Uterine Fibroids Treatments
Uterine fibroids, or leiomyomata, are benign (noncancerous) tumors that grow in or just outside the uterus. Uterine fibroids develop from the abnormal growth of uterus muscle cells.
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There are many treatment options for uterine fibroids and no single treatment is the best for everyone. If you have symptoms, let us know and we can discuss the best treatment options for you.
Women with uterine fibroids often times experience no symptoms or signs, or only mild ones that they can live with. In these cases, watchful waiting may be the best option because fibroids usually grow slowly or not at all, are not cancerous, rarely interfere with pregnancy, and have a tendency to shrink after menopause when reproductive hormones levels in the body decrease.
NON-INVASIVE PROCEDURES FOR FIBROIDS
MRI-guided focused ultrasound surgery (FUS) is:
- A noninvasive treatment option for uterine fibroids that requires no incisions and preserves your uterus.
- Performed while you’re inside an MRI scanner equipped with a high-energy ultrasound transducer for treatment. The scanner shows a precise location of the uterine fibroids, and the ultrasound transducer concentrates sound waves, or sonications, to heat and destroy fibroid tissue.
- Newer technology, that researchers are studying to determine more about its long-term safety and effectiveness. Data collected so far show that FUS for uterine fibroids is very safe and effective.
MINIMALLY INVASIVE PROCEDURES FOR FIBROIDS
Some surgical procedures can effectively destroy uterine fibroids without actually removing them.
- Uterine artery embolization. In this procedure, small particles (embolic agents) are injected into the uterine arteries, cutting blood flow to fibroids, causing them to shrink and die. Complications can occur if the blood supply to the ovaries or other organs is compromised.
- Myolysis. A laparoscopic procedure that uses an electric current or laser to destroy fibroids and shrink the blood vessels that supply them. Myolysis is not a common procedure. Cryomyolysis is a similar procedure that freezes the fibroids. Another related procedure is radiofrequency ablation, which is currently being studied.
- Laparoscopic or robotic myomectomy. In a myomectomy, fibroids are removed, preserving the uterus. If the fibroids are small and not great in number, a laparoscopic or robotic procedure may be best. In laparoscopic myomectomy, a small camera and slender instruments are inserted through small incisions in the abdomen to remove the fibroids from the uterus. In robotic myomectomy, a magnified, 3-dimensional view of the uterus is generated, allowing for greater precision, flexibility and dexterity than other techniques.
- Hysteroscopic myomectomy. If the fibroids are all contained inside the uterus (submucosal), the fibroids can be removed with minimal invasiveness by inserting the surgical instruments through the vagina and cervix.
- Endometrial ablation and resection of submucosal fibroids. Performed with a specialized instrument inserted into the uterus, this technique utilizes heat, microwave energy, hot water or electric current to destroy the uterine lining. This reduces menstrual flow or stops menstruation entirely. This technique is usually effective in stopping abnormal bleeding. For endometrial ablation, submucosal fibroids can be removed at the time of hysteroscopy, but fibroids outside the interior lining of the uterus are not affected.
TRADITIONAL SURGICAL PROCEDURES
Options for traditional surgical procedures include:
- Abdominal myomectomy. Women with multiple fibroids, very large fibroids or very deep fibroids, should consider this open abdominal surgical procedure to remove the fibroids. Many women who have been told that hysterectomy is their only option can actually have an abdominal myomectomy instead.
- Hysterectomy. The removal of the uterus remains the only proven permanent solution for uterine fibroids, but should be considered carefully as it is major surgery. Pregnancy is not possible after a hysterectomy. In addition, while most women who have a hysterectomy can keep their ovaries, women who decide to have their ovaries removed will begin menopause and must decide whether to take hormone replacement therapy.
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