Information about uterine fibroids
Minimally Invasive Therapy Unit & Endoscopy Training Centre
University Department of Obstetrics and Gynaecology
Royal Free Hospital
Pond Street
Hampstead
London NW3 2QG, UK

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A new website for gynaecologists interested in the surgical management of fibroids is now on line. www.fibroidsurgery.org

Common treatment options for uterine fibroids

The table below is based on a recent review article on the modern management of uterine fibroids which provides a useful comparison of the indications and relative merits of the various common treatments which are currently available:

Hysterectomy†
Myomectomy‡
Uterine artery embolisation (UAE)
MRI guided focused ultrasound myolysis
What is it?
Fibroids removed together with the uterus (womb) *
Fibroids are removed but not the uterus
Blood supply to uterus blocked resulting in fibroid shrinkage
Fibroids are heated up leading to shrinkage
Which fibroids are not suitable?
(All fibroids suitable)
(All fibroids suitable)
Fibroids on stalks
Submucous fibroids
Very large fibroids
Fibroids on stalks
Fibroids near vital structures (e.g. bowel, bladder) or nerves
Very large fibroids
What are the major advantages?
Only treatment which is guarantees a cure
No more periods/period pain
No chance of recurrence
Fibroids are removed
Best option if you wish to conceive
Non-surgical treatment
No need for general anaesthesia
Non-surgical treatment
No need for general anaesthesia
What are the major disadvantages?
Involves major surgery
Requires general anaesthesia
Cannot get pregnant
Involves major surgery
Usually requires general anaesthesia
Pelvic adhesions likely after abdominal or laparoscopic surgery
New fibroids can develop
Post-procedure pain
Infection
Premature menopause
1:4 women undergo hysterectomy within 2 years
Relatively long procedure time
Modest reduction in fibroid size
Skin burns
Injury to adjacent structures
High chance of treatment failure (up to 28%)
How long does it take?
1-2 hours
1-3 hours
1 hour
2-4 hours
How long will I be in hospital?
4-6 days (abdominal) to 2-3 days (vaginal or laparoscopic)
4-6 days (abdominal) to day case (hysteroscopic)
1-2 days
Outpatient
When am I likely to be able to resume normal activities?
4-6 weeks (abdominal) to 3-4 weeks (vaginal or laparoscopic)
4-6 weeks (abdominal) to few days (hysteroscopic)
Few days
Few days
What will happen to my fibroids?
Fibroids (and uterus) are removed
Fibroids are removed
Fibroids usually shrink by 50-70%
Fibroids usually shrink by 15-25%
What will happen to my periods?
Periods will stop
Periods usually become lighter and less painful
Periods usually become lighter and less painful
Periods usually become lighter and less painful
Can I become pregnant afterwards?
No
Yes
Pregnancy is not recommended at present
Pregnancy is not recommended at present

† Includes abdominal hysterectomy, vaginal hysterectomy and laparoscopic hysterectomy
‡ Includes open (abdominal) myomectomy, laparoscopic myomectomy, hysteroscopic myomectomy and vaginal myomectomy
* Hysterectomy means removal of the uterus but not ovaries and therefore does not result in the menopause

Based on: Levy BS. Modern management of uterine fibroids. Acta Obstet Gynecol Scand 2008;87(8):812-23.

Click here to download a copy of this table (as a pdf file).

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On the subject of surgeons:

Surgeons must be very careful when they take the knife! Underneath their fine incisions, stirs the Culprit -- Life!

Emily Dickinson, American poet (1830-1886)