alternative to hysterectomy for fibroids

The Non-Surgical Alternative to Hysterectomy and Myomectomy

In the past, most fibroids were treated with either a myomectomy – surgical removal of the fibroids – or a hysterectomy – total removal of the uterus. Both of these operations are highly invasive and require extensive recovery time. UFE or uterine fibroid embolization is minimally invasive, and requires less than a week for recovery, on average. It is a great alternative to hysterectomy for fibroids.

What Is a Hysterectomy?

Hysterectomy is a surgery performed by an OB/GYN where part of the uterus or the entire uterus is removed. It also may involve removing one or both ovaries, the cervix, and/or fallopian tubes. A hysterectomy may be performed to eliminate uterine fibroids, cancer, or other abnormalities of the uterus. It is normally performed under general anesthesia, requires a hospital stay, and can also require a fairly lengthy recovery following discharge.

A hysterectomy can be executed through one of many techniques including:

  • During a laparoscopic hysterectomy, the surgeon uses a thin instrument equipped with a light and a camera which is inserted through a small incision in the abdomen. Using other tools and guided by the camera, the surgeon dissects the uterus and removes it through other tiny incisions made in the abdomen.
    Recovery time is between 5-6 weeks.
  • The abdominal hysterectomy surgery is performed through an open incision made in the abdomen similar to that of a C-section and carries the highest degree of risk among the techniques. Recovery from an abdominal hysterectomy is normally between 6-8 weeks.
  • A robotic-assisted laparoscopic hysterectomy is a form of a hysterectomy that is the same as the laparoscopic hysterectomy except the surgeon is using a computer to control robotic arms. The technique and surgery steps are the same but the surgical instruments are being held by robotic arms. This allows greater precision and movement, however, it has not been proven that it yields superior results in hysterectomy. It will also cost the patient significantly more money to undergo this approach.
  • Vaginal hysterectomy – the uterus is removed through the vagina using a laparoscope and does not require any abdominal incisions. This technique is considered the least invasive of the surgeries. The surgeon may remove the entire uterus, part of the uterus, the cervix, fallopian tubes, ovaries, or all of the reproductive organs. Recovery time is about 4-6 weeks. However, this approach is almost never feasible in women suffering from fibroids. This is because the fibroids enlarge the uterus to such an extent to make this approach impossible.

What Is a Myomectomy?

A myomectomy is a surgical procedure done to cut fibroids out of the uterus and sew the uterus back together. A myomectomy is an invasive surgery that can leave the uterus weak and will not be able to sustain a vaginal birth in the future. It can also cause scarring and affect future fertility.

One of the most significant challenges in myomectomy surgery is that it rarely eliminates all the fibroids, and therefore, patients usually see reoccurrence within 3-5 years. It is performed under general anesthesia using one of the following techniques:

  • Open myomectomy –the surgeon removes any reachable fibroids through a large horizontal, c-section-like incision. The open myomectomy is a very invasive surgery and carries the most risk when compared to the other myomectomy techniques. It is usually done under general anesthesia and the typical recovery time is 6-8 weeks.
  • Laparoscopic myomectomy – several small abdominal incisions are made in the patient’s abdomen and the surgeon uses a laparoscopy that has a camera and a light mounted on it. This is inserted into one of the incisions while other tools are guided through the other incisions in the abdomen and the fibroids are cut up (i.e. morcellation) and removed. Recovery is typically about 4-6 weeks.
  • Hysteroscopic myomectomy – fibroids are accessed through the vagina using a laparoscope without the use of abdominal incisions. Normally, the surgeon uses a tool that contains a small loop that removes the fibroids using electricity. The hysteroscopic technique can only remove submucosal fibroids but is considered the least invasive surgical technique for removing fibroids and has a short recovery time.
  • Robotic-assisted myomectomy involves the same surgical process as a laparoscopic myomectomy with the exception that the surgeon is not holding the surgical instruments. Instead, they are being held by robotic arms which are being controlled by the surgeon via computer. Movements are more precise and the arms can move and bend to reach certain positions that the surgeon’s hand would not be able to. Recovery is about 4-6 weeks. This approach is more expensive for the patient then the traditional laparoscopic myomectomy.

What Is Uterine Fibroid Embolization (UFE)?

Uterine fibroid embolization (UFE) is a non-surgical procedure that does not require a hospital stay and is done in an outpatient setting. UFE is done by an Interventional Radiologist and works by cutting off the blood supply that is vital to the fibroids for their survival.

Why Is UFE a Better Alternative to Hysterectomy and Myomectomy for Fibroids?

UFE has many advantages over all the surgical approaches. Almost every single patient suffering from fibroids that is a candidate for surgery is also a candidate for UFE. To know if someone is a candidate, you must get a second opinion from an Interventional Radiologist and not a Gynecologist. Interventional Radiologists are the physicians that perform UFE.

Because UFE does not involve any surgical incisions, UFE is much safer than surgery with a much lower complication rate and much lower severity of complications. UFE patients are discharged home on the day of the procedure with just a bandaid at the top of the right leg or left wrist.

UFE can treat all types of fibroids no matter their size or number. UFE is permanent and is effective in 90% of patients. Unlike myomectomy, UFE treats all of the fibroids in the uterus, and therefore, the chance that a patient will need a second procedure is much higher with myomectomy than with hysterectomy.

Unlike hysterectomy, UFE can eliminate the symptoms caused by fibroids without the loss of your uterus. Even in women who are not interested in future fertility, losing the uterus will likely have significant negative consequences, e.g. sexual dysfunction, urinary leaking, and significant bone loss.

UFE provides 3 significant features to women suffering from uterine fibroids:

  • The very high success rate of the procedure – 90%;
  • It allows women to avoid the significant risks and long recovery of a surgical operation;
  • They get to keep their uterus!

UFE is also less expensive since it does not need to be performed in a hospital, and it has a much shorter recovery time (5-7 days).

If you’re suffering from fibroids and want your life back, contact the Atlanta Fibroid Center® and learn about a non-surgical alternative to hysterectomy and myomectomy. For more information call (770) 953-2600 and schedule your appointment today.

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