Myomectomy

Myomectomy is the surgical removal of Reference fibroids Opens New Window 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 Reference 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 Reference anemia Opens New Window before surgery by stopping uterine bleeding for several months.

Surgical methods for myomectomy include:

• Reference Hysteroscopy Opens New Window, which involves inserting a lighted viewing instrument through the vagina and into the uterus.
• Reference Laparoscopy Opens New Window, which uses a lighted viewing instrument and one or more small cuts (incisions) in the abdomen.
• Reference Laparotomy Opens New Window, which uses a larger incision in the abdomen.

The method used depends on the:

• Size, location, and number of fibroids.
  • Hysteroscopy can be used to remove fibroids on the inner wall of the uterus that have not grown deep into the uterine wall.
  • Laparoscopy is usually reserved for removing one or two fibroids, up to about 2 in. (5.1 cm) across, that are growing on the outside of the uterus.
  • Laparotomy is used to remove large fibroids, many fibroids, or fibroids that have grown deep into the uterine wall.
• Need to correct urinary or bowel problems. To repair these problems without causing organ damage, laparotomy is usually needed.

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