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Uterine Fibroids (cont.)

Surgery

Surgery options for treatment have both risks and benefits. Be sure to discuss these risks and benefits with the doctor. Some treatment options may not be right for a woman because of the characteristics of the fibroids or other health factors.

  • Myomectomy is the surgical removal of the fibroids only. This can be accomplished through hysteroscopy, laparoscopy, or, less frequently, an open procedure (an incision in the abdomen). The surgical approach depends on the size and location of the fibroid. Pretreatment with GnRH analogs has been shown to decrease blood loss and operative time in women undergoing myomectomy. Myomectomy has also been shown to have a decreased likelihood of injury to the bowel, bladder, or ureter than hysterectomy. The uterus is left intact in this type of procedure, and the patient may be able to become pregnant.
  • Hysterectomy is the surgical removal of the uterus (and fibroids). It is the most commonly performed surgical procedure in the treatment of fibroids and is considered a cure. Depending on the size of the fibroid, hysterectomy can be performed with incisions through the vagina or abdomen. In some cases the procedure may be performed using laparoscopy. Use of GnRH agonists can reduce the size of the fibroid to allow less invasive surgical techniques. In past experience, less blood loss has occurred using hysterectomy than myomectomy. Hysterectomy with removal of the Fallopian tubes and ovaries (called a salpingo-oophorectomy) may be indicated if there is suspicion of cancer or if ovarian masses are present.
  • Uterine artery embolization, or clotting of the arterial blood supply to the fibroid, is an innovative approach that has shown promising results. This procedure is done by inserting a catheter (small tube) into an artery of the leg (the femoral artery), using special X-ray video to trace the arterial blood supply to the uterus, then clotting the artery with tiny plastic or gelatin sponge particles the size of grains of sand. This material blocks blood flow to the fibroid and shrinks it. This method may prove to be a good option for women if other methods have not worked, she does not want surgery, or may not be good candidates for surgery. A specialist known as an interventional radiologist performs this procedure.
Medically Reviewed by a Doctor on 5/9/2014

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