Fibroid Surgery
Surgery is used to treat uterine fibroids usually only as a last resort, when all other treatments (for example, drug and hormone treatment) have failed to either relieve the patient's symptoms or help her to get pregnant. The type of surgical procedure carried out will depend on the location and number of your fibroids, and their size. It will also depend on your future plans for having children, as some types of surgery will leave you unable to do so. If you are interested in having surgery either to combat infertility or alleviate your symptoms, you should speak to a specialist about the advantages and disadvantages of each procedure.
Surgery For Fertility
The procedure most commonly used for women who still want to have babies is a myomectomy. During this operation, the fibroids themselves are removed from the walls of the uterus. If any fibroids are blocking the fallopian tubes or preventing sperm from travelling to the fallopian tubes from the cervix, this procedure should hopefully resolve that problem. A myomectomy cannot, however, be performed on all fibroid patients. If you have a very large number of fibroids, or they are in an awkward place, or they are particularly big, it may not be possible to simply remove them. For this reason, hormone treatment with GnHRa injections may be used before surgery to try and shrink the fibroids.
Surgery For Symptoms
A hysterectomy (removal of the uterus, and, possibly, the fallopian tubes and ovaries) may be performed on a woman who simply wants to eliminate her symptoms and no longer wishes to have children. This operation is almost always carried out as a last resort when a woman has very large fibroids or is experiencing severe vaginal bleeding. This procedure prevents fibroids from recurring. It can induce early menopause and cause a woman's sex drive to decrease.
Endometrial ablation is an alternative to the hysterectomy. A woman should not have children after undergoing this operation. The procedure is carried out to remove the lining of the uterus and the fibroids growing there. It is usually performed only if the fibroids are near the inner surface of the uterus. Various methods are used to remove the lining, including laser energy, microwave heating, a heated wire loop and hot fluid in a balloon. Although it is possible to become pregnant after having the procedure, doctors advise strongly against it, because there is no longer a uterine lining into which the foetus can safely implant. This is not an option, therefore, for woman who are hoping to have children.
New Surgeries
The procedures listed above are not the only types of surgery available for women seeking treatment for uterine fibroids. A range of new procedures have been developed, although there is a certain degree of uncertainty about their long-term effects, and availability in UK hospitals may be limited. Check out our page on new fibroid surgeries for more information.
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