Myomectomy: Types, Recovery, Risks and Pregnancy After Fibroid Removal
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is a myomectomy?
A myomectomy is a surgery that removes uterine fibroids while leaving the uterus in place, so pregnancy remains possible. It treats fibroids causing heavy or irregular bleeding, pelvic pain, or trouble emptying the bladder. Surgeons use an open, laparoscopic/robotic, or hysteroscopic approach, and recovery ranges from a few days to about six weeks. [1]
What the research says
Myomectomy leads to fewer repeat procedures than embolization. A meta-analysis of 13 studies (including 4 randomized trials) found that, at four-year follow-up, women treated with uterine artery embolization had higher odds of needing another procedure (OR 1.84) and of having a later hysterectomy (OR 4.04) than women who had a myomectomy. Embolization, however, had fewer early complications (OR 0.44). (Peng et al., Scientific Reports, 2024) [2]
Keyhole surgery is gentler than open surgery. Pooling 19 randomized controlled trials, laparoscopic myomectomy lowered the risk of fever after surgery by 57% (RR 0.43) and cut requests for pain medication by about half (RR 0.49) compared with open myomectomy, with no difference in blood loss. (Tanos et al., European Journal of Obstetrics & Gynecology and Reproductive Biology, 2023) [3]
Most women see their bleeding improve. A systematic review of 84 studies on uterus-sparing fibroid treatments found that six studies on myomectomy reported improved bleeding symptoms in up to 95.9% of patients, with no significant difference between surgical approaches. (Zhang et al., Reproductive Sciences, 2022) [4]
Key takeaways
A myomectomy removes fibroids only; the uterus stays, periods continue, and pregnancy stays possible. [1]
The three main approaches are open (abdominal), laparoscopic or robotic, and hysteroscopic, chosen by fibroid size, number and location. [1]
Recovery takes up to six weeks after open surgery, about two to four weeks after laparoscopic surgery, and just days after hysteroscopic surgery. [1]
New fibroids can grow later, especially in people under 40 who had many fibroids. [1]
Heavy bleeding, fever, uncontrolled pain, chest pain, trouble breathing, or red, swollen legs after surgery need prompt medical attention. [1]
What is a myomectomy?
A myomectomy is a procedure that removes uterine fibroids (also called leiomyomas) from the uterus while preserving the uterine tissue, so you can still become pregnant in the future. [1]
Fibroids are growths made of connective tissue and muscle cells. They can grow inside or outside the uterus, and they are almost always non-cancerous (benign). [1]
You can have one fibroid or many, and they vary in size. A myomectomy is an alternative to a hysterectomy, which removes the uterus, cervix and fibroids together. [1]
Who needs a myomectomy?
A myomectomy is recommended for people whose uterine fibroids cause symptoms and who want to keep their uterus, especially if they hope to become pregnant in the future. [1]
Your healthcare provider may suggest it when fibroids cause:
Pelvic pain
Irregular bleeding or bleeding between periods
Difficulty fully emptying the bladder [1]
Fibroids are extremely common, and some need no treatment at all. Whether you need treatment depends on three things: [1]
Factor | What your provider looks at |
Symptoms | How much the fibroids affect bleeding, pain and bladder function |
The fibroids themselves | Their size, location and number |
Your preferences | Whether you want to become pregnant or keep having periods |
If heavy periods have left you tired or run down, our guide to iron deficiency anemia explains what to ask your doctor.
What are the alternatives to a myomectomy?
Myomectomy is not the only fibroid treatment, and because every surgery carries some risk, providers may suggest non-surgical options first. [1]
Option | How it works | Keeps the uterus? |
Watchful waiting | Your provider rechecks you in 6 to 12 months unless symptoms develop | Yes |
Hormonal medication | Suppresses the ovaries to reduce bleeding and can shrink fibroids | Yes |
Another fibroid treatment your provider may offer | Yes | |
Radiofrequency ablation | Another fibroid treatment your provider may offer | Yes |
Myomectomy | Surgically removes the fibroids | Yes |
Hysterectomy | Removes the uterus, cervix and fibroids | No |
Sources: [1]. Your provider will recommend the best option based on your health history and preferences.
