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Treating symptomatic uterine fibroids with myomectomy: current practice and views of UK consultants.

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Related Experiment Video

Updated: Jul 6, 2026

Introduction of Intracapsular Rotary-cut Procedures (IRCP): A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation
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Conventional myomectomy.

Neelanjana Mukhopadhaya1, Chaminda De Silva, Isaac T Manyonda

  • 1Department of Obstetrics and Gynaecology, St. George's NHS Trust, London SW17 OQT, UK.

Best Practice & Research. Clinical Obstetrics & Gynaecology
|April 9, 2008
PubMed
Summary

Conventional abdominal myomectomy remains a vital treatment for symptomatic fibroids, especially for women desiring fertility preservation. Despite newer options, abdominal myomectomy offers advantages for large or multiple fibroids, with ongoing efforts to improve surgical outcomes.

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Area of Science:

  • Reproductive Medicine
  • Minimally Invasive Surgery
  • Gynecologic Surgery

Background:

  • Symptomatic fibroids present treatment challenges, with options ranging from hysterectomy to newer medical and minimally invasive therapies.
  • While newer treatments offer alternatives, they have limitations in efficacy, accessibility, and impact on fertility.
  • Conventional myomectomy, though associated with morbidity, remains a crucial option, particularly for uterine preservation and fertility.

Purpose of the Study:

  • To review the current role of conventional abdominal myomectomy in managing symptomatic fibroids.
  • To compare the efficacy and limitations of conventional myomectomy with newer treatment modalities.
  • To discuss strategies for optimizing outcomes following myomectomy, focusing on reducing complications and improving uterine function.

Main Methods:

  • Review of existing literature on fibroid treatments, including myomectomy, hysterectomy, medical management, uterine artery embolization (UAE), and magnetic-resonance-guided focused ultrasound surgery (MRgFUS).
  • Comparative analysis of the benefits and drawbacks of each treatment modality concerning efficacy, morbidity, fertility preservation, and accessibility.
  • Discussion of surgical techniques and innovations aimed at improving myomectomy outcomes.

Main Results:

  • Conventional myomectomy is effective for large or multiple fibroids without size limitations, unlike laparoscopic or vaginal approaches.
  • Newer treatments like mifepristone, UAE, and MRgFUS have limitations in efficacy, fertility impact, or technological requirements.
  • Conventional myomectomy, when skillfully performed, can improve assisted reproduction outcomes, though risks of blood loss, recurrence, and adhesions exist.

Conclusions:

  • Conventional abdominal myomectomy retains a significant role in managing symptomatic fibroids, especially when uterine preservation and fertility are priorities.
  • Ongoing innovation is needed to refine myomectomy techniques, minimize blood loss and adhesions, and ensure optimal uterine reconstruction for successful pregnancies.
  • Despite advancements, skilled conventional myomectomy remains a valuable option, challenging the notion that it is solely an older procedure.