Fibroid Management Tool

This is a surgery to remove fibroids without removing the uterus. A myomectomy can be done in different ways depending on how many fibroids you have and where they are. The different types of myomectomy procedures are laparoscopic myomectomy, abdominal myomectomy, and hysteroscopic myomectomy.

A myomectomy may be the best option for people who would like to get pregnant in the future. Fibroids can grow back after they have been removed in about 20 percent of cases (1 in 5 people).

Please talk to your doctor to see if myomectomy is a good option for you.

Laparoscopic myomectomy: Small (1 cm or less) incisions (cuts) are made on your abdomen (belly). The surgeon uses a small camera to see inside your abdomen to remove the fibroids. You may have some pain around the surgical area and some stomach cramping after the procedure. You may also have some vaginal bleeding. The recovery time is two to four weeks.

Open (abdominal) myomectomy: An incision is usually made on the bikini line (lower abdomen) to remove the fibroids. This is similar to a C-section incision. This method is used for patients whose fibroids are very large, or who have too many fibroids to remove using the camera. You should also expect some pain around the surgical area and some stomach cramping after the procedure. You may also have some vaginal bleeding. Sometimes the skin may be numb around the incision for a short time. An abdominal myomectomy has a longer recovery time (six to eight weeks).

General anesthesia is used for these surgeries. Possible risks include infection, bleeding, and injury to organs like the intestines, bladder, ureters, ovaries, uterus, or blood vessels. If your fibroid was deep in the uterus muscle, you may need to have a cesarean delivery in future pregnancies.

Hysteroscopic myomectomy: This surgery can be performed on patients with fibroids found in the inner lining of the uterine wall (submucosal). The surgery is done through the vagina instead of the abdomen. A hysteroscopic myomectomy has a faster recovery time (two-four days) and you do not need to stay in the hospital overnight. Monitored anesthesia care or general anesthesia is used for the surgery. Some side effects may include bleeding, cramping, and a possible need for a second procedure.

This is a surgery to remove your uterus (womb) and fallopian tubes. If you have this procedure, you won’t have your period anymore. If you have a hysterectomy, there is no chance that the fibroids will return in the future. You can’t get pregnant after a hysterectomy.

During a hysterectomy, the ovaries are usually not removed. If the ovaries are not removed, you will not have symptoms of menopause like hot flashes, and your moods and sex drive should be normal for you.

Different types of hysterectomies include laparoscopic, abdominal, and vaginal hysterectomy.

Laparoscopic hysterectomy: The surgeon makes three to four small (5mm to 1cm) incisions on the abdomen. A camera is used during the surgery to help remove the uterus. The general recovery time is two to four weeks. In addition, you cannot lift more than 10 pounds for 8 weeks. Also you cannot put anything in the vagina for 8 weeks.

Open abdominal hysterectomy: An incision is usually made on the bikini line (lower abdomen) to remove the fibroids. This is similar to a C-section incision. This is usually done for very large fibroids or patients who have had surgeries before. Usually, the whole uterus is removed. Sometimes, people decide to keep the bottom part of the uterus (cervix). The recovery time is six to eight weeks.

Vaginal hysterectomy: The uterus is removed through the vagina without any incisions or scars on the abdomen. This procedure may not be possible for women with a large uterus or who have had surgeries in their abdomen in the past. The general recovery time is two to four weeks. In addition, you cannot lift more than 10 pounds for 8 weeks. Also you cannot put anything in the vagina for 8 weeks

You should expect some pain around the surgical area and some stomach cramping after the procedure. You may also have some vaginal bleeding. Possible risks with hysterectomy are infection, bleeding, injury to organs like the intestines, bladder, ureters, ovaries, or blood vessels.

Please talk to your doctor to see if hysterectomy is a good option for you.

A doctor called an interventional radiologist puts a catheter (tube) through a vein in your arm or leg. Small particles are placed through the tube to block the blood supply to the fibroids. This can shrink the fibroids and can reduce discomfort, pain, or bleeding. Patients are usually sedated during the procedure but do not require general anesthesia. You’ll also need an MRI and sampling of the tissue in the lining of the uterus (“endometrial biopsy”) before this procedure. Because no incisions are made, recovery from this procedure is very short – about one week. You may stay in the hospital for one night to get help managing pain, which is the worst in the first few hours after the procedure.

You should also expect some pain in the arm or leg where the catheter was put in, and some pain in your uterus. You may also have some vaginal bleeding. Possible risks include infection and severe pain.

In some cases, the procedure may not work and you’ll still have symptoms. Sometimes the fibroids grow back in a few years after the procedure. Pregnancy may not be safe after UFE, so you should not have this procedure if you think you might want children in the future. Please talk to your doctor to see if UFE is a good option for you.

This is a minor surgery. You will be sedated (asleep) for this procedure, but most people do not need general anesthesia (a breathing tube). The doctor will place a camera through the vagina into the uterus. They will use a special device to cauterize (burn) the lining of the uterus. This decreases the amount of blood the uterus makes during your period. Some possible risks include infection, bleeding, pelvic pain, and injury to organs like the intestines, bladder, uterus, or blood vessels.

Most women have either lighter periods or no periods after the procedure. Some women continue to have heavy periods. Some women have improvement in their periods for a few years, but then have heavy periods again. This occurs more often if you are less than 45 years old. Endometrial ablation may not work as well in patients with fibroids or adenomyosis.

Pregnancy is not safe after endometrial ablation, so you should not have this procedure if you think you might want children in the future. Please talk to your doctor to see if endometrial ablation is a good option for you.

This procedure uses ultrasound waves to destroy fibroid tissue. It is done using an MRI machine, so you do not have any incisions. This treatment usually has a quick recovery time. Some possible risks are temporary numbness or tingling, and pain in your abdomen, uterus, or skin. Long-term effects of this procedure are still being studied. This procedure is not offered at the Boston Medical Center (BMC). Please talk to your doctor to see if this is a good fit for you.

For this surgery, small (1cm or less) incisions are made on your abdomen (belly). The surgeon uses a small camera to see inside your abdomen. Other small devices are placed through the incisions to locate the fibroids with an ultrasound and heat up the fibroids to cause them to shrink. General anesthesia is used for this surgery.

You should expect some pain around the surgical area and some stomach cramping after the procedure. The recovery time is about one week. Possible risks include infection, bleeding, and injury to organs like the intestines, bladder, ureters, ovaries, uterus, or blood vessels.

Sometimes fibroids can come back after this procedure. This is a new procedure, so we do not yet know if it is safe to become pregnant after the procedure. Please talk to your doctor to see if this procedure is a good option for you.