Hysterectomy is the only permanent cure for fibroids. Hysterectomy involves the removal of the uterus, either through the vagina in a laparoscopic procedure or an open surgical procedure. It is done under general anesthesia and three to five days of hospitalization, and four to six weeks of recovery. About one-third of all hysterectomies in the U.S. are due to fibroids.
Many women and their providers wish to examine alternatives to hysterectomy:
Myomectomy is a surgical procedure that removes just the fibroids, not the entire uterus. There are several ways to do this:
Hysteroscopic Myomectomy is used only for fibroids that are just under the lining of the uterus and that protrude into the uterine cavity. There is no surgical incision. A flexible scope (hysteroscope) is inserted through the vagina and cervix and removes the fibroids using a special tool attached to the scope. This is usually an outpatient procedure.
Laparoscopic Myomectomy is used if the fibroid is on the outside of the uterus. Small incisions are made so the doctor can insert a probe with a tiny camera and another probe with surgical instruments to locate and remove the fibroid. This involves general anesthesia.
Abdominal Myomectomy involves a surgical procedure where an incision is made in the abdomen to access the uterus and another incision is made in the uterus to remove the fibroid. Once the fibroid is removed, the uterus is stitched closed. This involves general anesthesia and requires a several-day hospital stay.
Myomectomy is frequently successful in controlling symptoms, but the more fibroids there are in a uterus, the less successful the surgery.
Uterine artery (or fibroid) embolization. A radiologist makes a tiny incision in the groin and passes a small tube called a catheter through the artery. When the catheter reaches the uterine artery, tiny particles of plastic or gelatin are released to stop blood flow to the fibroid, causing it to shrink. The procedure usually requires a one night stay in the hospital, and 2-4 weeks to recover. 78 to 94 percent of women who have had the procedure report significant or total relief of pain. This treatment is not recommended to women who intend to become pregnant. Embolization to treat uterine fibroids has been done for about 10 years, but embolization in the uterus is not new, as it has been used to treat heavy bleeding after childbirth for more than 25 years.
