Myomectomy side effects are usually temporary and improve as the body heals. Pain, tiredness, abdominal swelling and light vaginal bleeding are common during early recovery. More significant complications, such as infection, heavy bleeding, blood clots or injury to nearby organs, are much less common.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
Possible effects after myomectomy include:
- Pain and abdominal tenderness
- Temporary bloating or swelling
- Vaginal bleeding or discharge
- Fatigue
- Constipation
- Surgical scar formation
Less common complications include excessive blood loss, wound or pelvic infection, scar tissue inside the abdomen, blood clots and problems involving nearby organs. The individual risk depends partly on the size and number of fibroids and whether the procedure is performed through open abdominal, laparoscopic, robotic or hysteroscopic surgery.
For a broader explanation of the procedure and the different approaches used to remove fibroids, see our main guide to myomectomy surgery.
Myomectomy Side Effects at a Glance
| Side Effect or Complication | What You May Notice |
|---|---|
| Pain and tenderness | Abdominal or pelvic soreness during early healing |
| Swelling and bloating | Temporary abdominal fullness or tightness |
| Vaginal bleeding | Light bleeding, spotting or discharge after surgery |
| Fatigue | Low energy while recovering from surgery and anaesthesia |
| Infection | Fever, worsening pain, redness or unusual discharge |
| Heavy bleeding | Significant blood loss that may rarely require transfusion |
| Adhesions | Internal scar tissue that can occasionally cause future problems |
| Blood clots | Leg pain or swelling; chest symptoms require urgent assessment |
| Nearby organ injury | Rare injury involving structures such as the bladder, bowel or ureters |
Which Side Effects Are Normal After Myomectomy?
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
Some symptoms are expected because the uterus and surrounding tissues need time to heal. The exact experience differs according to the type of myomectomy, but common short-term effects include pain, tiredness, bloating and mild vaginal bleeding. These symptoms should generally become less noticeable rather than progressively worse.
1. Pain and Abdominal Tenderness
Pain or soreness is expected after myomectomy, particularly after abdominal surgery. You may experience:
- Lower abdominal aching
- Pelvic tenderness
- Pulling or tightness around the incision
- Discomfort when standing, walking or changing position
Pain is usually strongest during the first few days and gradually improves.
2. Abdominal Swelling and Bloating
Temporary abdominal swelling is common after myomectomy. This can result from:
- Inflammation caused by surgery
- Temporary slowing of bowel activity
- Fluid changes
- Gas used during laparoscopic or robotic surgery
After minimally invasive surgery, gas can sometimes cause temporary discomfort in the abdomen or shoulder. Bloating should gradually settle as mobility, digestion and surgical healing improve.
3. Vaginal Bleeding or Discharge
Light vaginal bleeding or discharge may occur after myomectomy. Vaginal bleeding and discharge can continue for several weeks during recovery in some patients. The amount and duration depend partly on the type of procedure performed.
Light spotting is generally less concerning than bleeding that becomes heavier over time. Contact your surgical team if you experience:
- Heavy vaginal bleeding
- Large blood clots
- Dizziness or faintness
- Bleeding that is rapidly increasing
4. Fatigue
Feeling unusually tired after surgery is common. Fatigue may be related to:
- Anaesthesia
- Surgical stress
- Blood loss
- Interrupted sleep
- Pain medication
- Reduced activity
Women who already had anaemia from heavy fibroid-related bleeding may take longer to regain their usual energy levels. Recovery should be gradual, with activity increased according to the surgeon's instructions.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
5. Constipation and Digestive Changes
Constipation can occur after surgery because of anaesthesia, pain medicines, reduced movement and changes in eating patterns. Some patients may also experience:
- Gas
- Abdominal fullness
- Reduced appetite
- Slower bowel movements
Walking gently, drinking adequate fluids and following postoperative dietary advice may help. Persistent vomiting, severe abdominal swelling or inability to pass stool or gas should be reported because these symptoms require medical assessment.
6. Scarring
External scarring depends on the surgical approach.
Abdominal Myomectomy
Open abdominal surgery leaves a larger incision, usually across the lower abdomen.
Laparoscopic or Robotic Myomectomy
Several smaller abdominal scars are usually left where surgical instruments were inserted.
Hysteroscopic Myomectomy
Because instruments are passed through the vagina and cervix, hysteroscopic myomectomy does not create an external abdominal scar. Most external scars become less noticeable over time, although scar appearance varies from person to person.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
What Are the Possible Complications of Myomectomy?
Myomectomy generally has a low rate of major complications, but all surgery carries some risk. The likelihood depends on factors such as the size, number and position of the fibroids, the complexity of surgery and the patient's overall health.
7. Excessive Bleeding
Bleeding is one of the more important risks during myomectomy because fibroids and the uterus can have a rich blood supply. Some women already have anaemia before surgery because of heavy menstrual bleeding. Surgeons use several techniques to reduce blood loss during the operation, but significant bleeding can occasionally occur. In some cases, a blood transfusion may be required. Doctors may check and treat anaemia before surgery to reduce the risk of complications related to blood loss.
