How are uterine fibroids treated?

More and more, doctors are beginning to realize that uterine fibroids may not require any intervention or, at most, limited treatment. For a woman with uterine fibroids that are not causing symptoms, the best therapy may be watchful waiting. Periodic pelvic examination and ultrasound may be recommended by your physician, depending on the size or symptoms of the fibroid. Some women never exhibit any symptoms nor have any problems associated with fibroids, in which case no treatment is necessary.

If a woman is experiencing anemia caused by heavy, prolonged menstrual bleeding; moderate to severe pain; infertility; or urinary tract or bowel problems; then she will require evaluation. The type of treatment offered is determined by the number, size, location, and symptoms related to fibroids. Additionally, the desire for fertility will also determine whether certain options are feasible.

Treatment options include:

  • Laparotomy, which involves an abdominal incision to remove all fibroids, no matter the size or location of the tumors. Today, laparotomy is more often used when the fibroids are too numerous to be removed with minimally invasive technology.
  • Uterine fibroid embolization. This procedure is performed by an interventional radiologist who works in collaboration with your gynecologist. A small catheter is placed in the uterine artery and small particles are used to block the flow of blood from the uterine artery to the fibroids. Loss of blood flow, shrinks the fibroids and thus improves symptoms. The procedure is performed with mild sedation and takes 60-90 minutes. Patients are typically able to return home the day after the procedure and back to work and activity in 10-14 days. This treatment is not offered to women who want children.