There are multiple options available for treating uterine fibroids. While some treatments have broad applications, others are best suited to specific situations. Hysteroscopic myomectomy, for instance, is a minimally-invasive surgical procedure recommended specifically for submucosal fibroids. Learn more about the procedure, the type of fibroid it treats, and if you’re a candidate.* 

What is a hysteroscopic myomectomy?

A hysteroscopic myomectomy is performed through the vagina, without abdominal incisions. It is usually used for submucosal fibroids no larger than 5 cm in diameter, and is performed in an outpatient setting, under either general or local anesthesia. If a local anesthetic is used, you will remain awake during surgery. Many women prefer general anesthesia, so they can be completely asleep throughout the procedure.

What are submucosal fibroids?

Submucosal fibroids grow just beneath the inner lining of your uterus. While not the most common fibroid type, they can be the most problematic, causing severe symptoms even when small. The most common and severe issues associated with submucosal fibroids are: 

• Heavy and irregular menstrual bleeding
• Fertility issues such as difficulty conceiving, and a high rate of miscarriages
• Passing large, and frequent, blood clots
• Pressure on the urinary system and intestines
• Anemia, with resulting dizziness and fatigue

What happens during a hysteroscopic myomectomy?

While hysteroscopic myomectomy is typically a short procedure, it involves several steps. Your gynecological surgeon will:

• Conduct a vaginal exam to determine the size and location of the uterus and fibroid 
• Use a device called a retractor to hold open your vagina, to allow for better visibility 
• Use forceps to grasp the front lip of the cervix (the lower part of the uterus) and pull it forward, which causes your uterus to open
• Insert a small, specialized camera through your vagina and cervix into your uterus
• Pump a harmless gas or fluid into your uterus, causing it to expand for better visibility and easier movement inside it
• Insert a wire loop with which to grab the fibroid tissue and snip it free from the muscular wall of the uterus
• Remove all surgical instruments, after which the gas or fluid is allowed to escape, and your uterus returns to its normal size.

What can I expect after a hysteroscopic myomectomy?

You will likely remain at the surgical facility for several hours after the procedure, but should be able to go home that same day, depending on the time of your surgery. Total recovery time is generally a few days.

If you have submucosal fibroids and are interested in this procedure, discuss your candidacy and any questions or concerns with your doctor. 

*PreOp Patient Education. (2018, May 8). Vaginal Fibroid Removal Myomectomy Surgery • PreOp Patient Education [Video file]. https://www.youtube.com/watch?v=Qd4sgoH5Hvs