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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.
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
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 preserves the uterus
while treating fibroids. It may be a reasonable treatment option if you
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.
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.
cases, a hysterectomy is needed when the surgery reveals that the
uterus is too overgrown with fibroids for a safe myomectomy.
Complete the surgery information form (PDF)surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
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):
April 19, 2013
Sarah Marshall, MD - Family Medicine & Divya Gupta, MD - Obstetrics and Gynecology, Gynecologic Oncology
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