25% of women over 35 will suffer from fibroid tumors. This percentage increases for African Americans. Given the vast numbers of women this affects new treatments have been developed to treat these non-cancerous tumors. Many women are chosing surgeries that do not remove the uterus.

One treatment that has gained success is myomectomy. Unlike a hysterectomy, which removes the uterus, a myomectomy is only the removal of the fibroids, leaving the uterus intact. There are several types of myomectomy surgery, including endoscopy, vaginal incision (colpotomy), or abdominal incision (laparotomy and mini-laparotomy). The choice of myomectomy depends on the number of fibroids, the location and the size. The patients' preference and the surgeons' skill should also be taken into consideration. These factors should be discussed in detail prior to surgery so that you and yor doctor can decide what is best in your case

Abdominal myomectomy is the most invasive of the myomectomy surgeries. This is usually done for very large or hard to locate fibroid tumors. This surgery is done under general anesthesia. An inscion is made, usually a "bikini cut" at the pubic hairline, so the uterus can be fully accessed. A laser is often used to make the inscion to limit bleeding. The advantage of this type of surgery is that the uterus can be fully explored to locate all fibroids. Also an electrosurgical instrument can be used to limit bleeding which is very important as many women have already experienced prolonged menstrual bleeding due to the fibroids. The recovery for this proceedure varies from women to women. The hospital stay is about 48 hours with an average of 2 to 4 weeks for recovery.

Laparoscopic myomectomy also takes place under general anesthesia, unless a new gasless technique is used, in which case a regional or epidural anesthesia may be administered. Several small 1/2-inch incisions in the abdominal wall are used in order to allow room for the laparoscope and other instruments. Then, using a laser, argon beam coagulation, or electrosurgery, the fibroids can be removed and the uterine wall repaired. A recently introduced technique for laparoscopic myomectomy involves using a bipolar needle or laser to perform "myolysis" of the fibroids. This does not involve surgically cutting into the uterus, but instead, it uses either electrical current or laser energy to coagulate the fibroids, resulting in their shrinking by 50% after surgery.

Hysteroscopic myomectomy is performed through the woman's cervical canal and does not involve any abdominal incisions. A device called a resectoscope can be used to either cut away the fibroids or electrical current can be used to "evaporate" the fibroids. With both a laparoscopic and/or hysteroscopic myomectomy, the patient goes home the same day of surgery. Most women are back to normal activities within 7-10 days.