What is myomectomy?

Sometimes an ultrasound examination during a laparoscopy or hysteroscopy will detect benign, non-cancerous growths on your uterus called fibroids. The surgical procedure to remove these fibroids is called myomectomy.

Fibroids grow when the muscle fibres in your uterus multiply. They are very common, especially in older women. Around 80% of women will experience them in their lifetime.

Some women may have mild symptoms such as longer, heavier periods, bleeding between periods, pain or pressure in the pelvis or lower back, pain during intercourse, or urinary problems. You may not have any symptoms at all, they may only be discovered when doing ultrasounds or other examinations.

There are different types of fibroids and some of them do cause infertility. Sometimes fibroids grow inside the cavity of your uterus, making it difficult for embryos to implant. Even if an embryo does begin to implant, fibroids inside your uterus can increase the risk of miscarriage, as they grow larger. Some grow within the wall of your uterus and may affect your fertility as they grow. Others grow on the outer surface of your uterus and don’t have a specific effect on your fertility, but they may cause other symptoms.

Depending on which type of fibroids you have, there are a number of different ways they can be removed:

  • Hysteroscopic myomectomy: For fibroids growing within your uterus, I will pass a very small telescope through the vagina, into the cervix and then the uterus, and then remove the fibroids. This procedure takes place under general anaesthetic.

  • Laparoscopic myomectomy: This is keyhole surgery for fibroids growing in the wall or on the outside of your uterus. You will be under general anaesthetic, and I will make small incisions just below your navel and pubic hairline, and pass a small diameter telescope through your abdominal wall, to be able to remove the fibroids.

  • Laparotomy: If you have many large fibroids, or they are grown deep into the wall of your uterus, I may recommend open surgery.

I will discuss with you the best method for removing your fibroids, to give you the best chance of falling pregnant.

Who is suitable for myomectomy?

If you have large fibroids (four centimetres or more in size) a myomectomy procedure may be recommended to remove them. The procedure leaves your uterus intact, and significantly improves your chances of falling pregnant – either naturally or with IVF treatment. It is the most common method of removing fibroids for women who want to have children.