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Medically reviewed on January 5, 2018


Myomectomy (my-o-MEK-tuh-mee) is a surgical procedure to remove uterine fibroids — also called leiomyomas (lie-o-my-O-muhs). These common noncancerous growths appear in the uterus, usually during childbearing years, but they can occur at any age.



Why it's done


  • You plan to bear children
  • Your doctor suspects uterine fibroids might be interfering with your fertility
  • You want to keep your uterus





    Studies suggest blood loss is similar between a myomectomy and hysterectomy. Also, with both, blood loss is higher with a larger uterus.



  • Pregnancy or childbirth complications. A myomectomy can increase certain risks during delivery if you become pregnant. If your surgeon had to make a deep incision in your uterine wall, the doctor who manages your subsequent pregnancy may recommend cesarean delivery (C-section) to avoid rupture of the uterus during labor, a very rare complication of pregnancy. Fibroids themselves are also associated with pregnancy complications.
  • Rare chance of spreading a cancerous tumor. Rarely, a cancerous tumor can be mistaken for a fibroid. Taking out the tumor, especially if it's broken into little pieces to remove through a small incision, can lead to spread of the cancer. The risk of this happening increases after menopause and as women age.

Strategies to prevent possible surgical complications

To minimize risks of myomectomy surgery, your doctor may recommend:

  • Iron supplements and vitamins. If you have iron deficiency anemia from heavy menstrual periods, your doctor might recommend iron supplements and vitamins to allow you to build up your blood count before surgery.
  • Hormonal treatment. Another strategy to correct anemia is hormonal treatment before surgery. Your doctor may prescribe a gonadotropin-releasing hormone (GnRH) agonist, birth control pills, or other hormonal medication to stop or decrease your menstrual flow. When given as therapy, a GnRH agonist blocks the production of estrogen and progesterone, stopping menstruation and allowing you to rebuild hemoglobin and iron stores.
  • Therapy to shrink fibroids. Some hormonal therapies, such as GnRH agonist therapy, can also shrink your fibroids and uterus enough to allow your surgeon to use a minimally invasive surgical approach — such as a smaller, horizontal incision rather than a vertical incision, or a laparoscopic procedure instead of an open procedure.


    Evidence suggests that not every woman should take GnRH agonist therapy before myomectomy. GnRH agonist therapy may soften and shrink fibroids enough to interfere with their detection and removal. The cost of the medication and the risk of side effects must be weighed against the benefits.

    Drugs that modulate progesterone action, such as ulipristal (ella), also may decrease symptoms and shrink fibroids. Outside the United States, ulipristal is approved for three months of therapy before a myomectomy.

How you prepare

Food and medications

You'll need to fast — stop eating or drinking anything — in the hours before your surgery. Follow your doctor's recommendation on the specific number of hours.


Ask your doctor about the type of anesthesia you may receive:

  • General anesthesia, which means you're asleep during surgery, is used for abdominal, laparoscopic, robotic and some hysteroscopic myomectomies
  • Spinal anesthesia, where medication is injected into your spinal canal to numb the nerves in the lower half of your body, is used for certain hysteroscopic myomectomies.

Finally, discuss with your doctor pain medication and how it will likely be given.

Other preparations



What you can expect


Abdominal myomectomy





Laparoscopic or robotic myomectomy





Hysteroscopic myomectomy


A hysteroscopic myomectomy generally follows this process:



After the procedure


Abdominal hysterectomy incisions

During an abdominal hysterectomy, your surgeon makes a vertical or a horizontal incision in your lower abdomen. A vertical incision (left) gives the surgeon greater access to your pelvis. A horizontal incision (right) follows your skin's natural lines, usually leaving a thinner scar.

Fibroid locations

There are three major types of uterine fibroids. Intramural fibroids grow within the muscular uterine wall. Submucosal fibroids bulge into the uterine cavity. Subserosal fibroids project to the outside of the uterus. Some submucosal or subserosal fibroids are pedunculated — they hang from a stalk inside or outside the uterus.


Outcomes from myomectomy may include:

  • Fertility improvement. Removing submucosal fibroids by hysteroscopic myomectomy can improve fertility and pregnancy outcomes. After a myomectomy, wait at least three months before attempting conception to allow the uterus enough healing time.

Tiny tumors (seedlings) that your doctor doesn't detect during surgery could eventually grow and cause symptoms. New fibroids, which may or may not require treatment, also can develop. Women who had only one fibroid have a lower risk of needing to have treatment for additional fibroids ― often termed the recurrence rate ― than do women with multiple fibroids.
