Abdominal hysterectomy is the most commonly performed type of hysterectomy in most countries. Certainly, if the fibroids are very large or if you are thought to have a lot of adhesions in your pelvis, then abdominal hysterectomy is generally the only option. Just as with myomectomy, however, there is a good chance that surgery can be done through a "bikini" type incision even in difficult cases.