Uterine Fibroids

Surgery

To treat uterine fibroids, surgery can be used to remove fibroids only (myomectomy) or to remove the entire uterus (hysterectomy).

Surgery is a reasonable treatment option when:¹⁴

• Heavy uterine bleeding and/or anemia has continued after several months of therapy with birth control hormones and a non-steroidal anti-inflammatory drug (NSAID).
• Fibroids grow after menopause.
• The uterus is misshapen by fibroids and you have had repeat miscarriages or trouble getting pregnant.
• Fibroid pain or pressure affects your quality of life.
• You have urinary or bowel problems (from a fibroid pressing on your bladder, ureter, or bowel).
• There is a possibility that cancer is present.
• Fibroids are a possible cause of your trouble getting pregnant.

Surgery Choices

Surgical treatment options include:

• Myomectomy, or fibroid removal. This is the only fibroid treatment that may improve your chances of having a baby.⁵ It is known to help with a certain kind of fibroid called a submucosal fibroid. But it does not help with any other kind of fibroid.¹
• Hysterectomy, or uterus removal. This is only recommended for women who have no future pregnancy plans. Hysterectomy is the only fibroid treatment that prevents regrowth of fibroids. It improves quality of life for many women, but it can also have negative long-term effects, such as pelvic organ prolapse. For more information, see the topic Hysterectomy.

Myomectomy or hysterectomy can be done through one or more small incisions using laparoscopy, through the vagina, or through a larger abdominal cut (incision). The method depends on your condition, including where, how big, and what type of fibroid is growing in the uterus and whether you hope to become pregnant.

Should I have surgery to treat uterine fibroids?

Uterine fibroid embolization (UFE) (also called uterine artery embolization) is a non-surgical option that shrinks or destroys a fibroid by cutting off its blood supply. For more information, see the Other Treatment section of this topic.

What To Think About

If you are hoping for a future pregnancy, myomectomy is your one surgical option. An abdominal myomectomy may be safer than a laparoscopic one—there is limited research about pregnancy safety after laparoscopic myomectomy.⁵

Heavy, prolonged, and painful periods caused by uterine fibroids will stop naturally after you reach menopause. If you are nearing menopause and your symptoms are tolerable, consider controlling symptoms with home treatment and medicine until menopause. Uterine fibroid embolization (UFE) may also be a reasonable option for you, although it has some risks.

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Author:	Kathe Gallagher, MSW	Last Updated: October 8, 2007
Medical Review:	Kathleen Romito, MD - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology Donald Sproule, MD, CM, CCFP, FCFP - Family Medicine
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