What treatment options are available for uterine fibroids? [Dr. Abadir]

Q: What treatment options are available for uterine fibroids?

A: Uterine fibroids are benign tumors of the uterus and they are treated when they cause symptoms typically of excessive bleeding or pain during the menstrual cycle. The standard treatment for many years has been to advise patients to have a hysterectomy, which removes the whole uterus, ends the menstrual cycle, and ends the symptoms associated with the menstrual cycle. Some women are opposed to that as they desire future childbirth or they just want to avoid a major operation, which can have a significant recovery time of up to six weeks. Based on that, some less invasive treatments have been developed in recent years.

One of them would be Uterine Fibroid Embolization, which is a procedure that deprives the fibroids of their blood supply. Any part of your body that doesn’t have a blood supply can’t survive, so the body essentially just slowly removes them over time. UFE is usually an outpatient procedure with a very short recovery time. It has a very high effectiveness of 92 – 95% and is very low in complications.

Other treatments are available for uterine fibroids. If you have one or two fibroids and the primary issue is bleeding, sometimes your OB-GYN can do an endometrial ablation, which is removing the inside lining of the uterus. It doesn’t do much in the way of getting rid of menstrual cramps, but it does get rid of the source of bleeding. If you’re desiring a future pregnancy, however, this is not an option for you, and it can have a relatively high rate of failure as the lining of the uterus can regrow.

Instead of doing a full hysterectomy, your doctor can do what’s called a myomectomy, which is trying to take out the individual fibroids and then sewing back the uterus once they’ve been removed. It is the most commonly prescribed treatment for women who are strongly desiring a future pregnancy. However, not all patients are candidates for it.

An experimental treatment that has been used in several locations is MRI guidance to take a high energy ultrasound. This destroys the fibroids in a manner much like Uterine Fibroid Embolization. It actually kills the fibroids where they are, and the body slowly resorbs them. Unfortunately, it has its limitations in terms of size and numbers of the fibroids, and it’s only offered in specific centers.
More videos from the interview with Dr. Abadir of the Fishkill Endovascular Center as he outlines causes and treatments for uterine fibroids: 

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