Midwest Reproductive Center


Choosing Myomectomy to Remove Uterine Fibroids

Fibroid tumors can cause pain, a heavy menstrual flow and even infertility, depending on size and location. If you are trying to conceive, Dr. Dan Gehlbach will present a case for either surgically removing fibroid tumors using myomectomy, or designing a fertility treatment plan to circumvent the uterine fibroid growth.

Myomectomy (my-o-MEK-tuh-mee) is a surgical procedure to remove the fibroid(s) and repair the uterus. Dr. Gehlbach believes that nearly all women can expect a successful outcome with myomectomy. Nearly thirty years of surgical experience–with open, minimally invasive and da Vinci Surgical System–positions Dr. Gehlbach to expertly assess and address issues with fibroids.

Women who plan to get pregnant one day will obviously opt for myomectomy over hysterectomy (removing the uterus). Additional benefits of myomectomy include improved fertility, and relief from the painful or troublesome symptoms that affect quality of life.

What to Expect with Myomectomy

Dr. Gehlbach performs low-risk myomectomies in the Midwest Reproductive Center surgery center. An experienced reproductive surgeon, Dr. Gehlbach specializes in minimally invasive laparoscopic or robotic techniques to avoid post surgical adhesions that can interfere with fertility.

When you are scheduled for a myomectomy with Midwest Reproductive Center, Dr. Gehlbach and our patient advocates will help answer questions about what to expect during fertility surgery:

  • In-office ultrasound allows Dr. Gehlbach to assess the size, location and number of fibroids present, and plan the appropriate surgical technique.
  • Your myomectomy will involve general anesthesia administered intravenously, (through an IV). Rest assured that we prioritize your comfort, and an experienced anesthesiologist will offer a numbing cream and sedative prior to your procedure.
  • Dr. Gehlbach will instruct you on food intake, drug interactions and other pre-surgical requirements.
    Laparoscopic or robotic techniques involve 2-3 tiny “keyhole” incisions in your abdomen, one for each instrument: a laparoscope (camera), grasping tool and a cutting tool. The surgery involves injecting a drug directly into the fibroid(s) to cut off the blood supply, then removing the fibroid(s) from the uterine wall with a laser. Dr. Gehlbach, practiced as a fertility surgeon and reproductive endocrinologist, painstakingly repairs the uterine lining, mindful that it will one day support a pregnancy.
  • You will not be allowed to drive home after your fertility surgery, so please arrange to have someone in charge of your care and transportation.
  • If you require open (abdominal) surgery, expect at least an overnight stay in the hospital, and 4-6 weeks of recovery. Most of Dr. Gehlbach’s laparoscopic patients go home the same day, and recover over 2-3 weeks.

Treating Deep, Submucosal Fibroids

In some cases when the fibroid bulges into the uterine wall, Dr. Gehlbach will recommend hysteroscopic myomectomy, with a vaginal entry for surgery. Similar to diagnostic fertility procedures that examine the uterus, ovaries and fallopian tubes, hysteroscopic myomectomy involves a thin, surgical tool (resectoscope) to find and remove fibroids.

Hysteroscopic myomectomy seems to have the highest post-surgery pregnancy rates of all of the surgical approaches to fibroid removal.

Potential Risks Associated with Myomectomy

  • Fibroids can cause heavy menstrual bleeding, so there may be elevated risk for excessive blood loss during surgery.
  • Although most fibroids are non-cancerous, your fertility specialist will order a biopsy to err on the side of caution.
  • Some women may need to opt for a cesarean delivery rather than vaginal delivery when they get pregnant after myomectomy.
  • In extreme situations, myomectomy is not successful, and Dr. Gehlbach will need to perform a hysterectomy instead.
  • As with any surgery, there is a risk for adhesions and infection.

The benefits of treating fibroid tumors, rather than adopting a “wait and see” approach, include an improved quality of life, reduced pain and discomfort, and greater chance for getting pregnant.

Contact Dr. Gehlbach and Midwest Reproductive Center to inquire about myomectomy, and removing fibroids to improve your chances for getting pregnant.