Why is it Performed?
Your gynaecologist may recommend this surgery if you have:
- Symptomatic fibroids causing heavy menstrual bleeding, pelvic pain, or pressure.
- Infertility or recurrent miscarriages linked to fibroids.
- Fibroids that are too large or numerous for less invasive treatments.
Before Surgery
Pre-operative tests:
- Pelvic ultrasound or MRI to map fibroids.
- Blood tests (e.g., check for anaemia).
Preparation:
- Fasting: No food/drink for 6–12 hours before surgery.
- Bowel prep: May be required to empty the bowel (your doctor will advise).
- Medications: Adjust blood thinners (e.g., aspirin) as instructed.
- Arrange support: Someone to drive you home and assist with daily tasks for 1–2 weeks.
During the Procedure
Anaesthesia: General anaesthesia (you’ll be asleep).
Incision:
- A horizontal (bikini-line) or vertical incision (4–6 inches) is made in the abdomen.
Surgery:
- Fibroids are carefully removed; the uterus is repaired with stitches.
- Blood loss is minimized; a blood transfusion may be arranged if needed.
Closure: The incision is closed with stitches or staples.
Duration: 1–3 hours (depends on fibroid size/number).
Risks and Complications
Common (temporary):
- Pain, bloating, or bruising at the incision site.
- Fatigue and light vaginal bleeding (1–2 weeks).
Serious (rare):
- Heavy bleeding requiring transfusion.
- Infection, blood clots, or damage to nearby organs (bladder, bowel).
- Scar tissue (adhesions) causing future pain or fertility issues.
- Fibroid recurrence (15–30% of cases).
Recovery
In the hospital:
- Stay for 1–3 days depending on recovery.
- Pain relief and monitoring for complications.
At home:
Rest: Avoid lifting >5kg, driving, or strenuous activity for 6 weeks.
Wound care:
- Keep the incision clean and dry.
- Report redness or discharge.
- Staples/stitches may need removal at 7–14 days if not absorbable.
Activity:
- Gentle walking to aid healing and prevent blood clots.
- Gradually resume normal tasks over 4–6 weeks.
Return to work: Typically 4–8 weeks depending on job demands.
Long-Term Effects
- Fertility: Many women conceive after recovery; discuss timing with your gynaecologist.
- Pregnancy risks: Higher chance of caesarean delivery due to uterine scarring.
- Fibroid recurrence: Regular follow-ups (ultrasounds), ideally annually.
Alternatives
- Medications: Hormonal therapies (e.g., GnRH agonists) to shrink fibroids.
- Minimally invasive options:
- Laparoscopic or hysteroscopic myomectomy (smaller incisions).
- Uterine artery embolization (blocks blood supply to fibroids).
- Hysterectomy: Removes the uterus (for women not planning future pregnancy).
eGynaecologist Advice
- You should consider annual monitoring if you are diagnosed with fibroids in uterus and take preventive actions in consultation with your gynaecologist to avoid long-term consequences.
- You should seek gynaecological help if you have severe pain, fever, or chills after myomectomy procedure or notice heavy bleeding or foul-smelling discharge from incisions
- You must seek gynaecological consultation if you have heavy bleeding (more than a regular period) severe pain, fever, or chills or foul-smelling vaginal discharge after colposcopy.
Frequently Asked Questions
Will I have a visible scar?
Yes, but it will fade over 6–12 months. Horizontal scars are often less noticeable.
How soon can I try to get pregnant?
Typically, after 3–6 months, depending on healing. Discuss your pregnancy plans with your gynaecologist.
Can fibroids grow back?
Yes – recurrence rates are 15–30%, but symptoms may not return. Fibroid monitoring with yearly scans is recommended
Is recovery longer than a hysterectomy?
Similar timeline, but myomectomy preserves the uterus.
