Reasons for Procedure

Possible Complications

What to Expect

Call Your Doctor

En Español

Myomectomy—Open Surgery

(Fibroid Tumor Removal; Uterine Fibroid Removal)

by Editorial Staff and Contributors

Definition

This surgery involves removing fibroids from the wall of the uterus (womb). Fibroids are noncancerous tumors in the muscle of the uterus.

Uterine Fibroid

Reasons for Procedure TOP

Myomectomy is done to relieve problems caused by fibroids without doing a hysterectomy (removal of the uterus). These problems can include:

Pelvic pain
Back pain
Pressure on the bladder
Abnormal vaginal bleeding
Difficulty becoming pregnant
Discomfort during sexual intercourse

The symptoms caused by fibroids are often successfully controlled with this procedure. This may include a return to a normal menstrual cycle and the ability to become pregnant.

Possible Complications TOP

Complications are rare, but no procedure is completely free of risk. If you are planning to have a myomectomy, your doctor will review a list of possible complications, which may include:

Bleeding
Surgical wound infection
Recurrence of fibroids
Damage to other organs
Wall of the uterus may be weakened if a large fibroid is removed
Reactions to anesthesia
Need for special precautions in pregnancy, such as the need to deliver by cesarean section
Pelvic adhesions that can cause pain and/or bowel blockage
Problems found during surgery that make removal of the uterus necessary
Severe scarring, resulting in infertility

Factors that may increase the risk of complications include:

Smoking
Alcohol abuse or drug use
Obesity
Chronic or recent illness
Use of certain prescription medications
Diabetes

Be sure to discuss these risks with your doctor before the procedure.

What to Expect TOP

Prior to Procedure

Your doctor may do the following:

Physical exam
Blood tests
Review your medications
Dilation and curettage (D&C) —a procedure to remove tissue from the lining of the uterus (endometrium)
Ultrasound—shows images of pelvic organs
Intravenous pyelogram —x-rays taken of the kidneys, ureters, and bladder after a contrast medium is injected into a peripheral vein (done if the fibroids are affecting the ureters)

You should discuss with your doctor:

Whether you should have hormone treatment for 2-4 months before the procedure—This treatment shrinks fibroids. It makes them small and reduces the risk of excess blood loss during the procedure.
If cancer is found in the uterus—One option is to remove the uterus during the myomectomy.
Whether you should donate your own blood for the procedure

Leading up to your procedure:

Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
Arrange for a ride home from the hospital. Also, arrange for help at home.
Do not eat or drink for at least eight hours before the procedure.

Anesthesia

General anesthesia is used most often. It will block any pain and keep you asleep through the surgery. It is given through an IV in your hand or arm.

Description of the Procedure TOP

An incision will be made in the lower abdomen. Muscles will be separated, and tissue will be cut to expose the uterus. Next, the fibroids will be removed. In some cases, you will be given a medication to reduce the amount of blood loss.

After removing the fibroids, the each layer of tissue in the uterus will be stitched. This will prevent blood clots, excess bleeding, and infection. Lastly, the stitches will be used to close the incision area.

Immediately After Procedure TOP

After the procedure, you will be:

Taken to the postoperative area
Watched for complications
Given IV fluids and medications

How Long Will It Take? TOP

1-2 hours

Will It Hurt? TOP

You will have abdominal pain and discomfort for 7-10 days. You will be given medication to help control the pain.

Average Hospital Stay TOP

2-3 days

Post-procedure Care TOP

Full recovery will take about 4-6 weeks. When you return home, do the following to help ensure a smooth recovery:

Wear sanitary pads or napkins to absorb blood. The first menstruation after the procedure may be heavier than normal.
Be sure to follow your doctor's instructions.

Call Your Doctor TOP

After you leave the hospital, contact your doctor if any of the following occur:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
Excessive vaginal bleeding (soaking more than one pad per hour) after the procedure
Excessive vaginal discharge that continues beyond one month after the procedure
Vaginal discharge has a foul odor
Severe abdominal pain
Headaches, muscle aches, lightheadedness, or general ill feeling
Nausea and vomiting
Constipation
Pain and/or swelling in one or both legs
Fibroid symptoms return after the procedure
Cough, shortness of breath, or chest pain
Pain, burning, urgency or frequency of urination, or persistent blood in the urine
New, unexplained symptoms

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Congress of Obstetricians and Gynecologists
http://www.acog.org

Women's Health—US Department of Health and Human Services
http://www.womenshealth.gov

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca

Women's Health Matters
http://www.womenshealthmatters.ca

References:

Uterine fibroid symptoms, diagnosis, and treatment. Society of Cardiovascular and Interventional Radiology website. Available at:
...(Click grey area to select URL)
Accessed October 29, 2014.

6/2/2011 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

Last reviewed December 2014 by Andrea Chisholm, MD
Last Updated: 12/20/2014

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