Procedure prep
Fasting Before a Myomectomy (Fibroid Removal)
A myomectomy removes fibroids from your uterus while keeping the uterus itself. It can be done open (through an abdominal cut), with keyhole instruments (laparoscopic or robotic), or from the inside through the vagina and cervix (hysteroscopic). This page walks you through the night-before basics so you feel ready.
Fasting for this procedure
→ Get your exact fasting times with the calculator
Medicines to check
- Blood thinners (aspirin, clopidogrel, warfarin, Eliquis, Xarelto) — these matter a lot when bleeding is a risk. See medications to stop.
- Avoid NSAIDs (ibuprofen, naproxen) in the days before, as they can increase bleeding — confirm with your team. Acetaminophen/paracetamol is usually fine.
- Estrogen, HRT, or the contraceptive pill — these can raise clot risk, so ask whether to pause them.
- Diabetes medicines & insulin — they need a plan. See diabetes tablets.
- Blood pressure medicines — confirm which to take with a sip of water on the morning of surgery.
- Iron tablets or other anemia treatment — keep taking as advised, as they help your blood count before surgery.
When this surgery may be delayed
- A positive or unknown pregnancy test — a routine test is usually done first
- A low blood count (anemia) that needs treating before surgery
- Fever, a new cough or cold, or a chest infection
- Vomiting or diarrhea in the day or two before
- Still taking a blood thinner that should have been stopped
Reports & documents to carry
- Photo ID and your insurance or hospital paperwork
- A list of all your medicines, doses, and any allergies
- Recent ultrasound or MRI scans showing your fibroids
- Recent blood test results, especially your blood count (Hb)
- A responsible adult to drive you home and stay with you after anesthesia
What to ask your anesthesia team
- Which route am I having — open, keyhole, or hysteroscopic — and what type of anesthesia?
- Which of my medicines should I stop, and which do I take on the morning?
- Should I have a blood test or be ready for the small chance of a transfusion?
- When can I eat and drink again, and will I go home the same day?
- If it's keyhole surgery, what should I expect for shoulder-tip pain afterward?
Your prep checklist
Tick things off as you sort them — saved on this device only, nothing is sent anywhere.
A general guide — your hospital's own instructions always come first.
Frequently asked questions
Will I need a blood transfusion?
Fibroid surgery can cause more bleeding than some operations, so your team checks your blood count (Hb) beforehand and may have blood available just in case. Most people do not need a transfusion, but it's a sensible precaution. If your count is low, they may treat it before surgery. Your surgeon can tell you your personal risk.
Why do I have shoulder pain after keyhole surgery?
If your myomectomy is laparoscopic or robotic, the surgeon fills your abdomen with carbon dioxide (CO2) gas to create space to work. A little of that gas can irritate the nerve under your diaphragm, which is felt as aching in the shoulder or shoulder tip. It's harmless and usually settles within a day or two as your body absorbs the gas. Gentle walking and the pain relief your team gives you both help.
Why do I need a pregnancy test before a myomectomy?
Because anesthesia and surgery on the uterus could affect an early pregnancy, hospitals routinely check a urine or blood pregnancy test on the day, even if you're sure you couldn't be pregnant. A positive or unclear result means the plan is paused and discussed with you. It's a standard safety step, not a judgment. Mention your last period and any contraception to your team.
Will I still be able to get pregnant after this?
A myomectomy is specifically chosen to remove fibroids while keeping your uterus, often with future pregnancy in mind. Your surgeon is the best person to discuss your individual case, including any advice about timing a pregnancy afterward or how you might deliver. This page focuses on getting you safely through surgery, so save fertility questions for your gynecologist.