Gynecology & Obstetrics

Fibroid Removal Surgery (Myomectomy)

Surgery that removes fibroids and repairs the uterus, for women with heavy bleeding or pressure symptoms who want to keep their womb or plan a pregnancy.

Fibroid Removal Surgery (Myomectomy) at Prakash Hospital, Gynecology & Obstetrics
Surgery duration
1 to 3 hours
Anaesthesia
General
Hospital stay
1 to 4 days
Recovery
2 to 6 weeks, by approach

Overview

Many women in their 30s and 40s have a fibroid and never know it. The trouble starts when fibroids grow. Periods flood through clothes, haemoglobin won't stay up, the belly looks pregnant, or the bladder sends you to the toilet every hour. For women hoping to conceive, a fibroid in the wrong place can get in the way too.

A myomectomy removes the fibroids and leaves the uterus in place. The surgeon cuts into the uterine wall over each fibroid, shells it out and stitches the muscle back together in layers, so it's strong enough to carry a pregnancy later. It can be done through keyhole cuts, through a bikini-line cut, or, for fibroids inside the cavity, through the cervix with a hysteroscope.

For most women, heavy bleeding and pressure symptoms improve markedly. Be aware of the limits, though. Myomectomy doesn't stop new fibroids growing, and some women need further treatment years later. Bleeding during the operation can be heavy, because the uterus has a rich blood supply.

We treat fibroids with medicines as well as laparoscopic and hysteroscopic surgery in our gynaecology department. Your surgeon chooses the approach from the number, size and position of your fibroids, which we map with ultrasound before the operation.

Why it's done

Myomectomy is for women whose fibroids cause symptoms and who want to keep the uterus, usually for a future pregnancy but sometimes simply by choice.

  • Heavy periods that cause anaemia and don't settle with medicines
  • Pressure on the bladder, with frequent urination or trouble emptying it, or on the bowel, with constipation or back pain
  • A fibroid that distorts the uterine cavity and may be behind difficulty conceiving or repeated miscarriage
  • A fibroid that is growing quickly or causing pain
  • A swollen abdomen from a large fibroid

Is it right for you?

Usually a good fit

  • Fibroids causing symptoms, and a wish to keep the uterus or have children
  • Fibroids that can be reached and removed safely, judged from your scan or MRI
  • Haemoglobin that is normal, or has been brought up with iron before surgery

May not be suitable

  • Fibroids with no symptoms, which usually just need a scan every year or so
  • Many fibroids in a woman whose family is complete, where a hysterectomy gives a more lasting answer
  • Pregnancy. Fibroids are generally left alone until after the birth
  • Suspected cancer of the uterus, which needs a different plan
  • Severe anaemia or an active infection, until treated

Types and techniques

Laparoscopic myomectomy

Done through 3 or 4 small cuts, and suited to a limited number of fibroids of moderate size. The fibroids are cut into smaller pieces to come out through the small cuts, ideally inside a bag. You usually stay 1 to 2 days and are back to normal in 2 to 4 weeks.

Open myomectomy

Done through a horizontal bikini-line cut, or occasionally an up-and-down one for a very large uterus. It's used for large, deep or numerous fibroids, often more than 4 or 5, because the surgeon can feel for small ones and repair the wall in layers. Expect 2 to 4 days in hospital and 4 to 6 weeks of recovery.

Hysteroscopic myomectomy

For fibroids bulging into the cavity (submucosal fibroids). They're shaved away through the cervix with a resectoscope, with no cuts on the abdomen, as a day-care procedure. Large ones may need two sittings.

Preparing for surgery

  • An ultrasound, and sometimes an MRI, to map the number, size and position of each fibroid
  • Blood count, blood group and cross-match, because blood loss can be significant
  • Iron tablets or an iron drip to correct anaemia. Some women are given hormone injections (GnRH analogues) for 2 to 3 months beforehand to shrink the fibroids and stop the bleeding
  • Ask your doctor how to manage blood thinners and diabetes medicines around surgery
  • Fasting for about 6 hours before surgery
  • Help at home for 2 to 6 weeks, depending on the approach
  • Contraception for the months after surgery while the uterus heals
  • Confirm insurance cover before booking a date. Our empanelled insurers page lists the panels

The procedure, step by step

  1. 01

    Anaesthesia

    You're given a general anaesthetic, and a catheter drains your bladder during the operation.

  2. 02

    Reducing blood loss

    The surgeon may inject a medicine into the uterine wall that narrows its blood vessels, or place a temporary band around the lower uterus in open surgery.

  3. 03

    Removing the fibroids

    A cut is made over each fibroid, which is grasped and shelled out of its capsule. The surgeon tries to remove as many as possible through as few cuts in the uterus as possible.

  4. 04

    Repairing the uterus

    The muscle is stitched in one or more layers to close the space each fibroid left. This repair is what lets the uterus carry a pregnancy later.

  5. 05

    Removing tissue and closing

    In keyhole surgery, fibroids are cut into pieces inside a bag and taken out through a small cut. All the tissue goes to the lab, and the skin is closed with dissolving stitches.

