Myomectomy

Myomectomy is a fertility-preserving surgery that removes uterine fibroids (also called leiomyomas) while keeping the uterus in place. Fibroids are benign (non-cancerous) growths that can cause symptoms like heavy bleeding, pelvic pain or pressure, bloating, urinary frequency, and anemia-related fatigue.

At Lotus Endometriosis Institute, we often evaluate fibroids in the bigger picture of pelvic pain and bleeding—because symptoms can overlap with conditions like endometriosis and adenomyosis. A thoughtful workup through our evaluation and diagnosis process helps clarify what’s driving your symptoms, so the treatment plan matches your goals (pain relief, bleeding control, fertility preservation, or all of the above).

If you’re exploring surgical options, you can learn more about our approach to complex pelvic surgery through surgery and advanced excision and browse our procedures.

A myomectomy may be recommended when fibroids are likely causing significant symptoms—especially heavy menstrual bleeding, pelvic pain, increasing pelvic pressure, urinary urgency, or infertility—and you want to preserve your uterus. It can also be considered when medications haven’t provided enough relief, or when fibroids are affecting quality of life, work, relationships, or daily function.

It’s also commonly discussed for people who want to optimize fertility or pregnancy outcomes. Depending on fibroid size and location, fibroids may interfere with implantation, contribute to miscarriage risk, or make pregnancy more complicated. A personalized plan is important—sometimes surgery is beneficial before trying to conceive, and other times a different pathway is safer or more effective.

Because fibroids can coexist with adenomyosis and endometriosis, myomectomy is most helpful when we’re confident fibroids are a major driver of your symptoms. If your pain includes bowel/bladder symptoms (like bladder pain, constipation, or painful bowel movements), we may discuss evaluation for overlapping conditions so nothing important is missed (see related conditions).

The goal of myomectomy is to improve symptoms while preserving the uterus. Many patients experience meaningful improvement in heavy bleeding and pressure symptoms, and some notice improvement in cramping and pelvic discomfort as healing progresses. If infertility is part of your story, myomectomy may improve the chances of pregnancy when fibroids are a key contributing factor—but no surgery can guarantee pregnancy, and your age, ovarian reserve, tubal factors, and coexisting conditions also matter.

It’s normal to have mixed feelings—relief that there’s a plan, and anxiety about recovery or recurrence. One important expectation-setting point: fibroids can come back over time, especially in younger patients or those with multiple fibroids. Your surgeon should discuss your individual recurrence risk and what follow-up (or medical therapy) may help reduce symptoms moving forward.

If pelvic pain has been long-standing, your nervous system and pelvic floor can stay “on high alert” even after the fibroid is removed. Many patients benefit from a comprehensive recovery plan that may include pain management, integrative medicine and lifestyle care, and/or pelvic floor therapy to address muscle tension, movement patterns, and sensitized pain pathways.

A myomectomy removes fibroids while preserving the uterus. The approach is individualized based on factors like fibroid size, number, and location, your symptoms, your anemia status, prior surgeries, and your fertility goals. Your surgeon should explain what approach they recommend and why, including what that means for scarring, recovery time, and future pregnancy planning.

At Lotus Endometriosis Institute, planning also includes looking for conditions that can mimic fibroid symptoms—particularly adenomyosis and endometriosis. When appropriate, surgical planning may include evaluating and treating other pelvic pain drivers during the same operation, so you’re not left with persistent symptoms that were never addressed.

Myomectomy is not “just removing growths”—it’s uterine reconstruction with an emphasis on preserving function. That’s why pre-op imaging review, careful counseling, and a realistic discussion of outcomes are essential parts of the procedure experience.

Recovery varies by surgical approach and by the complexity of the fibroids removed, but most patients should plan for a healing period measured in weeks—not days. You can expect temporary pelvic soreness, fatigue, bloating, and activity restrictions while the uterus heals. Many people can resume light activities earlier, but returning to higher-impact exercise, heavy lifting, or intense core work usually takes longer and should be guided by your surgeon.

Bleeding patterns often improve, but your first 1–2 cycles after surgery can be irregular or heavier/lighter than expected as the uterus recovers. If heavy bleeding has caused anemia, your team may recommend iron support and follow-up labs—fatigue often improves as your blood counts recover.

If sex has been painful (see pain during intercourse) or you’ve had longstanding pelvic pain, consider building in supportive care during recovery. Pelvic floor therapy and integrative strategies can be especially helpful for easing muscle guarding, improving mobility, and supporting a more complete return to daily life.

Myomectomy outcomes depend heavily on judgment and experience—especially in complex cases (multiple fibroids, prior surgeries, significant bleeding, or coexisting pelvic pain conditions). Preserving the uterus while removing fibroids is a balance: the goal is to relieve symptoms and maintain uterine integrity, while minimizing complications and adhesions that can affect pain or fertility.

Specialist-level expertise matters because fibroids don’t always explain the full symptom picture. Many patients with “fibroid pain” also have endometriosis or adenomyosis. When those conditions are missed, patients may go through surgery yet still have painful periods, bloating, or pelvic pain afterward. A team experienced in complex pelvic disease is more likely to identify overlapping drivers and plan appropriately.

Lotus Endometriosis Institute is led by Dr. Steven Vasilev, known for advanced minimally invasive surgery and complex pelvic cases. If you’re weighing myomectomy vs other options—or you’ve been dismissed or told symptoms are “normal”—we encourage you to schedule a consultation to review your imaging, goals, and next steps.