If you are also reading about adenomyosis or endometrial ablation, ask your doctor how those options compare with a myomectomy for your situation.
How is a myomectomy different from a hysterectomy?
A myomectomy removes only the fibroids and leaves the uterus in place, while a hysterectomy removes both the fibroids and the uterus. [1]
Myomectomy | Hysterectomy | |
What is removed | Fibroids only | Fibroids, uterus and cervix |
Periods afterward | Return after surgery | Stop permanently |
Future pregnancy | Possible | Not possible |
Can new fibroids grow? | Yes | — |
Source: [1]
What are the different types of myomectomy?
There are three main types of myomectomy: open (abdominal), minimally invasive laparoscopic or robotic, and hysteroscopic. [1] The surgeon chooses the type based on how large the fibroids are, how many there are, and where they sit in the uterus. [1]
Type | Incisions | Best suited for | Hospital stay | Recovery |
Open (abdominal) | One cut in the belly, vertical or horizontal | Extremely large fibroids | A few days | Up to 6 weeks |
Laparoscopic or robotic | Several small cuts, including one at the belly button | A minimally invasive option, easier on the body | May go home the same day | About 2 to 4 weeks |
Single port | One slightly larger cut at the belly button, no other cuts | A minimally invasive option | — | Generally quicker than open surgery |
Hysteroscopic | None (through the vagina) | Fibroids in the right spot inside the uterus | — | A matter of days |
Source: [1]
Open (abdominal) myomectomy
An open myomectomy removes fibroids through a single incision in the abdomen, which may run up and down or across. [1] It may be the best option for extremely large fibroids because the surgeon can see all the pelvic organs. Recovery is similar to other major surgery: a few days in hospital and up to six weeks at home before you feel fully yourself. [1]
Laparoscopic or robotic myomectomy
A laparoscopic myomectomy uses a small, lighted telescope inserted through the belly button, plus several other small cuts for surgical tools. [1] The fibroids are then removed through the vagina or through the small openings in the abdomen. If fibroids are cut into small pieces to remove them (morcellation), a hidden cancer could rarely be spread, so the FDA advises using a containment bag; ask your surgeon how your fibroids will be removed. In a robotic myomectomy, the surgeon uses a robot to control the instruments. [1] These minimally invasive surgeries generally mean quicker recovery and are easier on the body. [1]
Single-port myomectomy
A single-port myomectomy passes all surgical instruments through one opening near the belly button. [1] The belly-button incision is slightly larger, but there are no other cuts on the abdomen. [1]
Hysteroscopic myomectomy
A hysteroscopic myomectomy removes fibroids with no incisions at all. [1] When fibroids sit in just the right place inside the uterus, the surgeon passes a camera with a special attachment through the vagina into the uterus to remove them. It is quick compared with the other types. [1]
How should you prepare for a myomectomy?
Preparing for a myomectomy means following your provider's instructions on when to stop eating and drinking and whether to pause certain medications. [1]
Your provider will also explain how long you may stay in the hospital or surgical center and what lifestyle changes to make while you recover. Write down your questions and ask them before surgery so you know what to expect. [1]
On the day of surgery, you can expect:
An IV (intravenous line) in your arm or hand for fluids, medication and anesthesia, so you feel no pain during the procedure
Monitors to track your heart rate and other vital signs
Possibly a catheter to empty your bladder during surgery [1]
How long does a myomectomy take?
A myomectomy usually takes between two and three hours, depending on the type of surgery and the number and location of fibroids removed. [1] Ask your provider what to expect for your own procedure.
Is a myomectomy painful? A myomectomy can be painful, but pain relief is available both during and after surgery. [1] Talk to your surgeon beforehand about how your pain will be managed.
What are the risks of a myomectomy?
