Uterine fibroids are growths that develop in or on the uterus. Many women live with fibroids without symptoms, but others experience heavy menstrual bleeding, pelvic pressure, bloating, or fertility issues. When symptoms disrupt daily life, doctors often recommend fibroid removal, usually through a procedure called myomectomy.
While this surgery can provide relief, it comes with certain risks. Let’s understand these risks and how they can be managed, so you can approach your treatment with confidence.
Why Myomectomy? Understanding Your Options
Doctors perform a myomectomy to remove fibroids while preserving the uterus. Many women choose this procedure when they want to maintain fertility or avoid a hysterectomy. Depending on the fibroids’ size, number, and location, your doctor may suggest one of several surgical techniques: hysteroscopic (via the vagina), laparoscopic (minimally invasive), or open abdominal surgery.
Each method has benefits and risks. Your age, reproductive goals, and overall health will guide your OB-GYN in recommending the best approach. While a myomectomy is effective for symptom relief, you should understand the potential complications before proceeding.
General Surgical Risks of Myomectomy
Infection
After surgery, you may develop an infection at the incision site. Doctors treat infections with antibiotics, and early detection helps prevent serious complications.
Bleeding
Myomectomy can lead to blood loss, especially when removing large or deeply embedded fibroids. Surgeons use medications and advanced techniques to control bleeding during the operation.
Anaesthesia
Like any major surgery, myomectomy requires anaesthesia, which carries risks like allergic reactions or breathing difficulties. Most women tolerate anaesthesia well, but your anaesthesiologist will assess your risks and monitor you closely throughout the procedure.
Damage to Other Organs
During surgery, there is a slight risk of unintentional injury to nearby organs especially in complex cases or during open abdominal procedures. However, experienced surgeons take great care to avoid these complications and can manage them promptly if they arise.
Scarring
All surgical procedures cause some scarring. After myomectomy, you may develop internal adhesions that affect surrounding organs. These adhesions could lead to discomfort or impact fertility. While external scars depend on the surgical technique, minimally invasive options generally leave smaller marks.
Pain
You can expect pain after surgery, but your doctor will provide pain relief to help you recover comfortably. Follow their pain management advice and notify them of any unexpected discomfort so you can stay on top of your recovery.
Blood Clots
Surgery heightens your risk of developing blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism). To reduce this risk, your doctor will encourage early movement and may recommend compression stockings or blood thinners.
Myomectomy-Specific Risks
Fibroid Recurrence
Even after successful removal, fibroids may grow back. If you’re younger or have multiple fibroids, you face a higher chance of developing new ones.
Uterine Rupture
Although rare, uterine rupture can occur during pregnancy after a myomectomy, especially if the surgeon removes fibroids from deep within the uterine wall. To reduce this risk, your doctor may recommend a caesarean section for future deliveries.
Weakened Uterine Wall
Surgery to remove fibroids can weaken the uterine wall, depending on the fibroids’ size and depth. This weakening may affect the uterus’s structure during pregnancy or lead to complications later.
Sub-fertility Risks
While doctors often use myomectomy to improve fertility, the surgery itself may cause internal scarring or adhesions that impair reproductive function. Speak with your OB-GYN about your fertility goals before the procedure to understand the full picture.
When Hysterectomy Becomes Necessary
Severe Fibroids or Multiple Recurrences
In some cases, fibroids grow too large, recur frequently, or spread throughout the uterus, making myomectomy less effective. When this happens, your doctor may recommend the removal of your uterus, also known as a hysterectomy. This procedure eliminates the possibility of fibroid regrowth and can provide lasting relief from severe symptoms.
Other Health Conditions
Conditions such as endometriosis, adenomyosis, or gynaecological cancers may require a hysterectomy, particularly when fibroids contribute to a complex medical situation. Your doctor will weigh these factors before suggesting the most appropriate treatment.
Hysterectomy Risks
Although common and safe, hysterectomy remains a major surgery. While the removal of the uterus due to fibroids can offer permanent relief, it also carries risks like infection, bleeding, and hormonal changes, particularly if the ovaries are removed as well.
How to Minimise Risks of Fibroid Removal
Choosing the Right Procedure for Your Needs
You can reduce surgical risks by selecting the most appropriate procedure for your situation. If your fibroids are small and accessible, a minimally invasive technique may offer a safer and quicker recovery. Your doctor will help match the approach to your health goals.
Selecting an Experienced OB-GYN
Your surgeon’s experience plays a critical role in minimising complications. Choose an OB-GYN or fibroid specialist who regularly performs myomectomies. A skilled surgeon can navigate complex cases and ensure safe and effective results.
Following Pre- and Post-Surgical Care Guidelines
Adhering to your care team’s instructions before and after surgery protects your health. Before the operation, you may need to stop certain medications or manage underlying conditions. Afterwards, attend follow-ups, monitor your incision, and avoid strenuous activities to aid healing.
Monitoring for Complications Early
Watch for signs of complications like fever, heavy bleeding, unusual pain, or trouble urinating. If you notice anything concerning, call your doctor immediately. Prompt action often prevents minor issues from becoming serious problems.
Get an Opinion from Dr T.C. Chang
Although fibroid removal offers many benefits, it’s essential to be aware of the possible risks and how to manage them. Whether you’re considering myomectomy or facing the possibility of the removal of your uterus due to fibroids, understanding your options and the associated risks can empower you to make informed decisions for your reproductive health.
Dr TC Chang provides care to patients with complex fibroids. He takes a patient-focused approach, ensuring women understand their options and feel supported throughout treatment. Whether you aim to relieve symptoms or preserve your fertility, Dr Chang is here to help.
Book a consultation now.