Myomectomy -- Open Surgery
(Fibroid Tumor Removal; Uterine Fibroid Removal)
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Reasons for Procedure
- Pelvic pain
- Back pain
- Pressure on the bladder
- Abnormal vaginal bleeding
- Difficulty becoming pregnant
- Discomfort during sexual intercourse
- 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 (such as, 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
- Alcohol abuse or drug use
- Chronic or recent illness
- Use of certain prescription medicines
What to Expect
Prior to Procedure
- Physical exam
- Blood tests
- Review your medicines
- Dilation and curettage (D&C) —a procedure to remove tissue from the lining of the uterus (endometrium)
- Ultrasound—shows images of pelvic organs
- Intravenous pyelogram —x-rays taken of the kidneys, ureters, and bladder after a contrast medium is injected into a peripheral vein (done if the fibroids are affecting the ureters)
- Whether you should have hormone treatment for 2-4 months before the procedure—This treatment shrinks fibroids. It makes them small and reduces the risk of excess blood loss during the procedure.
- If cancer is found in the uterus—One option is to remove the uterus during the myomectomy.
- Whether you should donate your own blood for the procedure
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, such as:
- Aspirin or other anti-inflammatory drugs
- Blood thinners such as warfarin (Coumadin)
- clopidogrel (Plavix)
- Arrange for a ride home from the hospital. Also, arrange for help at home.
- Do not eat or drink for at least eight hours before the procedure.
Description of the Procedure
Immediately After Procedure
- Taken to the postoperative area
- Watched for complications
- Given IV fluids and medicines
How Long Will It Take?
Will It Hurt?
Average Hospital Stay
- Be sure to follow your doctor's instructions .
- 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.
Ask your doctor when you will be able to:
- Return to work and drive
- Resume sexual activity
- Resume strenuous activity (You may need to wait 2-6 weeks)
Call Your Doctor
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Excessive vaginal bleeding (soaking more than one pad per hour) after the procedure
- Excessive vaginal discharge that continues beyond one month after the procedure
- Vaginal discharge has a foul odor
- Severe abdominal pain
- Headaches, muscle aches, dizziness , or general ill feeling
- Nausea, vomiting, constipation , or abdominal swelling
- Pain and/or swelling in one or both legs
- Fibroid symptoms return after the procedure
- Cough , shortness of breath, or chest pain
- Pain, burning, urgency or frequency of urination, or persistent blood in the urine
- New, unexplained symptoms
National Uterine Fibroids Foundation http://www.nuff.org
Women's Health.gov http://www.womenshealth.gov
Health Canada http://www.hc-sc.gc.ca
Women's Health Matters http://www.womenshealthmatters.ca
Myomectomy. Duke University Medical Center Reproductive Endocrinology and Infertility website. Available at: http://www.dukehealth.org/Services/Fertility/Programs/Surgery/Myomectomy?search%5Fhighlight=myomectomy . Accessed June 1, 2008.
Uterine fibroid treatment options. Society of Cardiovascular and Interventional Radiology website. Available at: http://www.sirweb.org/patPub/uterineTreatments.shtml#my . Accessed June 1, 2008.
6/2/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
- Reviewer: Andrea Chisholm, MD
- Review Date: 12/2013 -
- Update Date: 00/11/2014 -