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Surgical Fibroid Removal Options: How To Choose Between A Hysterectomy And A Myomectomy

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Advantages, Risks, And What You Need To Know To Make An Informed Decision

When it comes to the chronic pain and heavy bleeding associated with fibroids, many women are relieved to learn how surgical intervention can help — and are surprised to find that they have options. Understanding the difference between a hysterectomy and myomectomy is essential for making the best decision for your health. A laparoscopic GYN specialist can expertly advise you on which procedure may be best for you. By learning the advantages and risks associated with these procedures, you can feel confident in making an educated decision on which fibroid surgery removal option will provide the best outcome.


Choosing a Minimally Invasive Myomectomy

For women looking to have children in the future, a myomectomy can remove fibroids while leaving the uterus intact to maintain fertility. The specialists at The Center for Innovative GYN Care use our advanced LAAM-BUAO® fibroid removal for fertility technique, an advanced laparoscopic myomectomy surgery that uses only two small incisions. When non-specialists perform a myomectomy, they often require larger or multiple incisions and the procedure can have a longer recovery time. The CIGC LAAM® technique makes it possible for even very large fibroids to be removed through small incisions.

Before undergoing surgery, our patient, Azundai, knew what she was looking for in a fibroid removal surgery.

“I made a list of everything I wanted. All of the fibroids had to be removed, I needed a small, barely visible scar, limited pain, and I needed to be able to get back to work quickly,” said Azundai. “Dr. MacKoul gave me the facts and I appreciated that. The surgery went off without a hitch. I looked at the list that I had created. No large incision! I have to look for it. I was back to work in two weeks.”

However, even when using minimally invasive techniques such as LAAM, a myomectomy is still a more complex and invasive procedure than a hysterectomy. A hysterectomy removes the uterus altogether. A myomectomy requires layers of sutures to ensure the uterus is strong enough to carry a fetus to term. These layers take longer to heal. With the LAAM myomectomy, the recovery time from surgery is up to two weeks. Patients can return to normal activity, including work. Regardless of the type of myomectomy a patient has, she must still wait until being cleared by her doctor before getting pregnant, which can be 6 months.

Although we have seen great success for women planning to conceive, the only time a myomectomy should be performed is when fertility and pregnancy is still an option. Otherwise, a minimally invasive hysterectomy may provide a better outcome, as it is generally considered to have less risk.

Unless you’ve arranged for a donor egg and plan on getting pregnant, women 45 or over need to consider the benefits of a hysterectomy to ensure fibroids do not grow back. It is important for women to understand that a myomectomy procedure does not guarantee that fibroids will not return, and the risk of multiple surgeries has to be weighed very carefully — any provider will need to consider the benefits versus the risks when they make their recommendation. It is at the discretion of the specialist if they are willing to perform a myomectomy procedure. Although fibroids will not continue to grow after menopause, the lack of blood supply to the uterus will cause existing fibroids to appear to shrink. In many cases, the low blood flow can cause fibroids

to become necrotic as they begin to die off, which results in painful inflammation in the uterus. Therefore, we recommend that even post-menopausal women talk to a specialist about removing their fibroids via hysterectomy to avoid unnecessary pain and complications.


Understanding the Reality of a Hysterectomy

Women can be frightened by the word hysterectomy because of false information, which can lead to unwarranted fear. A hysterectomy, or removal of the uterus, is actually less invasive than a myomectomy, and is the only cure for fibroids. A hysterectomy is often associated with a long recovery, intense pain, menopause, or loss of femininity — when, in reality, your uterus doesn’t control your hormones whatsoever. The term hysterectomy refers to removal of ONLY the uterus and the cervix. The ovaries continue to make estrogen and function normally, so menopause will not occur. A partial hysterectomy refers to removal of the uterus and cervix. Only a complete hysterectomy refers to removal of the uterus, cervix, tubes, and ovaries. With a minimally invasive technique, such as our DualPortGYN®, pain is limited and recovery time is brief.

A hysterectomy has a range of benefits outside completely curing fibroids. For example, the removal of fallopian tubes has been shown to reduce the risk of ovarian cancer. Removal of the ovaries, or oophorectomy, may be recommended for patients who have a family history of ovarian cancer or who test positive for BRCA-1, BRCA-2, or PALB3 gene mutations. Annual PAP tests are eliminated as well.

As minimally invasive hysterectomy specialists, The Center for Innovative GYN Care is a pioneer in the field of GYN surgery. Based on our experience and expertise, we have developed our powerful laparoscopic hysterectomy procedures using our DualPortGYN technique.

Our patient, Cassandra, was shocked at how painless her hysterectomy procedure was. “I felt so much better a day, two days after. I could have gone back to work 5 days later, but I had to slow myself down. I felt so good that I was overdoing it a little.”

Choosing A Fellowship-trained GYN Specialist

When the time comes to consider removing your fibroids, contact a specialist to determine which procedure is right for you. As board-certified, fellowship-trained surgeons, we devote our careers entirely to minimally invasive surgery and gynecologic oncology, encountering more complex conditions and more surgical volume — building our unique expertise and skill in the most advanced breakthrough procedures.

“Surgeons should be trained on powerful techniques that enhance surgical outcomes for their patients,” said Dr. MacKoul. “We always recommend the most minimally invasive procedure that has patient safety at the forefront and also has stellar results.”

We personalize every decision after we’ve gotten to know each and every patient to ensure they are receiving the best possible treatment plans. We take into consideration your life plans, such as having children, and your feelings about having future surgeries should additional tumors grow. Our goal is to have you fully understand your condition as well as your options — and we will only proceed with the most effective, minimally invasive techniques to return you to optimal health as quickly as possible.

When it comes to complex GYN conditions, there is no greater decision than choosing a specialist. The Center for Innovative GYN Care can provide you with peace of mind as well as confidence with regard to your GYN health.



The CIGC state-of-the-art specialists are available at three locations in the DC metro area. Virginia patients can visit the Reston, VA location, and Saturday appointments are available. Maryland offices are located in Rockville, MD and Annapolis, MD.

CIGC is dedicated to providing information and materials for women to help navigate the complicated healthcare system. The CIGC founders, minimally invasive GYN surgical specialists Dr. Paul MacKoul, MD and Dr. Natalya Danilyants, MD, developed their advanced GYN surgical techniques using only two small incisions with patients’ well-being in mind.

Their personalized approach to care helps patients understand their condition and the recommended treatment so that they can have confidence from the very start. Our surgeons have performed over 20,000 GYN procedures and are constantly finding better ways to improve outcomes for patients.

Book a consultation today with Paul MacKoul MD or Natalya Danilyants MD.

Dr. Paul MacKoul Reviews: Vitals | RateMDs | Google | Wellness | UCompare

Dr. Natalya Danilyants Reviews: Vitals | RateMDs | Google | Wellness | UCompare