Typical Healing Period Following Uncomplicated Open Myomectomy
Following an uncomplicated open myomectomy, patients typically achieve full recovery within 4-6 weeks, with return to usual activities occurring around 28 days (4 weeks) postoperatively.
Return to Activities Timeline
The median time to return to usual activities after open (abdominal) myomectomy is 28 days (interquartile range 14-35 days) 1. This represents a longer recovery period compared to minimally invasive approaches, where laparoscopic myomectomy patients return to usual activities at a median of 21 days 1.
- Return to work occurs at approximately 42 days (6 weeks) after open myomectomy, with an interquartile range of 27-56 days 1
- This is nearly 2 weeks longer than laparoscopic myomectomy, where median return to work is 22 days 1
Structural Healing and Uterine Recovery
The uterine structure undergoes progressive healing that can be objectively measured:
- Uterine cavity length and uterine volume stabilize by 6 weeks postoperatively 2
- Complete endometrial recovery requires 12 weeks (3 months) after myomectomy 2
- At 12 weeks, approximately 14% of patients may still show unusual findings near the uterine incision on MRI, though these are typically not clinically significant if no hematoma or edema is present 2
Pain Resolution
Postoperative pain follows a predictable trajectory:
- Open myomectomy is associated with slightly more pain compared to laparoscopic approaches in the immediate postoperative period 1
- By 24 hours postoperatively, pain scores between open and laparoscopic approaches show no significant difference 3
- The overall quality of life substantially improves regardless of surgical approach, with symptom severity scores decreasing by approximately 30 points within 6-12 weeks 1
Important Clinical Considerations
Patients should wait 2-3 months before attempting pregnancy to allow adequate healing of uterine incisions 4. This recommendation is critical to minimize the risk of uterine rupture during subsequent pregnancy, though this complication remains rare 4.
Common Pitfalls to Avoid
- Do not clear patients for full activity before 4 weeks, as this is the median recovery time and many patients require longer 1
- MRI findings at 6 weeks may still show incomplete endometrial recovery, which is normal and should not be interpreted as a complication 2
- Postoperative adnexal seromas occur in approximately 22% of patients and are typically benign findings on follow-up imaging 5
Quality of Life Outcomes
Both open and laparoscopic myomectomy are associated with improved quality of life for up to 10 years 6, 4. The clinical success rates for symptom relief include:
- 73% improvement in menorrhagia 5
- 64% improvement in pain symptoms 5
- 36-64% improvement in mass-related symptoms 5
The longer initial recovery period with open myomectomy does not translate to inferior long-term outcomes, as improvement in symptom scores and quality of life becomes equivalent to other surgical approaches by 2-3 months postoperatively 6.