In most cases, fibroids are only treated if they are causing symptoms. Treatment options range from medications to invasive surgery. Hysterectomy is the most common surgical procedure for fibroids, and in fact fibroids are the most common reason for hysterectomies. A hysterectomy eliminates the potential for recurrence of fibroids, but also eliminates the possibility of a woman getting pregnant in the future. There are other less invasive procedures for treating fibroids.
None of the drug therapies for uterine fibroids get rid of them entirely. Some of the drugs work by lowering estrogen and placing the woman in a state similar to menopause. The lowered estrogen may shrink the fibroids and relieve symptoms. Other methods of treatment, such as using contraceptive pills, have been shown to control excessive menstrual bleeding, but do not affect the size of the fibroid.
Minimally invasive and surgical options
There are several minimally-invasive and surgical options for the treatment of uterine fibroids. Minimally invasive surgeries generally feature less blood loss, shorter hospital stays, smaller incisions for minimal scarring and less need for pain medication than traditional open surgery. The best surgical option for each woman, whether open or minimally-invasive, is reserved for case-by-case evaluation.
- The Acessa™ Procedure is a relatively new treatment option for fibroids. It utilizes a technology called radiofrequency ablation, and treats each fibroid by applying energy through a small needle array. The surrounding normal uterine tissue is not damaged or otherwise affected. Over time, the treated fibroid tissue shrinks and may become completely reabsorbed by the body. Acessa is a minimally invasive surgical treatment performed under general anesthesia, and only two very small (approximately ¼”) abdominal incisions are needed during the procedure – there is no cutting, suturing or removal of the uterus itself.
- Uterine artery embolization (UAE) is a process in which small plastic or gelatin particles are injected through a catheter into the small arteries that supply blood to the fibroids, cutting off access to the blood supply and forcing the fibroids to shrink and die. Patients usually spend one night in the hospital for pain control after UAE. Recovery times average 7–10 days. UAE is sometimes referred to as Uterine Fibroid embolization (UFE).
- Myomectomy is a procedure in which uterine fibroids are surgically removed from the uterus. It addresses all but very small fibroids. Myomectomies can be performed laparoscopically or as open surgery. Recovery times average 2–6 weeks, depending on the type of surgical approach. Women who want to retain the option of bearing children can choose to have a myomectomy done instead of a hysterectomy.
- Hysterectomy is a surgery where all or part of a woman’s uterus is removed. It is the only completely curative procedure for fibroids. Hysterectomies are performed via laparoscopic or open surgical techniques. Recovery time averages 4–6 weeks. It is the most invasive of all fibroid treatments and therefore carries the highest risk.
- Focused ultrasound surgery — also called magnetic resonance-guided focused ultrasound surgery or focused ultrasound ablation — is performed while you're inside an MRI scanner equipped with a high-energy ultrasound transducer for treatment. The images give your doctor the precise location of the uterine fibroids. While the MRI monitors the targeted fibroid and surrounding structures, the ultrasound transducer focuses sound waves into the fibroid to heat and destroy small areas of fibroid tissue. Not widely available, focused ultrasound surgery typically is done at specialized clinics.
Fibroids are a common condition which can be painful and debilitating. But there is hope; fibroids are treatable and are not likely to cause long-lasting harm. Women who exhibit symptoms of having fibroids should see their healthcare provider as soon as possible to get treatment.