FAQ

I have fibroids, which method should I choose?

First of all, let's note that hysterectomy, or the removal of the uterus, should only be considered as a last resort after all other options have been considered. There are two basic options for treating fibroids: myomectomy, which removes only the fibroids, and fibroid embolization, which involves blocking the vessels that feed the fibroids in the uterus, killing and shrinking them in place.

What types of fibroids are the primary options for myomectomy?

In the "What to Know About Fibroids" section, we discussed the types and locations of fibroids. Submucous fibroids, which grow inside the uterus, and subserous fibroids, which grow outside the uterus, can rupture and fall into the uterine cavity or abdominal cavity after embolization treatment, causing discomfort. For fibroids with such a thin stalk, myomectomy should be the first option.

What types of fibroids might benefit from myomectomy or non-surgical treatments like fibroid embolization?

If there is a single fibroid, both myomectomy and fibroid embolization can be considered, as the surgery is relatively easy. Furthermore, if these fibroids are located on the anterior wall, radiofrequency ablation (RF ablation) can be easily performed. RF ablation involves inserting a needle into the fibroid through the skin, and the fibroid can be treated with heat under local anesthesia. HIFU, a rarely used method for single fibroids, is also an option. HIFU, meaning high...

Finally, if the patient wishes to conceive, myomectomy and embolization treatments carry similar risks in terms of fertility. The choice should be made based on the number and structure of the fibroids.

What types of fibroids might benefit from non-surgical treatments like fibroid embolization?

If there are multiple fibroids, or if they appear to occupy the entire myometrium, fibroid embolization should be the first choice. Because embolization treatment delivers occlusive particles to fibroids with abundant blood flow, treatment for all fibroids is possible in a single session. In fibroid embolization, the uterine tissue is preserved because it also receives blood from other sources. After embolization, all fibroids appear as dead tissue, while the uterine tissue is visualized as live tissue on a follow-up MRI.

Very large fibroids, in particular, carry a significant risk for surgery due to their high blood flow. Such cases are likely to require hysterectomy. Our colleagues specifically emphasize this possibility before surgery. Embolization is also the first choice for fibroids with such a large and abundant blood flow. It is also possible for a fibroid whose size and blood flow decrease after myoma embolization to subsequently undergo a myomectomy without risk. These treatments are called combination treatments (embolization followed by myomectomy). For very large fibroids, when embolization alone is insufficient, combination therapy should be considered.