Myomectomy surgery is a traditional treatment choice for women with symptomatic fibroids. Myomectomy cuts fibroid tumors off using different surgical techniques. Sometimes a myomectomy can be performed through small incisions in the abdomen with a laparoscopic approach but in cases of large or numerous fibroids, the patient will be advised to undergo an open myomectomy.
What Is an Open Myomectomy?
An open myomectomy is an invasive surgical procedure performed to remove fibroids from the uterus. The procedure is done under general anesthesia. Fibroids are removed through one long incision in the abdomen (the incision length is about 12 inches). Fibroids can grow individually or in clusters and can be very small or quite large which often makes it impossible for the surgeon to remove all the fibroids and their attempts can cause damage to nearby organs or severe blood loss.
Every woman who is about to have a myomectomy must sign a medical release form. This release states that she understands and agrees that if a gynecological surgeon is unable to stop excessive bleeding that occurred during surgery or to stitch the uterus back together, the surgeon will perform an emergency hysterectomy. In fact, the likelihood of hysterectomy increases with the size of the fibroids.
A myomectomy often does not treat all fibroids, many patients must undergo an additional surgery within five years to address new fibroids or further growth of previously existing fibroids.
Who Is A Candidate For an Open Myomectomy?
Women diagnosed with uterine fibroids that are experiencing heavy bleeding or other severe fibroid symptoms may be a candidate for an open myomectomy. An open myomectomy is performed in cases where large subserosal or intramural fibroids are present that could not be removed laparoscopically. It can also be advised in cases where there are numerous fibroids.
What to Expect From an Open Myomectomy?
Open myomectomy is performed under general anesthesia. During an open myomectomy, an incision that is referred to as a “bikini cut” is made in the lower abdomen to gain access to the uterus. Fibroids are cut out individually and removed. After the fibroids are removed, the uterus is stitched back together to heal. The patient spends a few hours in a recovery room and then is transferred to a hospital room for the next few days.
Recovery From an Open Myomectomy Surgery
Most patients stay a few nights in the hospital followed by approximately 6-8 weeks for recovery. The uterus requires up to 6 months to completely heal. After a myomectomy, patients who become pregnant require a C-section for delivery because the structural integrity of the uterus has been compromised. Some patients may experience difficulty conceiving due to the compromised uterus structure.
Risks Associated With Open Myomectomy Include:
- Uterine scarring,
- Severe blood loss,
- Surgical incision infection,
- Damage to nearby organs,
- Damage to the urinary system,
- Emergency hysterectomy,
- Bowel blockage and pain caused by pelvic adhesions, and
- Severe scarring that creates fertility issues.
Uterine Fibroid Embolization (UFE) vs Open Myomectomy
Uterine Fibroid Embolization (UFE) is an alternate treatment for uterine fibroids. It is a nonsurgical procedure performed by an interventional radiologist (not OB/GYN) and is 90% effective in eliminating all uterine fibroid symptoms. UFE treats every fibroid by cutting off their blood supply which causes them to permanently shrink and die. UFE cuts off the blood supply only to the fibroids, the uterus stays fully intact, and it’s possible to conceive and deliver vaginally after UFE.
Recovery time is less than a week and does not require a hospital stay; there is no stitching or scarring, the patients go home with a simple bandaid on their wrist.
Contact Atlanta Fibroid Center® at (770) 953-2600 or make an appointment online to find out if you are a candidate for UFE.