Radiofrequency ablation is a popular treatment option for women with up to five medium-sized intramural fibroids that are causing bulk symptoms and heavy bleeding. This procedure has been found to be particularly effective for Black women experiencing severe symptoms. A study involving 74 ethnically diverse women showed that both Black and white women experienced similar improvements in fibroid size and reductions in bleeding after undergoing radiofrequency ablation.
However, myomectomy is another treatment option for fibroids. This surgical procedure involves removing the fibroids, and while gynecologists can perform myomectomies, women with large fibroids are often referred to minimally invasive gynecological surgeons (MIGS) for the procedure. MIGS surgeons specialize in treating complex cases with minimally invasive techniques as opposed to traditional open abdominal surgery.
In a paper published in Health Equity, MIGS surgeons expressed concerns about the lack of discussion around treatment options for fibroids. They noted that many gynecologists don’t perform myomectomies laparoscopically, despite the fact that it can be a viable option for 90 percent of cases. The surgeons emphasized the importance of discussing all available treatment options with patients, including medical, radiological, and surgical options, to ensure the best possible outcomes.
Unfortunately, fibroids often return in the years following treatment. Factors such as age, the presence of multiple fibroids or an enlarged uterus, and other pelvic diseases can increase the risk of fibroid recurrence. In cases where fibroids continue to cause symptoms, hysterectomy may be the only definitive treatment option. This procedure removes both the fibroids and the uterus, providing a permanent solution to fibroid-related symptoms.
A study by Kaiser Permanente found that 8 percent of women who had undergone myomectomy and 18 percent who had undergone uterine fibroid embolization (UFE) eventually required a hysterectomy within six years of their initial treatment. This highlights the need for more research and advancements in treatments for fibroids to prevent recurrence and subsequent interventions.
In conclusion, radiofrequency ablation is an effective treatment option for women with up to five medium-sized intramural fibroids causing bulk symptoms and heavy bleeding. Myomectomy is another viable option that can be performed laparoscopically in most cases by MIGS surgeons specialized in treating complex cases with minimally invasive techniques as opposed to traditional open abdominal surgery.
While there is always a risk of recurrence after any form of treatment for
