Why would I have a Myomectomy?
Myomectomy may be considered if your fibroids cause symptoms, other forms of medication have proved ineffective or unsuitable and you would like to retain your womb. Myomectomy is also known as uterine sparing surgery for the treatment of fibroids.
How is the Myomectomy performed?
There are different ways to perform the myomectomy
In an abdominal myomectomy, an incision is made in your abdomen (which may be around 12 cm or less). This enables the doctor to reach the uterus so that the uterine fibroids can be removed. You will be given a general anaesthetic for this procedure. You can expect to stay in hospital for 3-4 days.
Sometimes smaller fibroids can be removed using keyhole instruments passed through tiny cuts in your abdomen. This is called a laparoscopic myomectomy. You will be given a general anaesthetic for this procedure. You can expect to stay in hospital for 1-2 days.
A hysteroscopic myomectomy (or hysteroscopic resection of the fibroids) is, where a small hysteroscope is inserted through the vagina and the cervix, so that one or more fibroids can be removed. This procedure is suitable for certain types of fibroids (submucous fibroids). You will be given a general anaesthetic and will probably be able to go home the same day.
What are the complications of a Myomectomy?
Most women will not experience any problems following a myomectomy. As with any surgery, there is a slight risk from the general anaesthetic. Other risks may include bleeding, infection, deep vein thrombosis and damage to other organs in the pelvis mainly the bowel, bladder or blood vessels.
How will my wound be closed?
Your incision sites may either be closed with very small sutures (stitches) if having a laparoscopy or with surgical glue. If you are having an abdominal myomectomy your wound will be slightly bigger. Stitches, surgical glue, clips or staples may be used. Sutures usually dissolve within 10-14 days for a laparoscopy. Glued sites may be left to heal, no intervention is required. If you are having an abdominal myomectomy, your stitches, clips or staples are normally removed by the nurse between 5-10 days.
How should I care for my wound?
Some oozing from the site(s) may be noted for the first 24 hours after your operation and a dry dressing may be applied. After this time the site should be left clean, dry and exposed. Should oozing continue and/or the areas become inflamed/red/ smelly, when you are at home, please seek advice from your GP or the surgeon, as you may have developed a mild infection. You may bathe and/or shower as normal, it does not matter if you get the sutures or glue wet.
When can I return to my normal activities?
You will feel tired in the first few days following your operation. Rest and recover and resume your normal activities when you feel ready to. However, avoid heavy lifting, housework and strenuous exercise for 10-14 days. Following laparoscopic surgery, you can normally return to work within 7-14 days. After an abdominal myomectomy, this might be slightly longer. Do not attempt to drive until you can wear your seatbelt comfortably and feel confident that you would be able to perform an emergency stop without any abdominal discomfort.
When can I have sex again?
It is better to avoid sexual intercourse until vaginal bleeding has stopped and you feel able and comfortable to have sex.
Will my periods be affected?
It is common to have some mild vaginal bleeding for up to seven days after your operation. Do not use tampons during this period, only sanitary towels. Tampons may increase your risk of developing a mild infection. If you feel your bleeding is prolonged or becomes offensive, please seek advice. Your periods can be affected by your operation. They may be heavier, lighter or delayed.
Will the fibroids grow back?
The recurrence of the fibroids could be due to either failure to remove them at initial surgery as they are very small and not seen or due to formation of the new fibroids. This is most likely to happen in someone who has many little fibroids. Recurrence is least likely in women with one or a few large fibroids.