Uterine fibroids affect between 20-25% of women of reproductive age. Every woman living with uterine fibroids is affected differently by them. Some are able to manage them and find ways to maintain a healthy and satisfying quality of life. Others find themselves in constant pain, unable to enjoy intimacy, and deeply affected by heavy periods and associated symptoms. 

When fibroids get too large or they start seriously affecting your everyday quality of life, surgical removal is often the best course of action, but how do you choose which ones are best for you? There are multiple surgical options for fibroid removal, and it’s important to work with your doctor to figure out which one is right for you. In the meantime, here is some more information that may be helpful.

Fibroids Removal Surgery
(This image is from Shutterstock.)

There are multiple reasons you may opt for surgical removal of your fibroids, including but not limited to: 

• Excessively heavy periods
• Pain or swelling in your abdomen 
• Bleeding between periods 
• Frequent urge to urinate 
• Trouble emptying the bladder 

One of the main reasons why women may opt to have their fibroids removed is if they plan on getting pregnant later. Fibroids can increase the risk of miscarriage.

The type of surgery you seek depends on several factors, including their size, location, quantity, and your childbirth plans. The most common types of fibroid removal surgery are: 

Myomectomy

Myomectomy allows you to have your fibroids removed and get relief from your symptoms while still preserving your uterus. It’s a viable option for women who are still interested in having children. The downside is that new fibroids may grow, and it’s possible you may have to have another procedure within five years; this is the case for more than a third of myomectomy patients. Under the myomectomy umbrella, there are three types of procedures, including: 

• Hysteroscopy – Ideal for patients with smaller and fewer fibroid growths, hysteroscopy allows your surgeon to remove fibroids that have grown inside the uterus by using a telescopic device to see your fibroids and using fluid to expand your uterus. The fibroid pieces are then broken up using another device, and the fragments wash out with the liquid. 
• Abdominal Myomectomy – Also known as laparotomy, an abdominal myomectomy is ideal for larger fibroids. Unlike hysteroscopy, where a telescope is inserted into the uterus through the cervix and vagina, abdominal myomectomy requires a larger incision in the belly, which may leave a larger scar. Fibroids are removed through the incision. 
• Laparoscopy – Laparoscopy is a blend between abdominal myomectomy and hysteroscopy. It includes two smaller incisions in the belly and the insertion of a small lighted telescope through one of the incisions. Your surgeon may cut your fibroids into small pieces before removing them. In robotic laparoscopy, your surgeon uses robotic arms to perform the procedure.

A hysterectomy is the complete removal of the uterus and can be ideal for people with multiple, large fibroids who don’t plan to have children. The three main types of hysterectomies include: 

• Laparotomy or Abdominal Hysterectomy
• Vaginal Hysterectomy
• Laparoscopic Hysterectomy

While hysterectomy will fully remove fibroids and eliminate symptoms, it will render you unable to have children. Other less invasive fibroid removal options include endometrial ablation and uterine fibroid embolization (UFE). Talk to your doctor about which options are best for you. Download the Responsum for Fibroids app to get more information and support through your fibroids diagnosis.