8. Infection
Infection can occur at the incision, within the pelvis or elsewhere after surgery. Possible warning signs include:
- Fever or chills
- Increasing abdominal or pelvic pain
- Increasing redness around an incision
- Warmth or swelling around the wound
- Pus or unusual wound discharge
- Foul-smelling vaginal discharge
Suspected infection should be assessed promptly because antibiotics or additional treatment may be necessary.
9. Adhesions or Internal Scar Tissue
Surgery involving the uterus can lead to the formation of adhesions, which are bands of internal scar tissue. Adhesions can develop between pelvic organs or around the surgical area. Many adhesions cause no symptoms. However, depending on their location, they can occasionally contribute to:
- Pelvic discomfort
- Difficulty during future surgery
- Fertility problems
10. Blood Clots
Blood clots are an uncommon but potentially serious complication after surgery. The risk is partly related to reduced mobility during recovery. Possible symptoms of a clot in the leg include:
- Swelling in one leg
- Calf pain or tenderness
- Warmth or redness
Chest pain, sudden shortness of breath or difficulty breathing requires urgent medical attention because a blood clot can occasionally travel to the lungs.
11. Injury to Nearby Organs
The uterus lies close to structures including the bladder, bowel, ureters and blood vessels. Rarely, one of these structures may be injured during surgery, particularly when fibroids are large, numerous or located in difficult areas. Additional surgical treatment may be required if significant injury occurs.
Can Myomectomy Affect Future Pregnancy?
Myomectomy preserves the uterus and is often chosen when future pregnancy is desired. However, removing fibroids from the uterine muscle creates areas that need to heal.
Depending on how deeply the uterus was cut and repaired, a future pregnancy may require additional monitoring. For this reason, some patients may be advised to deliver by caesarean section. The recommendation depends on the location and depth of the previous uterine incisions rather than simply the fact that a myomectomy was performed.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
Is Hysterectomy Ever Needed During Myomectomy?
Myomectomy is intended to preserve the uterus. This is most likely in unusual circumstances such as uncontrollable bleeding or when the surgeon discovers an unexpected condition that makes preservation of the uterus unsafe. This possibility should be discussed before surgery, especially in complex cases.
Is There a Risk With Morcellation?
During some minimally invasive myomectomies, large fibroids may need to be divided into smaller pieces so they can be removed through small incisions. This process is called morcellation. Very rarely, a growth believed to be a benign fibroid may actually be an undiagnosed cancer.
If such tissue is broken into pieces inside the abdomen, cancer cells could potentially spread. The risk is low but becomes more important with increasing age and after menopause. When morcellation is being considered, the surgeon should discuss the individual's risk and the method planned for removing the fibroid tissue.
Do Fibroids Come Back After Myomectomy?
Fibroid recurrence is not an immediate surgical side effect, but it is an important long-term consideration. Myomectomy removes the fibroids that are present at the time of surgery but does not prevent completely new fibroids from developing later.
Very small fibroids that were not removed may also increase in size over time. Recurrence does not automatically mean another operation will be required. Further treatment depends on whether the fibroids cause significant symptoms.
Do Side Effects Differ by Type of Myomectomy?
| Type of Myomectomy | Typical Recovery Considerations |
|---|---|
| Open abdominal | More postoperative pain, larger scar and longer recovery are generally expected |
| Laparoscopic | Smaller incisions and usually faster recovery than open surgery |
| Robotic | Similar minimally invasive recovery considerations to laparoscopy |
| Hysteroscopic | No abdominal incision and usually the shortest recovery period |
So, the full recovery may take up to approximately six weeks after open abdominal myomectomy, around two to four weeks after laparoscopic surgery and only several days after some hysteroscopic procedures. Individual recovery may be shorter or longer depending on the complexity of the surgery and whether complications occur.
When Should You Contact Your Doctor?
Contact your healthcare provider if you experience:
- Heavy or increasing vaginal bleeding
- Fever or chills
- Severe or worsening abdominal pain
- Pain that cannot be controlled with prescribed medication
- Increasing redness, swelling or discharge from the incision
- Persistent vomiting
- One-sided leg pain or swelling
- Difficulty passing urine
- Symptoms that suddenly become worse after initially improving
Seek urgent medical attention for chest pain, sudden shortness of breath, difficulty breathing, fainting or other severe symptoms.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
The Bottom Line
Most myomectomy side effects are temporary and improve as surgical healing progresses. Pain, abdominal swelling, fatigue, constipation and light vaginal bleeding are among the more common effects during early recovery.
More significant complications such as heavy bleeding, infection, blood clots, internal scar tissue or injury to nearby organs are less common. Myomectomy can also leave a scar in the uterine muscle, which may affect how a future pregnancy or delivery is managed. In rare circumstances, severe bleeding during surgery may make hysterectomy necessary.
The key distinction is whether symptoms are gradually improving. Heavy bleeding, fever, worsening pain, wound changes, leg swelling, chest pain or difficulty breathing should not be considered normal recovery symptoms and require medical assessment.
