Myomectomy Risks and Complications

Potential risks and complications after undergoing a myomectomy include: 

• Excessive blood loss: While blood loss is typically well controlled during a myomectomy, it’s important to pay attention to bleeding after the procedure. Patients that undergo fibroid removal surgery have the potential to bleed from the uterine incisions after the procedure. This may lead to blood loss that can cause lightheadedness, dizziness, nausea, and generalized malaise. Always contact your physician if you experience these symptoms following myomectomy, as you may need to be seen at a local hospital for evaluation. CIGC travel patients must stay within a certain distance from the surgery center so that CIGC surgeons can admit you to a hospital for which they have privileges to continue any necessary care. For most patients, all that is needed is a hospital evaluation, sometimes with a blood transfusion necessary. Always be sure to contact the physician on call before going to the hospital, so that appropriate instructions can be given. 
• Infertility: The risk of infertility is inherent to any myomectomy procedure performed using any technique and is dependent on the size, location and number of fibroids removed. The goal of a myomectomy is often to preserve fertility, but the ability to carry a pregnancy to term is never guaranteed after surgery. In some cases, the uterus may be too damaged due to fibroid growth to proceed with fertility goals.
• Tubal scarring: This can happen with fibroids that directly involve the fallopian tubes. Even when they are successfully removed, large fibroids can damage the fallopian tubes,² causing them to heal abnormally. Abnormal healing can also result in tubal and uterine wall defects if many fibroids needed to be removed.
• Adhesions: One of the longer-term complications after a myomectomy is the development of pelvic adhesions, which are thick bands of scar tissue. Adhesions can cause pain and problems with fertility over time. The risk of adhesions is higher with the larger incision used in an open myomectomy and if the surgeon performing the myomectomy is not a highly skilled expert in GYN surgeries.³
• Pregnancy or childbirth complications: These can include uterine rupture, abnormal placental development and intrauterine growth problems. Many patients who become pregnant will need to undergo a cesarean section for delivery due to weakening of the uterine muscle after removal of fibroids. While these kinds of complications are rare, it’s important to be closely monitored by your doctor throughout your pregnancy to catch any potential problems early.
• Infection: In rare cases, some patients may develop an infection at the incision sites. When caught early, infections are easily treated with antibiotics.
• Hysterectomy: If bleeding is uncontrollable or other life-threatening abnormalities are found, a hysterectomy may be necessary. This is very rare with the LAAM approach to myomectomy. 
• Spreading of cancerous tumors: This is an extremely rare complication but, in some cases, cancerous tumors may be present in the uterus at the time of fibroid removal. When these tumors are broken into small pieces to be removed, a process known as morcellation, cancerous cells can spread throughout the pelvic cavity. CIGC surgeons do not perform morcellation with a power morcellator during any LAAM procedure.