Treatment Options for Fibroid Tumors

Occurring in approximately 30% of women over the age of 35, and many during their childbearing years, uterine fibroids are the most common type of pelvic tumors in women. Uterine fibroids are benign, (non-cancerous); however, they can produce a wide variety of sometimes painful symptoms such as excessive bleeding, which can lead to iron deficiency, and bowel or urinary tract obstruction. Fibroids can cause painful intercourse and are a cause of pregnancy loss and infertility.

Medicinal Treatments

Treatments may depend upon various factors such as age and general health, type of fibroids and their severity, whether a woman is pregnant or if a woman would like to have a family in the future. Medicinal treatments include oral contraceptives, NSAIDS, androgens and hormonal therapy. Depo Leuprolide injections, a type of Gn-RH hormone injection which shrinks the fibroids by reducing the production of estrogen and progesterone, simulates menopause - complete with many of the commonly known side effects such as vaginal dryness, hot flashes and loss of bone density. As soon as the treatment stops, the fibroids begin to grow again.

Surgical Options - Hysteroscopy and Hysterectomy

Surgical methods of removal have been shown to be the most effective, however, they may have an adverse effect upon reproduction. Hysteroscopic resection of fibroids is a procedure done on women with fibroids inside the uterine cavity. A small camera and instruments are inserted through the cervix into the uterus and the fibroids are removed. Hysterectomy is the complete removal of the uterus with or without the ovaries. It is possible to complete a hysterectomy through the vagina without having to cut the abdomen; however, that is conditional upon the size of the tumors. With large tumors, an abdominal hysterectomy is often necessary. It is a major surgical procedure requiring a general anesthesia, a hospital stay and recovery period of up to six weeks. Pregnancy is no longer possible after a hysterectomy.

Surgical Option - Myomectomy

Myomectomy, a surgical procedure designed to leave the uterus intact after the removal of the fibroids is meant also to preserve reproductive potential. This type of surgery may be done with a laparoscope or could require an abdominal incision or the use of a hysteroscope. If the fibroids are larger they sometimes bleed uncontrollably and a hysterectomy may become necessary. While the larger tumors are removed, smaller ones can continue to go making this type of surgery only partially effective.

Non-Surgical Option - Embolization

A process called embolization is used to block blood vessels from the inside. A specialist uses catheters (tiny tubes) and medical imaging techniques to introduce a catheter into an artery in either the arm or groin which is manipulated into the uterine arteries and an angiogram is performed. This involves the injection of a substance into the artery of the uterus which will eventually find its way into the small arteries of the fibroids, blocking them and thus starving them. As a result, they die and are removed by the body itself. It is a very durable, long-lasting treatment and does not require surgery.

There are numerous ways to treat uterine fibroids. The final decision rests with both doctor and patient.