What Is Open Myomectomy Operation?

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

Why is it done?

This operation has a long history and remains the only surgical option when the fibroids are numerous and/or large, and there is a wish to preserve the uterus (e.g. for future child bearing).

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 and discomfort during sexual intercourse.

What to expect after surgery?

The surgery takes about 1-2 hours. The average hospital stay after surgery is 2-3days.

• You will have abdominal pain and discomfort for 7-10 days. Your doctor will give you pain medicine to help control the pain.
• Wear sanitary pads or napkins to absorb blood. The first menstruation after the procedure may be heavier than normal.
• Try to walk often. This will decrease the risk of blood clots.
• Take medicines as prescribed by your doctor. If you had to stop medicines before the procedure, ask your doctor when you can start again.
• Ask your doctor about when it is safe to shower, bathe, or soak in water.

What are the risks of the surgery?

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 (eg. 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

What are the alternatives to the surgery?

• Drug treatment - You can take drugs to make the fibroids smaller, but this is unlikely to be permanent and the fibroids may grow back.
• Hysteroscopic resection - We can remove submucous fibroids lying just beneath your endometrium using a special telescope, called a hysteroscope. We pass this into your uterus through your vagina. There is another leaflet within this series covering hysteroscopic resection of fibroids.
• Keyhole surgery - We can sometimes remove smaller fibroids using keyhole instruments passed through tiny cuts in your abdomen. This is called a laparoscopic myomectomy.
• Embolisation - This is a method of shrinking single fibroids by cutting off their blood supply. Under x-ray guidance we pass a fine tube, called a catheter, into an artery in your leg. We push it along to a position near the artery supplying blood to the fibroid. We inject tiny particles down the catheter to block the fibroid’s blood supply.
• Hysterectomy - This is an operation to remove your uterus. If you never want to become pregnant and do not mind losing your uterus then this would be a certain way of dealing with the problem.