Hysteroscopic Myomectomy

What Is a Hysteroscopic Myomectomy?

Hysteroscopic myomectomy is the gold-standard surgical treatment for submucosal fibroids. A small camera passes through your cervix to find fibroids so your doctor can remove them without cuts or stitches. Submucosal fibroids grow inside your uterine cavity and push against the lining. Your bleeding gets heavier, the pain builds and getting pregnant becomes harder the longer the fibroids remain rooted inside your uterus.

Felix Cohen, MD, FACOG performs this procedure at Hysteroscopy Center of New York. You can find his offices in Midtown Manhattan, Columbus Circle and Queens. During a hysteroscopic myomectomy, Dr. Cohen removes only the fibroids causing your problems. Your uterus stays untouched.

What Symptoms Tell Me I Need a Submucosal Fibroid Removal?

Symptoms of fibroids vary from one woman to the next, but your symptoms alone don’t confirm a fibroid. Dr. Cohen and his team excel in firm diagnoses, and he treats the issue during the same visit. This is especially helpful for Canadian and other out-of-town patients who don’t want to deal with multiple visits to treat symptoms, such as:

• Your periods are out of control
• Your pelvis doesn’t feel right
• You bleed when you shouldn’t
• You keep losing pregnancies
• Your IVF keeps failing

Dr. Cohen also checks for endometrial polyps, abnormal uterine bleeding and intrauterine adhesions in the same visit before recommending any treatment.

Are There Different Types of Fibroids?

Every submucosal fibroid sits at a different depth inside your uterine wall. The International Federation of Gynecology and Obstetrics classifies them into three types, based on their characteristics. The type of your fibroids informs Dr. Cohen about the approach to use and whether one session is enough to clear it. Types of fibroids treatable through hysteroscopic myomectomy include:

• Type 0 sits fully inside your uterine cavity with no part touching the wall. It’s the easiest to clear and you leave the same day with it completely gone.
• Type 1 has less than half its mass inside the wall. If you have a Type 1 fibroid, you get everything cleared in one procedure.
• Type 2 is more than halfway embedded in your uterine wall. Dr. Cohen examines each one and talks you through whether one session works or a staged approach makes more sense.

Knowing your fibroid type removes guesswork from your recovery. To fully understand how a diagnostic office hysteroscopy helps your NYC specialist determine the kind of procedure you need, Dr. Cohen walks you through the process at your consultation.

How Does Dr. Cohen Perform a Submucosal Fibroid Removal in Midtown Manhattan?

Dr. Cohen passes a tiny camera through your cervix, so he doesn’t need to make an incision. Saline flows in to open up your uterine cavity so he can see every surface clearly. When he finds a fibroid, he usually takes it out on the spot.

The procedure runs between 20 and 60 minutes at his Midtown Manhattan, Columbus Circle or Queens office. He’s affiliated with Mount Sinai, NYU Langone and Lenox Hill Hospital, but other fibroid surgeries don’t come close to the simplicity of this procedure or your easy recovery from it.

“Anyone can take out a fibroid,” says Dr. Cohen. “The trick is leaving everything around it untouched. That’s what your body needs to heal and, if pregnancy is your goal, to get there.”

How Does a Hysteroscopic Myomectomy Compare to Other Fibroid Removal Options?

Three different surgical methods treat uterine fibroids. Hysteroscopic, laparoscopic keyhole and open myomectomy. Hysteroscopic myomectomy is the only approach built for submucosal fibroids. It works entirely through your cervix with no need for an abdominal entry.

Laparoscopic myomectomy treats fibroids within the uterine wall with a two-to-four-week recovery. Open myomectomy requires a full abdominal incision and a six-week recovery. Compared to open surgery, hysteroscopic myomectomy costs up to 40 percent less and gets you home the same day.

“If the fibroid is inside the cavity, going through your abdomen makes no sense,” says Dr. Cohen. “Hysteroscopic removal is faster, safer for your uterus and gets you back to your daily routines in two days.”

Does a Myomectomy Improve My Chances of Getting Pregnant?

Taking out a submucosal fibroid gives your body a better shot at pregnancy. A fibroid inside your uterine cavity gets in the way of implantation. Your lining can’t do its job properly with a fibroid pressing against it. Peer-reviewed gynecology research shows pregnancy rates rise to as high as 80 percent after a hysteroscopic fibroid removal.

If you’re preparing for hysteroscopy for IVF and fertility, Dr. Cohen coordinates with your fertility team to get your cavity cleared before transfer day. The experts at Hysteroscopy Center of New York are all about fertility preservation, if that’s your concern.

What Can I Expect During Recovery After a Submucosal Fibroid Removal?

Your hysteroscopy insurance and financing questions get clear answers before you schedule. The office sends your pre- and post-procedure instructions ahead of your appointment. The first week after your submucosal fibroid removal in NYC typically includes:

• Same-day discharge from the office
• Feeling well enough to return to your desk the morning after
• Mild cramping and light spotting for the first 24-to-48 hours, manageable with over-the-counter pain relievers
• Pelvic rest for two weeks, meaning no intercourse and no tampon use while your uterine lining heals fully
• Your first period arriving on schedule or slightly later, although many women notice a lighter flow right away

“Most of my patients are genuinely surprised at how fast their recovery is,” says Dr. Cohen. “They expect something difficult, but they find themselves back to normal within 48 hours. To confirm that your cavity is healing properly, I schedule a follow-up.”

Frequently Asked Questions (FAQs) about Hysteroscopic Myomectomy