Generally, surgery is done when the fibroids result in significant symptoms.
If a female plans to conceive in the future, then Myomectomy is the only surgical option (in which the fibroids are surgically removed). In this procedure, the fibroids are removed by the surgeon, leaving the uterus in place.
Myomectomy can be of several types, based upon the size and location of the fibroids. All Myomectomies affect future fertility and carry a risk of scarring and adhesions. Also, the procedure involves the risk of undue bleeding, which may necessitate a Hysterectomy.
Myomectomy can be:
• Abdominal Myomectomy (Laparotomy): Removes fibroids present on the uterus’s external surface and the adjacent organs. An incision is done in the abdomen area.
• Laparoscopic Myomectomy: It is quite a simple and minimally invasive technique. A laparoscope removes fibroids through tiny 5-10 mm incisions done in the abdomen via the navel.
• Hysteroscopic Myomectomy: Best intervention for fibroids contained inside the uterus (submucosal). A telescope-like device is placed through the cervix. Then, fluid fills up the uterus to inflate the uterine walls. This increases the access and image of the uterus. A hysteroscope is used to eliminate the submucous fibroids.
With any technique that doesn't eliminate the uterus, new fibroids may develop and result in symptoms.