Recovery after a myomectomy depends heavily on the type of procedure you had. A hysteroscopic myomectomy (performed through the vagina with no incisions) can have you back to normal in just a few days, while an open abdominal myomectomy typically requires four to six weeks of recovery. Laparoscopic and robotic-assisted procedures fall in between, with most people recovering in two to four weeks. Here’s what to expect during each phase of healing.
Recovery Timeline by Procedure Type
If you had a hysteroscopic myomectomy, you likely went home the same day and can expect to feel fully recovered within about 48 hours. This procedure doesn’t involve any external incisions, so pain and downtime are minimal.
Laparoscopic or robotic-assisted myomectomy is also typically an outpatient procedure. You’ll go home the same day in most cases, with full recovery taking two to four weeks. The small incisions heal faster than a large abdominal cut, but you’ll still feel sore and fatigued for the first week or so.
An open (abdominal) myomectomy involves a larger incision and a hospital stay of one to two days. Full recovery takes four to six weeks, and the first two weeks are usually the hardest. You’ll notice gradual improvement each week, but expect to feel significantly more tired than usual for at least a month.
Pain in the First Week
Pain after a myomectomy is most intense in the first few days and steadily improves. For open surgery, your doctor will prescribe a narcotic pain medication for the initial days, but these should only be used for severe pain because they commonly cause nausea and constipation. Most people transition to over-the-counter pain relievers within the first week.
For laparoscopic procedures, you may also experience shoulder pain from the gas used to inflate the abdomen during surgery. This is temporary and usually resolves within a day or two. Walking, even short distances around your home, helps with pain, circulation, and overall recovery from the very first day.
Bowel and Bladder Changes
Constipation is one of the most common complaints after myomectomy, and it can last four to five days. It’s caused by a combination of anesthesia, reduced activity, and narcotic pain medications. A fiber supplement taken daily can help, and your surgeon may prescribe a stool softener to take twice daily for the first several days after surgery. If you haven’t had a bowel movement after a couple of days, a mild over-the-counter laxative is generally safe, but check with your doctor first. Straining is something you want to avoid because it puts pressure on your healing incision or surgical site.
Bladder issues are less common but possible. A small number of people have difficulty urinating after the procedure. Most patients have their surgical catheter removed before going home with no problems. If you find you can’t urinate once you’re home, this requires a trip to the emergency room so a catheter can be placed temporarily to let your bladder rest.
Vaginal Bleeding and Discharge
Some vaginal bleeding or spotting is normal after all types of myomectomy and can last for several weeks. This is not the same as a menstrual period. The bleeding is typically lighter than a normal period and gradually tapers off. You may also notice a watery or slightly discolored discharge. Use pads rather than tampons during this time to reduce the risk of infection.
Your first few menstrual cycles after surgery may be irregular, heavier, or more painful than what you’ll eventually settle into. It can take two to three cycles for your body to establish a new pattern. Most people notice a significant improvement in heavy bleeding and pelvic pressure symptoms within a few months of surgery.
Lifting and Physical Activity
The general rule after any surgery involving incisions is to avoid lifting anything heavier than 10 pounds. That’s roughly the weight of a gallon of milk. This restriction helps prevent your incision from reopening and reduces the risk of bleeding. If you’re not sure whether something is too heavy, don’t pick it up.
Light walking is encouraged from day one and is one of the best things you can do for your recovery. It improves blood flow, helps prevent blood clots and pneumonia, and eases constipation. But anything more vigorous, including running, cycling, or core exercises, needs to wait. The exact timeline depends on your procedure type and how you’re healing, so your surgeon will give you personalized clearance. For open surgery, most people are told to avoid strenuous exercise for the full four to six weeks. For laparoscopic procedures, the restriction is shorter but still typically at least two to three weeks.
Driving is off-limits while you’re taking narcotic pain medication, and you should also be able to turn comfortably and brake quickly before getting behind the wheel. For many people after open surgery, that means about two weeks. After laparoscopic surgery, some people feel ready to drive within a week.
Sexual Activity and Pelvic Rest
You should avoid sex for at least two weeks after myomectomy. Some people need to wait longer depending on the type of surgery they had, particularly after open abdominal or hysteroscopic procedures where the uterine cavity was entered. Your surgeon will tell you when it’s safe. Pelvic rest during this period means nothing should be inserted into the vagina, including tampons and douches. This allows the internal surgical sites to heal and reduces infection risk.
Planning for Pregnancy After Surgery
If you had a myomectomy to improve your chances of conceiving, the most common advice is to wait before trying to get pregnant, but the ideal waiting period isn’t clearly defined. A systematic review of over 1,000 women found that roughly a third were advised to wait three to six months, and another third were told six to twelve months. The variation reflects the fact that there isn’t strong evidence pointing to one specific timeline as safer than another.
The main concern is uterine rupture during a future pregnancy if the surgical site hasn’t fully healed. The deeper the incision into the uterine wall, the longer most surgeons want you to wait. If your myomectomy involved a deep cut into the muscular wall of the uterus, your doctor may also recommend a planned cesarean delivery rather than vaginal labor, because the contractions of labor could stress the scar. This is a conversation to have with your surgeon before you start trying to conceive.
Incision Care at Home
For laparoscopic or open procedures, keeping your incision clean and dry is the priority. You can typically shower 24 to 48 hours after surgery, letting soapy water run over the incision without scrubbing it. Pat it dry gently afterward. Avoid soaking in a bathtub, pool, or hot tub until your surgeon gives the all-clear, which is usually at least two to four weeks after surgery.
Watch your incision daily for signs of infection: increasing redness, swelling, warmth, or drainage that looks cloudy or smells unusual. A small amount of clear or slightly pink drainage in the first few days is normal. Surgical glue or adhesive strips will fall off on their own over one to two weeks. Don’t pull them off early.
What the First Month Looks Like
The first week is the hardest for everyone regardless of procedure type. You’ll be managing pain, dealing with fatigue, and adjusting to limited mobility. Most people feel noticeably better by the end of week two, with energy gradually returning. By week three or four after laparoscopic surgery, many people feel close to normal. After open surgery, weeks three and four are when the corner turns, but full energy levels may not return until week five or six.
Emotionally, recovery can be more draining than people expect. Hormonal fluctuations, disrupted sleep, limited independence, and the physical discomfort all take a toll. It helps to have meals prepped or delivered, to set up a comfortable resting spot with everything you need within reach, and to accept help from others during the first two weeks especially. Recovery is not linear. You may feel great one day and exhausted the next, and that’s a normal part of the process.