Fibroids are benign tumors that can invade the uterus. They range in size from very small such as the diameter of a golf ball to extremely large as in the size of a cantaloupe or greater. Often these tumors, even the larger ones, are asymptomatic. Other times, though, they can cause pain and heavy bleeding. In cases where fibroids become troublesome, there are multiple options for treating fibroid tumors.
Nonsurgical
If a woman is near menopause, she and her physician may decide to treat the symptoms she is experiencing with pain medications, exercise and hormone therapy to control bleeding and help shrink the tumors. Following menopause, a woman with fibroids may find the tumors have shrunk on their own or disappeared completely. Most women become menopausal around age 50, according to St. Peter's Health Care Services in Albany, N.Y.
Excision
There are several types of fibroid treatments that involve excising the tumors. One common procedure is myomectomy, in which the tumors are surgically removed leaving it possible for the woman to bear children in the future, according to the Mayo Clinic. The biggest drawback to a standard myomectomy is that more blood is lost than in a hysterectomy. Another excision treatment is endometrial ablation and resection in which a scope is pushed through the cervix into the uterus. The scope is then used to scrape and burn the fibroid tumors that it can reach. This procedure usually renders the woman permanently infertile, according to the Mayo Clinic. A similar procedure is myolysis, in which the tumors are frozen or burned with laparoscopic surgery.
Ultrasound
Sometimes high intensity beams from an ultrasound can be directed against fibroid tumors. An MRI (magnetic resonance imaging) scan is used to guide the ultrasound beams, which annihilate fibroids with their high heat level. This procedure focuses on repetition because only small areas can be destroyed at a time.
Uterine Fibroid Embolization
This treatment, commonly referred to as "UFE," is a non-surgical procedure that involves putting a catheter into an artery and then moving it to the uterus. Particles are then injected that barricade the flow of blood to the tumors. According to the Radiological Society of North America (RSNA), the fibroids dry out and become smaller and pieces may even be expelled (the RSNA estimates this happens in 2 to 3 percent of women who undergo the procedure). If there is remaining fibroid material a physician may need to perform a D & C (dilation and curettage) to remove it. Uterine fibroid embolization works well in eliminating tumors but is not recommended for women who want to bear children because the procedure's effect on fertility is unknown. A benefit of this procedure is it is minimally invasive. A risk of UFE is the possibly of infection that can occur in any procedure involving insertion of a catheter.
Hysterectomy
For some women a hysterectomy may be advised. There are three basic types of hysterectomy. A subtotal hysterectomy is one in which only the uterus is removed. A total hysterectomy takes out the uterus and cervix. It can sometimes be performed vaginally. A "Journal of Gynecologic Surgery" article published July 6, 2004, says it is universally accepted that vaginal hysterectomy has a shorter recovery time and has fewer complications than abdominal hysterectomy. Sometimes a radical hysterectomy must be performed in which the uterus, fallopian tubes, cervix and ovaries are taken out. Discuss in detail with your physician which is the best option for your particular case.
