Laparoscopic myomectomy can cause pain and soreness after surgery, but you should not feel pain during the operation because it is performed under general anaesthesia. After surgery, most patients experience abdominal tenderness, cramping or discomfort around the small incisions for the first few days.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
The pain is generally:
- Most noticeable during the first few days
- Manageable with appropriate pain relief
- Gradually reduced as healing progresses
- Less severe than pain after open abdominal myomectomy for many patients
Some women also develop temporary shoulder or upper-abdominal discomfort from the carbon dioxide gas used during laparoscopy. For a broader explanation of how fibroids are removed using different surgical techniques, see our main guide to myomectomy surgery.
Laparoscopic Myomectomy Pain at a Glance
| Stage | What You May Feel |
|---|---|
| During surgery | No awareness of surgical pain because general anaesthesia is used |
| First 24–48 hours | Abdominal soreness, cramping and tenderness around the incisions |
| First few days | Pain gradually improves; gas-related shoulder discomfort may occur |
| First 1–2 weeks | Mild tenderness or pulling may remain during movement |
| By 2–4 weeks | Most patients are substantially recovered from minimally invasive myomectomy |
Does Laparoscopic Myomectomy Hurt During Surgery?
No. Laparoscopic myomectomy is generally performed under general anaesthesia, which means you are unconscious during the operation and do not feel the surgical procedure being performed.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
During surgery, several small incisions are made in the abdomen. A camera and specialised instruments are inserted through these openings so the surgeon can remove the fibroids and repair the uterus. Pain usually becomes noticeable only after the anaesthesia begins wearing off.
How Painful Is Laparoscopic Myomectomy After Surgery?
Some postoperative pain is expected because both the abdominal tissues and uterus have been operated on. The intensity varies between patients, but common sensations include:
- Aching in the lower abdomen
- Pelvic cramping
- Tenderness around the small incisions
- A pulling sensation when standing or changing position
- Abdominal tightness
- Temporary shoulder pain from surgical gas
Pain is usually strongest during the early postoperative period and becomes progressively milder over the following days. Although laparoscopic surgery uses small external incisions, fibroids may be removed from deep within the uterine muscle. This means internal healing is still taking place even when the skin incisions appear minor.
What Does the Pain Feel Like?
There is no single type of pain experienced after laparoscopic myomectomy. Different sensations may come from different parts of the procedure.
Incision Pain
The small cuts in the abdominal wall may feel sore, tender or sensitive, particularly when coughing, laughing, standing or getting out of bed. This usually improves quickly as the incisions begin healing.
Pelvic or Uterine Cramping
The uterus has been cut and repaired where the fibroids were removed, so pelvic aching or cramping can occur. Some patients describe this as similar to strong menstrual cramps.
When Is the Pain Usually Worst?
The first 24 to 48 hours are generally the most uncomfortable period. During this time, patients may need regular pain medication and may find movements such as standing, sitting down or getting into bed uncomfortable.
The overall pattern should then be one of steady improvement. By the end of the first week, many patients notice that pain has reduced considerably, although some tenderness may remain.
How Long Does Pain Last After Laparoscopic Myomectomy?
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
For most patients, significant postoperative pain improves substantially within the first several days. A typical pattern may be:
- Days 1–3: abdominal soreness and cramping are most noticeable
- Days 4–7: pain usually becomes easier to manage and movement improves
- Weeks 1–2: mild tenderness or pulling may remain during certain activities
- Weeks 2–4: most patients are considerably more comfortable and approaching normal recovery
The exact timeline depends on how extensive the surgery was. Removal of multiple, very large or deeply located fibroids may cause more discomfort and require a longer recovery than removal of a smaller number of accessible fibroids.
Is Laparoscopic Myomectomy Less Painful Than Open Myomectomy?
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
Generally, yes. Laparoscopic myomectomy is considered minimally invasive because the surgeon operates through several small abdominal incisions rather than one larger incision. Compared with open abdominal myomectomy, the laparoscopic approach generally involves:
- Smaller abdominal incisions
- Less trauma to the abdominal wall
- Less postoperative pain
- Shorter hospital stay in many cases
- Faster overall recovery
Recovery after laparoscopic myomectomy commonly takes around two to four weeks, compared with approximately four to six weeks after open abdominal surgery. However, laparoscopic myomectomy is still a significant operation on the uterus, so some postoperative pain should be expected.
What Factors Affect How Much Pain You Feel?
Pain after laparoscopic myomectomy varies considerably between individuals. Factors that may influence discomfort include:
- The number of fibroids removed
- The size of the fibroids
- How deeply the fibroids were located in the uterine muscle
- The number and location of abdominal incisions
- The length and complexity of surgery
- Individual sensitivity to pain
- Whether postoperative bloating or constipation develops
This means two patients who both undergo laparoscopic myomectomy may have noticeably different experiences during recovery.
How Is Pain Managed After Laparoscopic Myomectomy?
Pain management usually begins immediately after surgery. Depending on the individual patient and the extent of surgery, treatment may include:
- Paracetamol or acetaminophen
- Anti-inflammatory pain medicines when medically appropriate
- Stronger prescription pain medicine for a short period if required
- Gentle movement and walking
- Rest and appropriate positioning
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
When Is Pain After Laparoscopic Myomectomy Not Normal?
Pain should gradually improve after surgery. Contact your healthcare provider if you develop:
- Severe pain that is getting worse rather than better
- Pain that is not controlled by the recommended medication
- Increasing abdominal swelling with severe pain
- Fever or chills
- Increasing redness, warmth or discharge from an incision
- Heavy vaginal bleeding
- Persistent vomiting
- Difficulty passing urine
Can Pain Continue for Several Weeks?
Mild abdominal or pelvic tenderness can occasionally continue for several weeks, particularly after extensive removal of multiple or deep fibroids. The important distinction is whether the discomfort is gradually improving.
Pain that remains severe, starts getting worse again after improving or continues well beyond the expected recovery period should be assessed. Persistent pelvic pain is not something that should automatically be accepted as normal simply because surgery was performed recently.
The Bottom Line
Laparoscopic myomectomy is not pain-free, but patients do not feel the procedure itself because it is performed under general anaesthesia. After surgery, abdominal soreness, uterine cramping, incision tenderness and temporary gas-related shoulder pain are common. The first few days are usually the most uncomfortable.
Pain normally becomes progressively milder during the first week, with overall recovery taking approximately two to four weeks for many patients. Because laparoscopic surgery uses smaller incisions and causes less trauma to the abdominal wall, postoperative pain is generally less than after open abdominal myomectomy.
The key sign of normal recovery is improvement. Pain that becomes increasingly severe, cannot be controlled with medication or occurs with fever, heavy bleeding, wound changes or significant abdominal swelling should be medically assessed.
