Myomectomy is the surgical removal of fibroids from the wall of the womb which is then repaired and the womb left in place. Because a woman keeps her uterus, she may still be able to have children. If a woman does become pregnant after a myomectomy, she may need to have a Cesarean delivery. Sometimes, though, a myomectomy causes internal scarring that can lead to infertility.
Myomectomy is a major operation and sometimes it is impossible for every fibroid to be removed (as some may be too small to be discovered). Therefore fibroids may develop again, even after the procedure. If they do, more surgery is needed in 20-40% of cases. Fibroids may be removed through an incision in the abdomen (laparotomy), or by laparoscopic surgery. With this method the fibroids can be removed through 3 or 4 small cuts on the abdomen of one inch size.
The method used depends on the location and size of the fibroids. Hysteroscopic surgery can also be used to remove fibroids that protrude into the cavity of the uterus. The fibroids may be removed with a resectoscope, a tiny wire loop that uses electric power and can be inserted through the hysteroscope. Although it cannot remove fibroids deep in the walls of the uterus, it often can control the bleeding these fibroids cause. This type of treatment is often done with pain relief, but you may not need to stay in the hospital.