Surgical Treatments for Fibroids
The most dramatic method of treating fibroids is surgery. However, before you allow your doctor to steer you down this route, please read the information on each of the possible surgical techniques. Make an informed choice about which treatment options are right for you. And remember, in at least half of all cases, fibroids cause no complications at all, meaning that you can simply leave them alone.
The operation to remove fibroids is called a myomectomy. The size of your fibroids and their position in your uterus will determine who a doctor performs your operation. For example, you’ll be given a hysteroscopic myomectomy (using laser surgery) if your fibroids are growing on the inside of your uterus and are around 1in, or smaller. If your fibroids are on the outside of your uterus, you’ll have an abdominal myomectomy. For this, the surgeon will make a small incision in your abdomen in order to remove the growths. In both cases you’ll be given a general anaesthetic.
If you require a myomectomy, make sure you find a highly recommended specialist to perform it. Badly performed, a myomectomy can lead to significant blood loss, which may even require a full hysterectomy or may lead to the development of adhesions (scar tissue) that can, in turn, cause infertility.
If fibroids are stopping you from becoming pregnant, a myomectomy along with the natural approach to treatment (ideally for six months before you try for a baby) is by far the best way forward: The fibroids will be removed, and your body will be in ultimate balance for conception.
The most extreme of all surgical techniques to treat fibroids is a hysterectomy. Doctors often take the approach that it’s easier to remove the whole uterus than to perform a myomectomy to remove the individual fibroids. Make a calculated decision as to whether or not this is right for you. In most cases, it is not at all necessary to be so radical with the surgery. Fibroids are usually perfectly treatable by other methods.
Endometrial Ablation and Resection
If you don’t want to conceive, and your fibroids are causing heavy periods, you may be offered an endometrial ablation and resection. In this procedure a surgeon inserts a laser or heated wire into the uterine cavity to destroy the tissue of the uterine lining. It’s an irreversible treatment and will prevent a fertilized egg form ever implanting in your uterus.
There are two fairly new surgical techniques in the treatment of fibroids. Myolysis (laser ablation) is a technique in which the center of the fibroid is destroyed by a laser. This constricts the blood flow to the fibroid, causing it to shrink and die. The other technique, uterine artery embolization, injects tiny particles into certain arteries going into the uterus in order to “starve” the fibroids of a blood supply and so to shrink them. There is a risk of infection with this technique.