Myomectomy, sometimes also called fibroidectomy, refers to the surgical removal of uterine leiomyomas, also known as fibroids.

Removal is necessary when the fibroid causes pain or pressure, abnormal bleeding, or interferes with reproduction.

[3] A fibroid that is located in a submucous position (that is, protruding into the endometrial cavity) may be accessible to hysteroscopic removal.

This may apply primarily to smaller lesions as pointed out by a large study that collected results from 235 patients with submucous myomas who were treated with hysteroscopic myomectomies; in none of these cases was the fibroid greater than 5 cm.

To reduce bleeding during myomectomy, the use of misoprostol in the vagina and the injection of vasopressin into the uterine muscle are both effective.

[9] There is less evidence supporting the usefulness chemical dissection (such as with mesna), vaginal insertion of dinoprostone, a gelatin–thrombin matrix, tranexamic acid, infusion of vitamin C, infiltration of a mixture of bupivacaine and epinephrine into the uterine muscles, or the use of a fibrin sealant patch.

However, in selected cases myomectomy may become necessary during pregnancy, or also at the time of a caesarean section to gain access to the baby.