Myomectomy, sometimes referred to as Open Myomectomy, is a surgical procedure that is most often suggested to women of childbearing age who would like to get pregnant in the future. This technique is used to remove fibroids while leaving the uterus intact and helps preserve or improve the woman’s fertility.
If your NYC Ob/Gyn is recommending a myomectomy procedure, then you likely have been suffering from one or more of the following fibroid-related symptoms:
- Heavy, prolonged or painful menstrual periods with or without clotting
- Pelvic pressure and pain, distended and bloated abdomen
- Moderate to severe menstrual cramps
- Pain during sex and loss of libido
- Weak bladder control, frequency in urination due to bladder pressure
- Inexplicable weight gain
- An enlarged uterus
- Anemia (low blood count) that can lead to a lack of energy and fatigue
- Lower back pain and pain in the back of the legs
- Constipation
- Infertility
Women who are offered a myomectomy as a treatment option by their gynecologist are often instructed to have an open myomectomy procedure. Open myomectomy is an effective fibroid removal procedure, but it requires larger incisions and can cause more complications and longer recovery times than newer, minimally invasive myomectomy surgery techniques.
The most common methods used for myomectomy are:
- Open Myomectomy procedure, sometimes referred to as Abdominal myomectomy — this procedure allows the doctor to remove the fibroids through an open surgical incision in the lower abdomen. This type of procedure is best women who have very large fibroids. Viva Eve’s NYC fibroid specialists usually recommend this procedure only when other, less invasive myomectomy procedure methods are not appropriate.
- Laparoscopic myomectomy — this procedure allows the doctor to remove the fibroids through several small incisions and may be done robotically. This method is less invasive, and recovery is faster than with open myomectomy. This type of procedure is best for women with a few small fibroids.
- Vaginal Myomectomy (link to Vaginal Myomectomy page), also referred to as Hysteroscopic myomectomy — this procedure requires the doctor use a special scope to remove the fibroids through the vagina and cervix. This procedure may be best women who have smaller fibroids inside the uterus.
- LAAM link to LAAM page (Laparoscopic Assisted Abdominal Myomectomy) – one of the most advanced minimally invasive myomectomy procedures. This procedure allows the doctor to remove multiple fibroids of any size and at any location and uses the best elements of both laparoscopic and open approaches for fibroid removal.
How is an Open Myomectomy Performed?
This procedure is performed under general anesthesia and takes 1-2 hours. Your NYC fibroid specialist make an incision 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 the fibroids are removed, each layer of tissue in the uterus will be stitched. Lastly, the stitches will be used to close the incision area. After the procedure, you will be taken to the postoperative are and given IV fluids and medications.
Results & Recovery after Myomectomy
Recovery time before you can return to normal activities depends on what type of myomectomy procedure you have. Recovery times for each type are:
- Open myomectomy: four to six weeks
- Laparoscopic myomectomy: two to four weeks
- Vaginal myomectomy: two to three days
With less invasive myomectomy procedures you will most likely be able to go home the same day as the surgery. You will almost certainly need to stay 2-3 days at the hospital overnight if you have an open myomectomy. You will likely experience some pain after the procedure, and your NYC fibroid specialist will provide medication to treat the discomfort. You may also have spotting for a few days to several weeks.
Your NYC Ob/Gyn will advise you to avoid any lifting heavy objects or engage in any strenuous physical activity until the incisions have fully healed. You will also be advised against having sexual intercourse or using tampons during your recovery after the procedure.
Your NYC Ob/Gyn will advise you when it is safe to start trying to conceive if you plan to get pregnant in the near future. Your doctor may recommend you wait three to six months for the uterus to fully heal, depending on which kind of surgery you’ve had.
The doctors at VIVA EVE are experts in performing both open myomectomies and also less invasive myomectomy procedures, including LAAM and will be happy to discuss all the medically sound options available. Our board-certified NYC fibroid specialists will work with you to choose the treatment path that’s best for you and your unique circumstances. Whether you are looking into starting treatment with us, or are simply seeking a second opinion, we invite you to come in for a consultation. You will always be heard at Viva Eve.