Benefits and risks

Benefits

  • Keeps the uterus and the possibility of pregnancy
  • Heavy bleeding improves for most women, so haemoglobin can recover
  • Relief from bladder and bowel pressure and from abdominal swelling
  • A better chance of pregnancy when a fibroid was distorting the cavity
  • Lab confirmation that the fibroids were benign

Possible risks

  • Heavy bleeding that may need a transfusion, more likely with large or many fibroids
  • Switching from keyhole to open surgery partway through
  • Very rarely, well under 1 in 100, a hysterectomy to control bleeding
  • Scar tissue (adhesions) around the uterus, tubes or ovaries, which can affect fertility
  • New fibroids growing over the years, with some women needing further treatment
  • A weaker area in the uterine wall, with a small risk of it tearing in a later pregnancy or labour

Recovery timeline

How quickly you recover depends on the approach, so ask your surgeon which timeline applies to you.

  1. 01

    Day 0 to 2

    Regular painkillers keep you comfortable, the catheter comes out early and you're up and walking within a day. After keyhole surgery most women go home in 1 to 2 days.

  2. 02

    Days 3 to 7

    After open surgery you usually go home on day 3 or 4. Eat fibre and drink plenty of water so you don't strain, and include protein with every meal to help the wounds heal. Our post-surgery diet chart can help you plan meals.

  3. 03

    Weeks 2 to 6

    After keyhole surgery, most women are back at work in 2 to 4 weeks. After open surgery, allow 4 to 6 weeks. Don't lift buckets of water or gas cylinders until your surgeon says the wound has healed.

  4. 04

    Months 3 to 6

    The scar in the uterus firms up over these months. Most women are advised to wait 3 to 6 months before trying to conceive, and your surgeon will confirm the timing based on how deep the repairs were.

When to call your doctor

  • Fever of 38°C or above
  • Heavy vaginal bleeding
  • Increasing abdominal pain or swelling, vomiting, or not passing wind
  • Redness, swelling or discharge from the wound
  • Calf pain, chest pain or breathlessness
  • Feeling dizzy or faint, which can be a sign of internal bleeding

Call us on +91-8826000033 or come straight to our 24/7 emergency department.

Alternatives to surgery

Medicines

Tranexamic acid and anti-inflammatory medicines reduce bleeding, and a hormonal coil helps when fibroids are small and the cavity isn't distorted. GnRH injections shrink fibroids for a few months, but none of these removes them.

Hysterectomy

If your family is complete, a laparoscopic hysterectomy removes the fibroids for good, and they can't come back.

Uterine artery embolisation

An interventional radiologist blocks the blood supply to the fibroids through a thin tube passed into an artery in the groin, and some patients are referred elsewhere for it. It's less suited to women planning a pregnancy.

Watching and waiting

Fibroids that cause no symptoms don't need treatment, and they usually shrink after menopause.

Talk to our Gynecology & Obstetrics team

Ask about your options, the cost and your insurance before you decide. See the insurance and TPA panels we work with.

This page explains Fibroid Removal Surgery (Myomectomy) in general terms. Your own plan depends on your health, your test results and your doctor's advice. Please read our medical disclaimer.

Your care team

Fibroid Removal Surgery (Myomectomy) is led by our Gynecology & Obstetrics team, with other departments stepping in at each stage of your care.

Gynecology Department
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Gynecology Department

At Prakash Hospital, our Obstetrics and Gynecology Department provides expert care for women at every life stage — from prenatal care and childbirth to gynecological health and menopause management.

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High-Risk Pregnancy Care

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PCOS Management

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Prenatal and Postnatal Care

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Frequently Asked Questions

Answers to common questions about Fibroid Removal Surgery (Myomectomy) at Prakash Hospital, Noida.

Can fibroids grow back after a myomectomy?

New ones can. The operation removes the fibroids present at the time, but it doesn't stop your body growing more. Women with many fibroids, and younger women with more years before menopause, are the most likely to see them return.

How long should I wait to get pregnant after a myomectomy?

The uterus needs time to form a strong scar where the fibroids were removed. We generally advise waiting 3 to 6 months before trying, and longer after a very deep repair. Use contraception until your surgeon gives the go-ahead.

Will I need a caesarean in a future pregnancy?

It depends on how deep the surgery went. If the cavity was opened or the wall was cut deeply, a planned caesarean is usually advised to avoid the scar tearing in labour. After removal of small fibroids on the surface, a vaginal birth may be possible. Keep your operation notes for your obstetrician.

Can fibroids turn into cancer?

Fibroids are benign and almost never become cancer. A rare cancer called leiomyosarcoma can look like a fibroid on a scan, and it's more likely after menopause or when a growth enlarges quickly. That's why all removed tissue goes to the lab.

Is myomectomy covered by insurance?

Most health policies cover surgery for fibroids that cause symptoms, though many have a waiting period for this condition. We offer cashless treatment for gynaecological procedures with most insurers, so check your policy before booking the date.

Should I change my diet because of fibroids?

No particular diet shrinks fibroids. If heavy bleeding has left you anaemic, eat iron-rich foods such as green leafy vegetables, chana, rajma and dates, with a vitamin C source like lemon or amla, and take any iron tablets you're prescribed. Our guide to iron has more ideas.

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