Fibroid Treatment Options

Uterine Fibroid Treatment Options

The goal of current fibroid treatments is to reduce the symptoms (bleeding, pain) and/or to reduce the size of the fibroids or to simply eliminate the fibroids via a surgical procedure. Doctors take a number of factors into consideration when they plan the best therapy. For example, the severity of the symptoms, the size of the fibroids and their location, the age of the patient, and their wishes to preserve their womb or fertility all play a major role in deciding the best treatment option.

You should discuss treatment options with your doctor or gynaecologist.

 With this in mind, these are the types of fibroid treatment available (see tab below):

MEDICINES

The following drugs are commonly used for the treatment of uterine fibroids. In most cases, these medicines are used in order to control the symptoms caused by the uterine fibroids.

  • GnRH-analogues
  • Levonorgestrel intra-uterine devices
  • Oral contraceptives & progestins
  • Selective progesterone receptor modulators (SPRMs)

NON-SURGICAL PROCEDURES

There are a number of non-surgical options for the treatment of uterine fibroids, ranging from the noninvasive to the minimally invasive. Depending on your individual situation your doctor should discuss with you which treatment options are available and highlight those most suited to your circumstances.

  • MRI-guided focused ultrasound intervention
  • Myolysis
  • Uterine artery embolisation

SURGICAL PROCEDURES

Surgery is an option if all types of medication have been ineffective and your fibroid symptoms remain particularly severe. There are a number of surgical procedures to consider. Your doctor should refer you to a specialist to discuss all the options with you, including the benefits of each procedure and the associated risks.

  • Hysterectomy
  • Myomectomy
    • Abdominal myomectomy
    • Hysteroscopic or vaginal myomectomy
    • Laparoscopic myomectomy

MEDICINES

The following drugs are commonly used for the treatment of uterine fibroids. In most cases, they are used to control the symptoms caused by the uterine fibroids.

In all cases, the healthcare professional should be consulted in order to provide the most appropriate information for you.

SELECTIVE PROGESTERONE RECEPTOR MODULATORS

Selective progesterone receptor modulators (SPRMs) are a type of oral medicines which modify the activity of the hormone progesterone.

Ulipristal acetate 5mg is the only SPRM to be licensed for the intermittent or pre-operative treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age.

For more information, please refer to the related patient information leaflet (PIL) of your country.

GONADOTROPHIN-RELEASING HORMONE (GnRH) ANALOGUES

Gonadotrophin-releasing hormone (GnRH) analogues are a class of hormone treatments that work by making the body release a small amount of oestrogens, which causes the fibroids to shrink.

They modify the production of hormones involved in the normal menstrual cycle of a female. GnRH analogues are also licensed for the pre-treatment of uterine fibroids prior to surgery.

For more information, please refer to the related patient information leaflet (PIL) of your country.

ORAL CONTRACEPTIVES AND PROGESTINS

Contraceptives prevent the release of an egg from the ovaries and in turn stop the monthly menstrual cycle.

For more information, please refer to the related patient information leaflet (PIL) of your country.

LEVONORGESTREL INTRA-UTERINE DEVICES

Intra-uterine devices (IUDs) are devices that are inserted into the womb (uterus) and release levonorgestrel (a progestin). This causes the womb wall to thicken, preventing sperm from reaching the egg.

For more information, please refer to the related patient information leaflet (PIL) of your country.

NON-SURGICAL PROCEDURES

There are a number of non-surgical options for the treatment of uterine fibroids, ranging from the non-invasive to the minimally invasive.
Depending on your individual situation your doctor should discuss with you which treatment options are available and highlight those most suited to your circumstances.

Magnetic resonance imaging-guided focused ultrasound surgery

Magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS) is a non-invasive procedure specifically used for treating fibroids in women who do not want to have children.

MRgFUS uses focused, high-frequency, high-energy ultrasound beams to destroy fibroids one at a time by heating them until they solidify.

mri_2

Uterine artery embolisation

Uterine artery embolisation (UAE) is a procedure where a catheter is used to deliver small particles that block the blood vessels supplying the fibroids. This causes the fibroids to shrink.

As with any procedure, there are risks and potential complications associated with it such as ovarian failure, infection, vaginal discharge etc.

uterine-artery-embolisation

Myolysis

Myolysis is a procedure that destroys fibroids in the womb (uterus) by using focused energy. It can be done during a laparoscopy procedure, but can only target one fibroid at a time.

During a myolysis procedure, surgical needles are inserted into the womb through a small incision in the belly and the fibroids are shocked with electricity.

This makes the fibroid blood vessels tighten and shut down, cutting off the blood supply to the fibroid. This procedure can affect fertility and should not be used if you wish to become pregnant in the future.

SURGICAL PROCEDURES

Surgery is an option if all types of medication have been ineffective and your fibroid symptoms remain particularly severe. There are a number of surgical procedures to consider. Your doctor should refer you to a specialist to discuss all the options with you, including the benefits of each procedure and the associated risks.

HYSTERECTOMY

A hysterectomy is a surgical procedure that removes the entire womb (uterus).

After a hysterectomy, it is impossible to get pregnant or have periods, regardless of age. Therefore, hysterectomy is the definitive treatment for fibroids because the procedure not only eliminates existing fibroids, but also the possibility of ever having them again.

MYOMECTOMY

A myomectomy is an umbrella term for surgical procedures that remove fibroids with minimal effect on the womb or a woman’s fertility. There is however a small risk of rupture of the womb (uterus) during future pregnancies.

There are three main myomectomy procedures:

  • Abdominal
  • Hysteroscopic or vaginal
  • Laparoscopic

HYSTEROSCOPIC OR VAGINAL MYOMECTOMY

Hysteroscopic myomectomy utilises a hysteroscope, which is a viewing instrument with a camera and a light attached to it.
The hysteroscope is inserted through the cervix, the neck of the womb (uterus), to see inside of the womb.
Once the fibroids are located, another instrument called a resectoscope is used to cut fibroids into small pieces. The pieces are then removed through the cervix.

Hysteroscopic

LAPAROSCOPIC MYOMECTOMY

A laparoscopic or robotic myomectomy is used to remove subserosal or pedunculated fibroids.
During this procedure, a laparoscope and other instruments are inserted through incisions in the abdomen, and are then used to cut fibroids away from the womb (uterus) wall. It allows the uterus to be left in place.
In some cases, a robot can be used for fibroids that are more difficult to reach.
Robotic myomectomy allows many women who previously would have had a laparotomy to have a minimally invasive surgery instead.

laparoscopic

ABDOMINAL MYOMECTOMY

Abdominal myomectomies are done when fibroids grow too big or when there are too many to use other treatments.
The surgeon makes a cut on the abdomen and then on the womb to get inside it and remove the fibroids.
Once the fibroids are located, they are peeled away from the womb wall. This method causes very little bleeding or scarring.

Disclaimer

"You are now leaving www.fibroidsconnect.com". Links to all outside websites are provided as a resource to our visitors.

Gedeon Richter accepts no responsibility for the content of other websites.

Send this to friend