Hysteroscopic Myomectomy
Educational information only, not medical advice. Talk with a qualified clinician before making decisions about your care.
Uterine fibroids (also called myomas) are benign (non-cancerous) tumors that originate in the uterus and are made primarily of muscle tissue. Fibroids are the most common pelvic tumor in women and vary widely in size, number, and location within the uterus. If fibroids are located partially or totally inside the uterine cavity (where menstrual bleeding occurs) then they are called submucous. Approximately ten percent of all fibroids are the submucous type.
Submucous fibroids can cause heavy menstrual bleeding, painful menstrual periods (dysmenorrhea or cramps), and are a common cause of infertility (inability to become pregnant). Hysteroscopic myomectomy is the technique of removing uterine fibroids from inside the uterine cavity. This is performed under direct vision with the use of a small camera called a hysteroscope. It is a safe and effective procedure with minimal or no damage to the normal tissue of the uterus.
Why is hysteroscopic myomectomy performed?
By the time a woman is 50-years-old, she will have about a 50% chance of having fibroids. This likelihood can be higher for women in families with other female relatives who also have fibroids, such as a mother or sisters.
A gynecologist with specialized training or interest performs a hysteroscopic myomectomy. Specialized instruments such as a loop with electricity or a mechanical cutting device are used with the hysteroscope to remove submucous myomas.
A woman may want to consider having a hysteroscopic myomectomy if she has the following symptoms:
- Abnormal bleeding
- Heavy menstrual bleeding
- Difficulty becoming pregnant
- Pain or cramping symptoms
What are the risks of this procedure?
Every procedure will have some risk, or possibility of having a complication or bad outcome. Hysteroscopic myomectomy takes place entirely inside the uterine cavity and therefore has less risk to the patient than other types of surgeries that also treat fibroids. Some of the risks of hysteroscopic myomectomy include the following:
- Damage or cuts to the cervix, or opening of the uterus
- Putting a hole in the uterus, which may lead to more procedures
- Inability to completely remove the fibroid with one surgery
- Fluid overload (intravasation). Hysteroscopic surgery requires distending the uterine cavity with fluid so the surgeon can see and operate. In some cases, fluid can be absorbed into the bloodstream through opened blood vessels. Excessive absorption can cause electrolyte imbalances (most commonly low sodium, called hyponatremia), fluid in the lungs (pulmonary edema), brain swelling, and, rarely, life-threatening complications. Your surgical team carefully monitors fluid input and output throughout the procedure. The AAGL has established guidelines limiting allowable fluid absorption — generally no more than 1,000 mL of low-sodium fluid or 2,500 mL of normal saline in healthy patients, with stricter limits for older patients or those with heart or kidney conditions. If fluid limits are reached, the procedure may be stopped early and completed in a second session.
- Development of adhesions (scar tissue) inside the uterine cavity weeks or months after the procedure
What should I expect after surgery?
Because the entire procedure is performed inside the uterine cavity, symptoms after surgery are minimal. Generally, these symptoms will only last for several hours to a day or two after the procedure. Common symptoms after hysteroscopic myomectomy include the following:
- Mild-to-moderate uterine cramping that is treated with over-the-counter pain medication
- Bleeding or spotting that may be heavy or last for several weeks
- Symptoms related to the use of general anesthesia, such as sleepiness and fatigue
- Eventual improvement in bleeding issues or fertility (ability to get pregnant)
When should I call my doctor?
Serious complications following hysteroscopic myomectomy are not likely to happen. However, notify your surgeon if you experience any the following symptoms:
- Difficulty breathing or shortness of breath
- A fever of 100.4°F or higher
- Severe nausea and vomiting
- Severe or heavy bleeding from the vagina
- Inability to urinate or have a bowel movement
Patient information sheet
Download the printable AAGL patient information sheet for this procedure.
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DISCLAIMER: This material is for informational purposes only. The information presented should not be relied on as a substitute for medical advice, independent judgment or proper assessment by a doctor, with consideration of the circumstances of each case and individual needs. The information presented here is not intended to diagnose health problems or to take the place of professional medical care. This document reflects information available at the time of its preparation. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only. All users agree to read and abide by the AAGL’s complete terms of use agreement found on its website. AAGL disclaims all liability to users of the information. © 2026 AAGL. All rights reserved.