The table below is based on a recent review article on the modern management of uterine fibroids which provides a useful comparison of the indications and relative merits of the various common treatments which are currently available:
|
Hysterectomy† |
Myomectomy‡ |
Uterine artery embolisation (UAE) |
MRI guided focused ultrasound myolysis |
| What is it? |
Fibroids removed together with the uterus (womb) * |
Fibroids are removed but not the uterus |
Blood supply to uterus blocked resulting in fibroid shrinkage |
Fibroids are heated up leading to shrinkage |
| Which fibroids are not suitable? |
(All fibroids suitable) |
(All fibroids suitable) |
Fibroids on stalks
Submucous fibroids
Very large fibroids |
Fibroids on stalks
Fibroids near vital structures (e.g. bowel, bladder) or nerves
Very large fibroids |
| What are the major advantages? |
Only treatment which is guarantees a cure
No more periods/period pain
No chance of recurrence |
|
Fibroids are removed
Best option if you wish to conceive |
Non-surgical treatment
No need for general anaesthesia |
Non-surgical treatment
No need for general anaesthesia |
| What are the major disadvantages? |
Involves major surgery
Requires general anaesthesia
Cannot get pregnant |
Involves major surgery
Usually requires general anaesthesia
Pelvic adhesions likely after abdominal or laparoscopic surgery
New fibroids can develop |
Post-procedure pain
Infection
Premature menopause
1:4 women undergo hysterectomy within 2 years |
Relatively long procedure time
Modest reduction in fibroid size
Skin burns
Injury to adjacent structures
High chance of treatment failure (up to 28%) |
| How long does it take? |
1-2 hours |
1-3 hours |
1 hour |
2-4 hours |
| How long will I be in hospital? |
4-6 days (abdominal) to 2-3 days (vaginal or laparoscopic) |
4-6 days (abdominal) to day case (hysteroscopic) |
1-2 days |
Outpatient |
| When am I likely to be able to resume normal activities? |
4-6 weeks (abdominal) to 3-4 weeks (vaginal or laparoscopic) |
4-6 weeks (abdominal) to few days (hysteroscopic) |
Few days |
Few days |
| What will happen to my fibroids? |
Fibroids (and uterus) are removed |
Fibroids are removed |
Fibroids usually shrink by 50-70% |
Fibroids usually shrink by 15-25% |
| What will happen to my periods? |
Periods will stop |
Periods usually become lighter and less painful
|
Periods usually become lighter and less painful |
Periods usually become lighter and less painful |
| Can I become pregnant afterwards? |
No |
Yes |
Pregnancy is not recommended at present |
Pregnancy is not recommended at present |
† Includes abdominal hysterectomy, vaginal hysterectomy and laparoscopic hysterectomy
‡ Includes open (abdominal) myomectomy, laparoscopic myomectomy, hysteroscopic myomectomy and vaginal myomectomy
* Hysterectomy means removal of the uterus but not ovaries and therefore does not result in the menopause
Information about uterine fibroids