How can you treat fibroids?

There are a few medications which can shrink fibroids. However these medications usually do not make the fibroid disappear. These medications decrease female hormones to cause the fibroid to shrink.

There are also some radiological techniques which can shrink fibroids. These are uterine artery embolisation and MRI guided focussed ultrasound.

The only definitive way to remove a fibroid is to cut it out surgically. This can be done in one of three ways.

  1. Hysteroscopically – this is where a camera (hysteroscope) is placed into the uterus and the fibroid is dissected out from the inside. This is only suitable for fibroids growing on the inside of the uterus – submucosal.
  2. Laparoscopically – this is KEY HOLE surgery. Four small cuts are made on the abdomen and the fibroid is removed using key hole instruments. This is only suitable for fibroids less than 9cm. To remove the fibroid it needs to be morcellated – chopped into tiny pieces to get it out of your abdomen.
  3. Open surgery – this means making a cut on the abdomen. Either a cut like a caesarean section or an up and down cut. Planning the incision depends upon where the fibroid/s are located and how large they are.

Sometimes the fibroids are so many and so large that the best operation is in fact a hysterectomy. Cutting fibroids out causes two main problems – bleeding and adhesions. Adhesions are scar tissue formation making things in your abdomen stick together that shouldn’t stick together. Such as the bowel sticking to the uterus where the fibroid was removed from. Hysterectomy can be a safer an easier procedure than removing the fibroids. However, hysterectomy is clearly not the appropriate choice if you are planning to have children.