The main risks of a myomectomy are bleeding, infection, blood clots, damage to nearby organs, allergic reactions to anesthesia, and a higher chance of needing a C-section in future pregnancies. [1]
Risk | What it means |
Bleeding | Blood loss linked to the surgery |
Infection | An infection after the operation |
Clots that can form after surgery, which is why walking early matters | |
Organ damage | Injury to organs near the uterus |
Anesthesia reaction | An allergic reaction to anesthesia medication |
Future C-section | Increased chance of needing a cesarean delivery |
Source: [1]
These complications are uncommon, and your healthcare team takes steps to prevent them. [1]
What is recovery like after a myomectomy?
Recovery after a myomectomy depends on the type of surgery and on whether any problems arise, and ranges from a few days to about six weeks. [1]
Type of myomectomy | Hospital stay | Full recovery |
Hysteroscopic | Quick procedure with no incisions | A matter of days |
Laparoscopic or robotic | May be the same day | About 2 to 4 weeks |
Open (abdominal) | After a few days in hospital | Up to 6 weeks |
Source: [1]
You can expect some pain for the first few days, and your provider will give you pain medication. You will also be encouraged to move your legs and take short walks to lower the risk of blood clots such as deep vein thrombosis. [1]
What to expect while you heal:
Vaginal bleeding and discharge for a few weeks
No lifting heavier than 5 to 10 pounds (about 2 to 4.5 kg) for the first week, and longer after open surgery
No sexual intercourse for six weeks, and nothing placed inside the vagina during recovery
A gradual return to activity, rather than jumping straight back into your normal routine [1]
How much rest do you need? Every type of myomectomy needs at least a few days of rest. If possible, arrange for someone to help at home for the first one to three days, and follow your provider's advice on returning to normal activities. [1]
Can fibroids come back after a myomectomy?
Fibroids can come back after a myomectomy, because new fibroids may grow in the uterus over time. [1]
People under 40 who had many fibroids have a higher risk of new fibroids. People close to menopause, or those who had only a few fibroids, are less likely to see them return. [1]
Can you get pregnant after a myomectomy?
You can still get pregnant after a myomectomy, because the uterus is left in place. [1]
Tell your surgeon about your pregnancy plans before the operation so they understand your goals. You may have a higher chance of needing a C-section, because of possible complications during a vaginal delivery. [1] If you are already trying to conceive, our guide to female infertility explains other factors worth discussing with your doctor.
What changes in your body after a myomectomy?
Most people notice no major body changes after a myomectomy other than relief from fibroid symptoms. [1]
Periods: Most people have lighter and more regular periods after surgery. [1]
Menopause: The uterus keeps working normally, so a myomectomy does not cause menopause, and periods return shortly after surgery. [1]
Scars: An open myomectomy leaves a scar below the underwear line. Laparoscopic scars are smaller and sit near the belly button, and may show with a two-piece swimsuit or short top. A hysteroscopic myomectomy leaves no scar. Most scars fade over time. [1]
Contact your provider if a scar becomes painful or sensitive. [1]
When should you call a doctor after a myomectomy?
Call your healthcare provider after a myomectomy if you have heavy bleeding, signs of infection, pain your medication does not control, chest pain or trouble breathing, or red, swollen or cramping legs. [1]
Contact your provider if you notice:
Heavy bleeding
Fever, chills or other flu-like symptoms
Pain that your medication does not control
Chest pain or trouble breathing
Red, swollen legs or cramping in your legs [1]
Conclusion
A myomectomy removes uterine fibroids that cause bleeding, pain or bladder problems while keeping the uterus, so periods continue and pregnancy remains possible. The type of surgery depends on the size, number and location of your fibroids, and recovery ranges from a few days to about six weeks. New fibroids can grow later, so ongoing follow-up matters. Because myomectomy is one of several fibroid treatments, the best choice comes from an honest conversation with your provider about your symptoms, your health history and your plans for the future.
Your next step: Save or print this guide and bring it to your next appointment. Use the tables above to ask your surgeon which type of myomectomy suits your fibroids, how long your recovery should take, and what your plans for pregnancy mean for your care. To compare your options, read our guides to hysterectomy and uterine artery embolization.
