Myomectomy

Myomectomy is surgery that removes uterine fibroids (leiomyomas) and preserves the uterus.¹ Fibroids can play a part in infertility, recurrent pregnancy loss, or abnormal uterine bleeding. In those cases, restorative care favors myomectomy over hysterectomy, the removal of the uterus. The goal is to restore the normal shape of the uterus, not to remove the organ.

There are three main approaches. The choice depends on the location, size, and number of the fibroids.

Hysteroscopic myomectomy is for submucosal fibroids, which grow into the cavity of the uterus. The surgeon works through the cervix. There is no incision in the abdomen.

Laparoscopic myomectomy uses small incisions in the abdomen. It removes fibroids on the outer surface (subserosal) or within the wall (intramural). Recovery is faster than with open surgery.

Open myomectomy (laparotomy or mini-laparotomy) is for fibroids that are large, many, or deep in the wall. Surgeons choose it when a scope cannot reach the fibroids well.

Restoring the cavity of the uterus matters for fertility. Some fibroids bulge into the cavity and change its shape. These fibroids are linked to failed implantation and early pregnancy loss. Removing them corrects the structural problem at its source. The restorative principle applies: restore function, then let conception happen on its own terms.