Removal of Fibroids

A myomectomy, or fibroid removal surgery, removes fibroids while leaving the uterus intact in order to maintain fertility.

The main reason a myomectomy is performed is to preserve the uterus for pregnancy, or to remove fibroids that are preventing the uterus from becoming pregnant. A myomectomy is generally a more invasive procedure than a hysterectomy, and is not recommended for women who no longer are able to have children.

The majority of fibroids are small and asymptomatic; however many women with fibroids have significant pain and bleeding that interfere with their daily lives and request treatment. Symptoms are directly related to the number, size and location of the tumors.

Fibroid symptoms are typically classified into three categories:

1) Heavy menstrual bleeding

2) Bulk related symptoms including pelvic pressure and pain

3) Reproductive dysfunction or infertility

Fibroids can grow in the muscle of the uterus, in the cavity or on the outside. Fibroids that are in the muscle, require an incision in the uterus for removal. The incision can be deep in the muscle, and will require repair and a longer healing time. In addition, the fibroids need to be removed through the abdominal wall in a myomectomy, which increases the size of the incisions and leads to increased pain.

There are some fibroids that protrude into the uterine cavity called submucosal fibroids. This type of fibroid can be removed via a D&C with a morcellation device. This type of procedure doesn’t require an incision into the uterus and is a lower risk surgery compared to an open procedure through the abdominal wall.

This is important to understand, as many women believe a myomectomy is a less painful procedure than a hysterectomy. If preserving fertility is possible, a myomectomy is appropriate. If fertility is no longer an option, and fibroids are recurring, a hysterectomy may be a better solution.

A Pelvic Ultrasound is the first-line test used to diagnose and evaluate uterine fibroids.