Ask An Expert: Uterine Fibroids Procedures

Content provided by the Faculty of the Harvard Medical School

Ask An Expert: Uterine Fibroids Procedures

Question:

Which procedure is better for the removal of uterine fibroids, endometrial ablation or hysterectomy? I do not plan on having any more children.

Answer:

Fibroids are benign muscular tumors of the uterus. They are quite common, occurring in up to 40 percent of women. If a woman with fibroids has no symptoms, treatment is not required. If fibroids grow rapidly or are responsible for abnormal bleeding, pain, or fertility problems, then treatment is indicated.

Several treatment options are available for fibroids. The best choice depends on the patient's symptoms, her therapeutic goals, and the size and location of the fibroids.

Endometrial ablation is a procedure in which a cauterizing device is placed within the uterine cavity and electric current is applied. The glandular tissue lining the uterine cavity is destroyed, while the rest of the uterine tissue is preserved. It is effective for the treatment of small fibroids that are close to the uterine cavity in women with no plans for future pregnancy. Its main advantage is that it is minimally invasive and has a short recovery time.

A hysterectomy is the removal of the entire uterus by a surgical incision either in the vagina or the abdominal wall. It is a more invasive procedure with a longer recovery. However, it offers the advantage of assuring that fibroids will not re-form, and thus is considered definitive treatment. Sometimes it is the best choice for fibroids that are growing fast, to assure there is no sign of cancer. Sometimes it is chosen for larger fibroids that are pressing on other pelvic structures such as the urinary bladder.

Other options such as hysteroscopic resection, myomectomy, and uterine artery embolization are also available. Each patient should discuss her unique situation with her physician to determine the best choice for her.

Joan Bengtson, M.D., is assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics, Gynecology & Reproduction at Brigham and Women's Hospital.

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Last updated:	January 24, 2007

Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.

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