Abdominal myomectomy

A myomectomy takes out fibroids from the uterus. Uterine fibroids are growths on the outer wall, on the inner wall, or inside the wall of the uterus. They are not cancer.

The surgery is done through a cut the doctor makes in your lower belly. The cut is also called an incision. In many cases, the doctor makes the cut just above the pubic hairline. In other cases, the cut runs from the belly button to the pubic hairline. Both cuts leave a scar. It often fades with time.

You may stay in the hospital for 1 to 4 days. You can expect to feel better each day. But you may need about 4 to 6 weeks to recover.

This surgery should decrease the pain and heavy bleeding that are caused by fibroids. You will still have your uterus. Having this done should not affect your ability to have children. Sometimes it is done to help fertility. But there is a chance that surgery could harm the uterus. This can cause problems with a future pregnancy. Talk to your doctor about this before your surgery.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start out by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• For 4 to 6 weeks, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
• Avoid strenuous activities, such as biking, jogging, weightlifting, and aerobic exercise, for 4 to 6 weeks.
• You may shower. Pat the incision dry when you are done. Do not take a bath for the first week after surgery or until your doctor tells you it is okay.
• Ask your doctor when you can drive again.
• You will probably need to take 2 to 4 weeks off work. It depends on the type of work you do and how you feel.
• Ask your doctor when it is okay for you to have sex or use tampons. Do not douche.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, take an over-the-counter medicine such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Read and follow all instructions on the label.
  Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines contain acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor tells you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If you have strips of tape on the cut (incision) the doctor made, leave the tape on for a week or until it falls off.
• Wash the area daily with warm, soapy water and pat it dry.
• Keep the area clean and dry. You may cover it with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.

Other instructions

• Talk to your doctor if you want to try to get pregnant soon. Your doctor can tell you when it's safe to do so. If you don't want to get pregnant, talk with your doctor about birth control.
• You may have some light vaginal bleeding. Wear sanitary pads if needed.
• Wear loose, comfortable clothing and avoid anything that puts pressure on your belly for a few weeks.