The presence of a fibroid does not mean that it needs to be removed. Removal is called for when the fibroid causes pain, abnormal bleeding, or pressure.
A myomectomy can be performed in a number of ways, depending on the location and number of lesions and the experience of the surgeon. Typically a myomectomy is performed via a laparotomy, the uterus incised, and the lesion(s) removed. A fibroid that is located in a submucous position may be accessible to hysteroscopic removal. In some instances also laparoscopy can be utilized to extirpate fibroids.
Complications of the surgery include the possibility of significant blood loss leading to a blood transfusion, the risk of adhesion or scar formation around the uterus, and the possible need later to deliver via cesarean section. Development of new fibroids will be seen in 42-55% of patients undergoing a myomectomy