Further reading from trusted organizations:
Uterine Fibroids — patient FAQ (The American College of Obstetricians and Gynecologists)
Uterine Fibroids — professional overview (Merck Manual Professional Version)
FAQ
Is a myomectomy a major surgery?
An open myomectomy is major surgery, with a few days in hospital and up to six weeks of recovery. Laparoscopic, robotic and hysteroscopic myomectomies are less invasive and generally heal faster.
How long does it take to recover from a myomectomy?
Recovery from a myomectomy takes a few days after hysteroscopic surgery, about two to four weeks after laparoscopic surgery, and up to six weeks after open surgery. Your surgeon will tell you when to return to normal activities.
Is a myomectomy painful?
A myomectomy can be painful, especially in the first few days after surgery. Pain relief is given during and after the procedure, so talk to your surgeon about how your pain will be managed.
Can fibroids grow back after a myomectomy?
New fibroids can grow after a myomectomy. People under 40 who had many fibroids have the highest risk, while people near menopause or with only a few fibroids are less likely to see them return.
Can I get pregnant after a myomectomy?
Pregnancy is still possible after a myomectomy because the uterus stays in place. Share your pregnancy plans with your surgeon before the operation so they understand your goals.
Will I need a C-section after a myomectomy?
A myomectomy can increase the chance of needing a C-section, because of possible complications during vaginal delivery.
Will a myomectomy leave a scar?
A myomectomy leaves a small scar unless it is done hysteroscopically. Open surgery leaves a scar below the underwear line, laparoscopic scars are smaller and near the belly button, and most scars fade over time.
When should I call my doctor after a myomectomy?
Contact your provider after a myomectomy if you have chest pain or trouble breathing, heavy bleeding, fever or chills, pain your medication does not control, or red, swollen or cramping legs.
How long is the hospital stay after a myomectomy?
It depends on the type of surgery. Hysteroscopic and many laparoscopic myomectomies let you go home the same day or the next day, while open surgery often needs a stay of a few days.
How long should you wait to get pregnant after a myomectomy?
Many surgeons advise waiting a few months so the uterus can heal. Your surgeon will tell you how long to wait based on the surgery you had.
Related Reading
Uterine Artery Embolization: Effective Relief for Fibroids and Bleeding explains the nonsurgical procedure that shrinks fibroids by blocking blood flow.
Hysterectomy (Surgical Removal of the Uterus) covers the types of hysterectomy, recovery and risks.
Heavy Menstrual Bleeding (Menorrhagia): Symptoms, Causes, Diagnosis and Treatment explains causes of heavy periods and how they are treated.
Adenomyosis: Complete Guide to Symptoms, Causes, Diagnosis & Treatment explains another common cause of painful, heavy periods.
References
Cleveland Clinic. Myomectomy: Purpose, Procedure, Risks, Results & Recovery. Cleveland Clinic. Last updated January 11, 2023. https://my.clevelandclinic.org/health/treatments/15448-myomectomy
Peng J, Wang J, Shu Q, et al. Systematic review and meta-analysis of current evidence in uterine artery embolization vs myomectomy for symptomatic uterine fibroids. Sci Rep. 2024;14(1):19252. PMID 39164326. https://doi.org/10.1038/s41598-024-69754-0
Tanos V, Lee SC, Alexander K, et al. Laparoscopic myomectomy complications: META analysis on RCTs and review of large cohort studies. Eur J Obstet Gynecol Reprod Biol. 2023;287:109-118. PMID 37302233. https://doi.org/10.1016/j.ejogrb.2023.06.008
Zhang J, Go VA, Blanck JF, et al. A Systematic Review of Minimally Invasive Treatments for Uterine Fibroid-Related Bleeding. Reprod Sci. 2022;29(10):2786-2809. PMID 34480321. https://doi.org/10.1007/s43032-021-00722-z
Medical disclaimer
This article is for general educational purposes only and does not replace professional medical advice, diagnosis or treatment. Always talk to a qualified healthcare provider about your symptoms and treatment options. If you have chest pain, trouble breathing or heavy bleeding after surgery, seek emergency care immediately.
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