Uterine Fibroid Surgery in Singapore: Myomectomy Procedures and Recovery

Being told you may need surgery for fibroids can bring up many questions, especially if you hope to have children. It is normal to feel worried or unsure where to begin.

Understanding Uterine Fibroid Surgery

Uterine fibroids are usually non-cancerous growths in the muscle of the womb. Many women live with them without problems. Others have heavy periods, pelvic pressure or trouble conceiving, and may wish to learn more about treatment options, including surgery.

The decision can involve several considerations. Patients often think about the operation, the recovery and future fertility. These are relevant concerns, and a healthcare professional can discuss them with you.

What Is a Myomectomy and How Does It Differ from Other Fibroid Surgeries?

A myomectomy is a surgical procedure that removes uterine fibroids while keeping the uterus (womb) in place. The surgeon can perform it:

• Through keyhole incisions
• Through the vagina and cervix
• Through an open abdominal cut

Women who wish to preserve their fertility options often consider it.
Other treatments take a different approach:

• Hysterectomy: Removes the whole uterus. It ends periods and the ability to carry a pregnancy.
• Uterine artery embolisation: Blocks the blood supply to the fibroids so they may shrink. The fibroids stay in the body, and it is generally not advised for women planning a pregnancy.
• Myomectomy: Removes the fibroids themselves and repairs the uterine wall.

Think of the uterus as a house and the fibroids as unwanted furniture. A myomectomy clears out the furniture and keeps the house. A hysterectomy removes the house as well.

At AOGC, treatment often follows a stepwise path. Your doctor may start with monitoring or medication where suitable. Surgery may follow when those options are not enough or when your symptoms or fertility goals call for it.

Myomectomy vs Hysterectomy vs Uterine Artery Embolisation

The right option depends on the size, number and location of your fibroids. It also depends on how severe your symptoms are and whether you plan to have children. The table below gives a general comparison.

Your doctor will tailor these general ranges to your situation.

Who Is a Candidate for Surgical Removal of Uterine Fibroids in Singapore?

Not every fibroid needs surgery. Small fibroids that cause no symptoms are often monitored. Your gynaecologist may discuss the surgical removal of uterine fibroids in Singapore when conservative management may no longer be sufficient.
Surgery may be considered if you have:

• Heavy bleeding that does not improve with medication
• Significant pelvic pain or pressure
• Fibroids that are growing quickly
• Fibroids that may affect fertility or contribute to recurrent miscarriage
• Large fibroids that may press on nearby organs

A healthcare professional can help determine which options may be suitable for you.

When Medication and Monitoring May Not Be Enough

Medication may help ease heavy bleeding or reduce fibroid size for a time. It may not suit everyone, and the effect may fade once you stop. You may wish to discuss surgery with your doctor if your symptoms keep disrupting your work, sleep or daily life.
Regular scans can help your doctor track growth. A sudden change in size or symptoms may be worth discussing with your doctor.

Fibroids and Fertility

Some fibroids may change the shape of the womb cavity. They may make it harder for an embryo to implant. Others may not be linked to fertility problems.
If you hope to conceive, a conversation with your doctor may be helpful. A healthcare professional can help determine whether the fibroids need treatment first. In some cases, fibroids that grow larger or more numerous may make surgery more complex.

Types of Myomectomy Procedures Available in Singapore

Your surgeon chooses the approach based on the size, number and location of your fibroids. Minimally invasive techniques are often considered where they are suitable.

Laparoscopic (Keyhole) Myomectomy

Laparoscopic means keyhole surgery. The surgeon makes a few small cuts in your abdomen. A thin camera and fine instruments go through them. The surgeon removes the fibroids in small pieces and repairs the uterine wall with stitches.
This approach may mean smaller scars, less pain and a shorter stay in hospital. It may suit fibroids that are modest in size and number.

Hysteroscopic Myomectomy

Hysteroscopic means using a thin, lit telescope passed through the vagina and cervix (the neck of the womb). There are no cuts on your abdomen. The surgeon removes fibroids that bulge into the womb cavity from the inside.
It may suit fibroids that sit just beneath the womb lining. Some women go home on the same day.

