fibroids. In JS Berek, ed., Berek and Novak's Gynecology, 15th ed., pp. 438–469. Philadelphia: Lippincott Williams and Wilkins.
- Practice Committee of the American Society for Reproductive Medicine, Society of Reproductive Surgeons (2008). Myomas and reproductive function. Fertility and Sterility, 90(3): S125–S130.
Last Revised: April 19, 2013
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