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Myomectomy

This is surgical removal of the fibroids alone. It is usually only offered to women who want children, because there is a very high incidence of re-growth of fibroids and adhesions. (Adhesions occur when tissues grow into one another after surgery causing severe pain and requiring surgical correction.)

Myomectomy is an invasive surgical technique often taking longer than hysterectomy and requiring considerable convalescence like hysterectomy. As with hysterectomy, if the fibroids are small the procedure can be performed through the vagina or, in a few centres, laparoscopically (via a small incision) or hysteroscopically (using a a tubular instrument that can be inserted along the vagina into the uterus).

Women maintain fertility and a high percentage (studies vary), 40-50% will go on to achieve pregnancy afterwards, if fibroids were preventing conception. Laparoscopic myomectomy is discussed further in this article from Capital Doctor, February 2004.

However most women having myomectomy will need to have a hysterectomy later.

There is some debate at the moment about which is more successful if a woman wishes to become pregnant - myomectomy or embolisation.  Women with 'pregnancy wishes' were originally told not to have embolisation by NICE, so there is less data for embolisation.  A number of studies have been carried out comparing the two and some are still underway. One Interventional Radiologist has treated 60 women who have had successful pregnancies after embolisation.

Read our Myomectomy FAQs
 

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