Open (Abdominal) Myomectomy

Open surgery uses a single cut across the lower abdomen, much like a caesarean incision. It gives the surgeon direct access to the womb. Doctors often advise it for very large or numerous fibroids, or for fibroids in difficult positions.
Recovery is longer, and this approach may be considered for complex fibroids.

What to Expect Before, During, and After Fibroid Removal

Preparing for Your Surgery

Your doctor will first review your symptoms and scan results. You may need an ultrasound or MRI to map the fibroids. Blood tests may be used to assess your haemoglobin (the oxygen-carrying part of your blood) and your general fitness for surgery.

If your blood count is low, your doctor may suggest iron supplements or other treatment first. You may be asked to fast for several hours before surgery. Your team may also advise you on which medicines to pause, as this varies by individual.

What Happens During the Procedure

You will usually receive anaesthesia, which generally means you will be asleep during the procedure. The surgery can take from under an hour to several hours. The length depends on the approach and on how many fibroids need removal.

The surgeon aims to remove the fibroids. For fibroids in the womb wall, the surgeon may then close the layers with stitches, which can support healing of the wall.

The First Few Days After Surgery

You will usually wake up in a recovery area. Some pain, bloating or light vaginal bleeding is common, though experiences vary by individual. The nurses can provide pain relief and may help you start moving gently. Walking early may help your circulation and your recovery, and a healthcare professional can advise what is suitable for you.

Before you go home, your doctor will usually explain wound care, warning signs and when to return for review.

Myomectomy Recovery Time: A Week-by-Week Guide

Myomectomy recovery time usually ranges from a few days after hysteroscopic surgery to about two to four weeks after keyhole surgery. Open surgery often takes four to six weeks. Recovery varies by individual, and your own pace may differ.

Weeks One to Two

You may notice tiredness, mild cramps and some spotting. Some keyhole patients may feel shoulder-tip discomfort from the gas used during surgery. It usually settles within a few days.

• Rest and short daily walks are commonly encouraged.
• Heavy lifting is usually avoided in early recovery.
• Wound care instructions, such as keeping wounds clean and dry, are commonly given by your doctor.
• Pain relief is usually prescribed by your doctor.

You may have a wound check about one to two weeks after surgery.

Weeks Three to Six

Your energy may return gradually. Many women who had keyhole surgery return to desk work within two to four weeks. After open surgery, recovery may take closer to four to six weeks.

Your doctor may review you around six weeks after surgery. This visit may check your healing and discuss your next steps.

Returning to Normal Activities and Exercise

Gentle walking is often encouraged early in recovery. Your doctor may advise waiting several weeks before strenuous exercise, heavy lifting or sex. Open surgery may require a longer wait. Your own comfort matters, and it may be helpful to ask your doctor before restarting any intense routine.

Recovery Milestones at a Glance

• Hysteroscopic: Often back to light activity within days; many routines within about one to two weeks.
• Laparoscopic: Light work in about two to four weeks; exercise timing is discussed with your doctor.
• Open: Light work in about four to six weeks; exercise timing is discussed with your doctor.
• Follow-up: Wound check at about one to two weeks; review at about six weeks.

Understanding Fibroid Removal Risks and How They Are Managed

Every operation carries some risk. Serious complications are generally uncommon, but they can occur.

Common Risks and Side Effects

• Bleeding: Fibroids often have a rich blood supply. Your surgeon may plan ahead, may use medication or techniques to limit blood loss, and may check your blood count beforehand. Rarely, a blood transfusion may be needed.
• Infection: This can affect wounds, the womb or the urinary tract. Sterile technique is generally used in hospitals, and your doctor may give antibiotics. Wound care at home may also help.
• Adhesions (scar tissue): Internal scar tissue can form as you heal, a bit like sticky bands between organs. Handling tissue gently and using repair techniques may help reduce this.
• Injury to nearby organs: The bladder or bowel can rarely be affected. Imaging and surgical technique may help lower this risk.
• Womb wall weakness: The scar in the womb wall may need time to heal. For this reason, the timing of any future pregnancy is worth discussing with your doctor.

