The surgery performed to remove uterine fibroids is known as myomectomy. It’s an operation that’s done while preserving the uterus. Uterine fibroids are tissue growths that form in the uterus, which are almost always noncancerous. A myomectomy is an option for women with fibroids who intend to become pregnant in the future or those who wish to retain their uterus. Various types of myomectomies can be done, some of which are more invasive than others.

Signs one might need a myomectomy
If one has uterine fibroids that cause the following symptoms to appear, the healthcare provider might suggest a myomectomy.

• Discomfort in the pelvis
• Bleeding irregularly or in between cycles
• Heavy hemorrhaging during periods
• Inability to completely clear the bladder.

Types of myomectomies and recovery timelines

Hysteroscopic myomectomy
If a woman has fibroids on the inner wall of her uterus (submucosal fibroids), she will be advised to opt for a hysteroscopic myomectomy. It is carried out by passing a hysteroscope, a long tool with a camera on the end, through the vaginal channel into the uterus. The surgeon can thus locate the fibroid tissues and remove them using a morcellating blade. With only a little sedation needed, most patients can complete the process as an outpatient procedure. Occasionally, a hysteroscopic myomectomy may need to be done in two phases due to the size and placement of the fibroids.

A hysteroscopic myomectomy typically only requires one to two days of recovery time, after which the patient can start doing usual activities again.

Abdominal myomectomy
Similar to a complete hysterectomy, an abdominal myomectomy involves the targeted removal of the fibroid. It is also known as a laparotomy. General anesthesia is used to conduct this surgical procedure. For the surgeon to see the uterus clearly, a sizable incision is created in the lower abdominal wall. The fibroid tissue will then be surgically removed, and the cuts made will then be sutured.

After an abdominal myomectomy, recovery takes four to six weeks. One should avoid doing any strenuous activities or heavy lifting during this period. Surgeons may recommend taking four to eight weeks off from work. Walking every day can help in the healing process. The basic idea is to try and stay active. Being sedentary can increase the risk of developing deep vein thrombosis, which refers to blood clots in the legs. Not getting enough activity can also prolong the timeline for recovery.

Laparoscopic myomectomy
A minimally invasive technique to remove uterine fibroids is laparoscopic myomectomy. Four incisions will be made on the abdomen, and the surgeon will use a laparoscope, a specialized tool with a light and camera, to work through one of the incisions. On a video display, the doctor can see the uterus. The other cuts are to insert instruments to remove the fibroids.

Myomectomy with robotic assistance is yet another minimally invasive type of treatment. To remove numerous fibroids that are intricate, or deeply embedded in the uterine wall, the surgeon uses assistance from a robotic arm.

Recovery from a laparoscopic myomectomy is frequently quicker as compared with more invasive procedures. There is no agreed-upon standard for medical stays or recuperation time. Although in some instances patients have been able to leave the hospital the same day of the surgery, many surgeons report that it is better to remain in the hospital for 1-2 days. It will take between two to four weeks to completely recover. One can resume their daily routines after roughly two weeks from the procedure.

Risks
A myomectomy is usually not a complicated surgery; hence, the chances of any complications are very low. Still, rarely some issues can occur during the operation, including:

Scar tissue formation
After surgery, the incisions made can lead to the formation of adhesions, which refer to scar tissue.

Excess bleeding
Most women with uterine growths tend to have anemia, because of heavy menstrual bleeding. This increases their risk of blood loss. The doctor might suggest a few ways to increase blood count before performing the surgery.

Hysterectomy
Though this is rare, the need for a hysterectomy may arise during a myomectomy if the bleeding cannot be controlled or if other abnormalities are found.

Complications with pregnancy
The fibroids’ type and quantity will affect one’s chances of getting pregnant. During the surgery, if the surgeon made many deep incisions in the uterine wall, any following pregnancies may need to be done via C-section to avoid any complications. The uterus may even rupture as pregnancy develops or during labor because a myomectomy can weaken the organ.