Fibroids: myomectomy or hysterectomy?

If you have uterine fibroids, one of the first questions is whether to remove only the fibroids and keep the uterus (myomectomy) or remove the uterus (hysterectomy). Here is how the decision is made.

By Dr. César Cantú · Minimally Invasive Gynecologic Surgeon · Member of the AAGL · Hospital Ángeles Valle Oriente, Monterrey, Mexico · Updated July 2026 · Leer en español

There is no single answer: it depends on your case and on what you want. My role is to explain the options clearly so we decide together at your evaluation.

The two options, in short

Myomectomy — the uterus is preserved. The fibroids are removed and the uterus is reconstructed. It is the option when you want to keep the possibility of pregnancy or simply keep your uterus. In some people fibroids can return over time.

Hysterectomy — the uterus is removed. It eliminates fibroids definitively, because the organ where they grow is removed. It is considered when you no longer wish to become pregnant, when symptoms are significant, or when the size and number of fibroids make reconstruction impractical.

When the case allows, I perform both through minimally invasive surgery (laparoscopy): no open abdominal incision, small incisions, less pain, and a usually faster recovery than open surgery.

What is taken into account?

  • Your desire for pregnancy (now or in the future) — tends to favor myomectomy.
  • The number, size and location of the fibroids.
  • Your symptoms (heavy bleeding, pain, pressure, anemia).
  • Your age and personal priorities.
  • Imaging studies (ultrasound and, when needed, MRI to map the fibroids).

The decision is yours, informed: I explain the options and recommend the one that best protects your health for your case.

Frequently asked questions

Can I get pregnant after a myomectomy?

In many cases myomectomy is chosen precisely to preserve that possibility. Timing and care are defined for your case.

Do fibroids come back after a myomectomy?

They may return in some people over time, since the uterus is preserved; it is part of what we discuss when choosing.

Does a hysterectomy cause menopause?

Removing the uterus ends menstruation and the possibility of pregnancy, but if the ovaries are preserved it does not bring on hormonal menopause. We clarify this for your case.

How long is recovery?

With minimally invasive surgery it is usually shorter than with open surgery; it varies by procedure and person.

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Educational content; it does not replace an individual medical evaluation.