A healthcare professional can help explain which risks may apply to your fibroids and your chosen approach.

Fibroid Recurrence

Fibroids can grow back after a myomectomy. The operation removes the fibroids that are present, but it may not change the tendency to form new ones. Research suggests that recurrence varies from person to person. It may be influenced by age, the number of fibroids present and whether small fibroids were not detected on scans.

If new fibroids appear, they may stay small and cause no symptoms. Regular follow-up may help your doctor identify changes and discuss options.

Fertility After Myomectomy

For many women, preserving fertility is a common reason to consider a myomectomy. When fibroids are contributing to difficulty conceiving or to miscarriage, removing them may help in some cases. A doctor can help determine whether your fibroids are likely to be a factor.

• Timing of pregnancy: The womb needs time to heal, and the length of time varies by individual. Doctors often suggest waiting about three to six months after keyhole or hysteroscopic surgery. After open surgery, or if the fibroids were deep in the womb wall, the wait may be longer. Your surgeon can discuss an individual timeline with you.
• Delivery planning: If the surgeon cut deeply into the womb wall, a caesarean delivery may be recommended. This may help reduce strain on the scar during labour. After a hysteroscopic myomectomy, vaginal birth may still be possible, depending on several factors. Your obstetrician can discuss this with you as your pregnancy progresses.

Some women go on to have pregnancies after a myomectomy, though outcomes vary from person to person.

Taking an Informed Approach to Your Fibroid Treatment

When your symptoms or fertility goals call for it, a myomectomy is an established option. It may ease heavy bleeding and pressure and help preserve your ability to have children.

A personalised assessment is important. Your specialist can explain your scans, outline each choice and answer your questions. You can take time to decide, and you can ask for clarification as often as you need.

When to Seek Professional Help

You may wish to see a specialist if you notice any of the following:

• Periods lasting longer than seven days
• Bleeding through one or more pads or tampons every hour for two or more consecutive hours
• Pelvic pain that disrupts your daily life
• Difficulty conceiving
• Frequent urination or a sense of pressure on your bladder
• Rapidly growing swelling in your abdomen

Commonly Asked Questions

How long does it take to recover from a myomectomy in Singapore?

Recovery depends on the approach. Hysteroscopic surgery often needs only a few days. Keyhole surgery usually takes about two to four weeks, and open surgery about four to six weeks. Your doctor can discuss a personalised timeline with you.

Can fibroids grow back after surgical removal?

Yes, they can. A myomectomy removes the existing fibroids but does not remove the tendency to form new ones. Regular follow-up helps your doctor detect any new growth early and discuss options.

Will I need a caesarean section if I become pregnant after a myomectomy?

Not always. If the surgeon cut deeply into the womb wall or entered the uterine cavity, your obstetrician may recommend a caesarean to protect the scar. After a hysteroscopic myomectomy, vaginal birth may be possible. Your doctor will discuss this with you during pregnancy. Vaginal birth after myomectomy is considered feasible and relatively safe in many cases, with studies showing favourable outcomes for vaginal delivery without uterine rupture.

How do I know if I need surgery or if medication is enough?

Your symptoms, scan findings and fertility plans guide this choice. Medication or monitoring often suits mild symptoms. Surgery may be considered when symptoms persist, fibroids grow or fertility is affected. A specialist assessment can help clarify which option may be suitable for you.

Next Steps

Before your consultation, you may wish to:

• Write down your questions about fibroid size, location and treatment preferences.
• Bring any previous scan reports or request copies of your imaging.
• Note your symptoms, including how long your periods last and how heavy they are.
• Think about your fertility goals and share them openly.

You can read more on the uterine fibroids page to see how monitoring, medication and the surgical removal of uterine fibroids fit together.