Treatment and Risks

The treatment for uterine fibroids depends on the size and location of the fibroids and the severity of your symptoms. If you do not have symptoms, your doctor may decide that there is no need to treat the fibroids. However, your doctor will likely recommend yearly visits to have them checked.

Fibroid Treatments

Watchful Waiting

An initial phase in diagnosis and treatment, your doctor may suggest observation and regular examinations to see if conditions improve on their own.

Medication

Medical therapy for uterine fibroids may include the use of drugs to provide control of symptoms. These drugs include non-steroidal anti-inflammatory drugs (NSAIDs), birth control pills and hormone therapy.

Uterine Fibroid Embolization (UFE)

UFE is a less invasive technique intended to block the flow of blood to uterine fibroids, depriving them of the oxygen and nutrients they require to grow. The procedure is performed under conscious sedation, typically lasting less than one hour.

Ablation

Endometrial ablation is a procedure that is intended to treat and remove the lining of the uterus. The uterine lining or endometrium is tissue that thickens and sheds in cycles causing your period. After this tissue is removed most women see a marked reduction in the heaviness of their menstrual flow and some may never experience a period again.

Myomectomy

Myomectomy is the removal of fibroids. This surgical procedure preserves the possibility of getting pregnant.1 It can be done in several ways and may require hospitalization:

  • Open: Open surgery requires an abdominal incision to remove large or numerous fibroids that have grown deep into or outside the uterine wall. Recovery is typically 4 to 6 weeks.
  • Laparascopic: Laparoscopic myomectomy calls for one or more small incisions near your belly button. A lighted viewing instrument is used to remove the uterus. Recovery is typically 2 to 4 weeks.
  • Hysterocopic: Hysteroscopic myomectomy involves placing a thin, lighted instrument through the vagina and cervix into the uterus to locate and remove fibroids on the inner wall of the uterine cavity. No incisions are needed and recovery is short.

Hysterectomy

Hysterectomy is the surgical removal of the uterus and a permanent solution to uterine fibroids. The ovaries may or may not be removed as well. Abdominal, laparoscopic and vaginal hysterectomies are all surgical procedures that eliminate any possibility of getting pregnant. They may require hospitalization and recovery is typically 2 to 6 weeks.

Procedural Comparison

  Medication Ablation UFE Myomectomy Hysterectomy
Removal of Uterus No No No No Yes
Recovery Time N/A Outpatient 1-2 weeks 2-4 weeks 2-6 weeks
Minimally Invasive N/A Yes Yes Yes No
Preserves Ability to Get Pregnant Yes Yes, but decreased Yes Yes Yes

Polyp Treatments

Watchful Waiting

An initial phase in diagnosis and treatment, your doctor may suggest observation and regular examinations to see if conditions improve on their own.

Hysteroscopic Tissue Removal

A basic procedure in which a doctor inserts a hysteroscope through the vagina to visualize the polyp and then uses a resection device to remove excess tissue.

Hysterectomy

Hysterectomy is the surgical removal of the uterus and a permanent solution to uterine polyps. The ovaries may or may not be removed as well. Abdominal, laparoscopic and vaginal hysterectomies are all surgical procedures that eliminate any possibility of getting pregnant. They may require hospitalization and recovery is typically 2 to 6 weeks.

Risks

There are several treatment options for uterine fibroids and polyps.  Factors, such as the size and location of the tumor, the severity of symptoms, a desire for future pregnancy, and so on will influence the type of treatment that is right for you. It is important to have a detailed discussion with your physician about your options, including benefits and potential risks. The treatment options and information described on this page are not intended to substitute for a physician’s judgement. Only you and your physician can decide the choice that is best for you.

Myomectomy

While complications of hysteroscopic myomectomy are rare, some women experience cramping, mild pain or nausea following the procedure. Other more serious risks, such as bleeding, infection and surgical complications are also possible. It’s important to discuss these issues with your doctor.

Uterine Fibroid Embolization (UFE)

Your interventional radiologist will prescribe medications to keep you comfortable while you are recovering. Like any treatment, there can be side effects or complications with UFE that you may experience during your recovery.

All patients have some symptoms of Post-Embolization Syndrome (PES). For example, pelvic pain or cramping, nausea, fever, vomiting or malaise are typical. Symptoms vary per patient and last for a short time.

Rare complications that may appear sometime after the procedure are:

  • Reduced blood flow to the leg
  • Allergic drug reactions
  • Infection
  • Uterine ischemia (a decreasing or ineffective blood supply to the uterus)
  • Uteroenteric fistula (an abnormal connection between ureter and gastrointestinal tract)

 

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