It is estimated that at least one in four women have uterine fibroids, non-cancerous tumors growing within the uterus. The location of these fibroids may be beneath the lining of the uterine cavity, entirely within the muscle layer or beneath the outer covering of the uterus. Patients suffer from heavy menstrual bleeding, pressure related to the size and location of the fibroids, pain, miscarriage, and infertility. Not all fibroids cause symptoms, and treatment is only necessary when symptoms interfere with the patient’s quality of life.
Surgical Services
101 Dudley Street
Providence, RI 02905
P: (800) 921-9299
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Treatment for fibroids depends on a patient’s symptoms. For heavy menstrual bleeding, hormonal, and non-hormonal medications are used to decrease the amount of bleeding. For minor cramps, patients should use non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen. Currently, there are no long-term medications which shrink the size of fibroids.
Fibroids can also be treated surgically. The type of surgery depends on the number and size of fibroids and where the fibroids are located.
In patients who want to preserve their uterus, a myomectomy is the most common surgical option. During a myomectomy the surgeon removes the fibroids and repairs the uterus. After the uterus has healed it is safe to become pregnant.
Hysteroscopic Myomectomy: This procedure is best when the fibroids are located within the uterine cavity. This technique uses a small, narrow telescope allowing the surgeon to visualize and remove the fibroids through the vagina, without the need for any incisions. Hysteroscopic myomectomies are same day surgeries and patients can often return to work in 3 days.
Laparoscopic Myomectomy: Laparoscopic myomectomy is a procedure where a small camera is placed in the belly button and specialized small instruments are used to remove the fibroids and repair the uterus. The small incisions result in minimal trauma on surrounding tissues and less pain for the patient. Thus, patients stay in the hospital shorter and have a faster recovery and return to activities. There is also a decreased risk of infection and other complications. Laparoscopic myomectomy is usually a same day procedure, so patients can recover in their own homes. This procedure is technical and may require a surgical specialist.
If you are interested consulting with a specialist for a laparoscopic myomectomy, Click here for more information >>
Robotic Myomectomy: Robotic myomectomy is a type of laparoscopic surgery where an automated robotic tool is used by surgeons to operate. The robot can help if the case is complex or if the surgeon prefers the robot for increased accuracy and precision. This is also a minimally invasive option with small incisions, and patients usually go home the same day. The da Vinci® Robotic System is the one used by Women and Infants surgeons.
Abdominal (Open) Myomectomy: When the fibroids are too large to be removed through a minimally invasive route, an abdominal, or open procedure can be necessary. During this surgery a large cut is made on the abdomen and the fibroids are removed through this. Patients who have an abdominal myomectomy often stay in the hospital for 1-2 nights while they recover.
For patients who do not want to preserve their uterus, a hysterectomy is often the best surgical option. A hysterectomy removes the entire uterus containing the fibroids, which prevents the fibroids from growing back. There are many ways to perform a hysterectomy including vaginal, laparoscopic, robotic, and abdominal surgeries. The type of hysterectomy will depend on the size and number of fibroids, and on the surgeon’s expertise. Most hysterectomies are performed through a minimally invasive route and patients can be safely discharged home the same day or the next day. Click here to learn about hysterectomy options >>
For patients who want to preserve their uterus and have a minimally invasive procedure to shrink their fibroids, radiofrequency ablation is an option. This is an alternative to hysterectomy or myomectomy. This newer technology uses ultrasound guidance to target uterine fibroids and apply energy to treat them. The surrounding uterine tissue is not affected. At Women and Infants, we offer the laparoscopic radiofrequency ablation (Lap-RFA) procedure Acessa®. This is a minimally invasive same day procedure resulting in fast recovery and return to activities.
Patients should be aware that there is limited data on reproductive outcomes after radiofrequency ablation.
Uterine fibroid embolization is a non-surgical minimally invasive procedure to treat bleeding and pressure symptoms from uterine fibroids. This procedure preserves the uterus and involves no abdominal incisions. The procedure is performed by Interventional Radiologists and typically requires a one night hospital stay. Talk to your gynecologist to see if this procedure is right for you. Learn more about Interventional Radiology >>
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