“WHAT IS THE ANSWER TO MY UTERINE FIBROID QUESTION?”  A PATIENT ASKS HER INTERVENTIONAL RADIOLOGIST AND GYNECOLOGIST

NOTE:  This is general information.  Each case must be evaluated on an individual basis as to which procedure holds the most benefits and risks, advantages and disadvantages.  The recovery period may vary depending on the woman's medical situation.  Refer to: Diagnosing Uterine Fibroid Tumors.

“Uterine Fibroid photos used by permission of John P.A. George, MD - www.lapscope.com.”

Recovery is defined as the time until the patient can return to most normal activity. 

Hysterectomy – is the removal of the uterus.  A surgical procedure for the treatment of uterine fibroids.  Hysterectomy is the only procedure that cures fibroids in every patient.  Recovery period 4 - 8 weeks.  –  Paul Indman, M.D. and Robert Worthington-Kirsch, M.D.

Total Hysterectomy - (sometimes called “simple hysterectomy”)- The uterus (with the cervix) is removed.  Tubes and ovaries may or may not be removed.

Total Hysterectomy with bilateral salpingo-oophorectomy – The entire uterus, fallopian tubes, and ovaries are removed.

Supra-cervical Hysterectomy –  The part of the uterus above the cervix is removed.  Tubes and ovaries may or may not be removed.

Partial (Subtotal) Hysterectomy – This is another term for supra-cervical hysterectomy.

Vaginal Hysterectomy- The uterus is removed through the vagina, so an abdominal incision is not required.  It may not be possible to do this with a very large uterus, or if there is other disease in the pelvis that needs to be treated.   The cervix is removed during a vaginal hysterectomy.

Laparoscopic Hysterectomy – A small telescope (laparoscope) is placed through the belly button, and several other tiny incisions are made to place other instruments.  These instruments are used to free the uterus.  It is possible to leave in the cervix (laparoscopic supra-cervical hysterectomy), or the cervix can be removed.  The removal of tubes and ovaries is optional.  If part of the surgery is done through the laparoscope and some through the vagina, the procedure is called a Laparoscopic Assisted Vaginal Hysterectomy (LAVH). 

Radical Hysterectomy – This procedure is usually used for cervical cancer.  The doctor removes the cervix, uterus, both fallopian tubes, and both ovaries.  It may entail removing varying amounts of the surrounding tissues to ensure that as much of the cancer is removed as possible. The surgical method may also be different. It would be very unusual to have a Radical Hysterectomy performed on someone with fibroids.  

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Abdominal Myomectomy (laparotomy)– a surgical procedure to cut fibroids out of the wall of the uterus. This is the procedure that is usually chosen by women who want to preserve fertility and/or preserve their uterus.

The major drawback to the procedure is that the fibroids may come back. (Recurrence rates vary tremendously, but average 20%.  Young women and women with many myomas have a greater risk of recurrence than older women or women with just a few fibroids. - Paul Indman, M.D.)     Recovery period 4 - 6 weeks. 

Laparoscopic Myomectomy – A procedure where a doctor inserts a small device, laparoscope, through an incision in the abdomen to remove the uterine fibroids.  Recovery period 1 - 3 weeks.

“Uterine Fibroid photos used by permission of John P.A. George, MD - www.lapscope.com.” 

Hysteroscopic Myomectomy – A small device, hysteroscope, is inserted through the vagina and into the uterus to remove uterine fibroids.  (The recovery period could be as little as a few days for this procedure. - Paul Indman, M.D.)  Hysteroscopic resection:   Recovery period 1 - 3 days.

Refer to Paul Indman, M.D. web site:
Abdominal Myomectomy
Laparoscopic Myomectomy
Hysteroscopic Myomectomy

Refer to William Parker, M.D. web site:
Abdominal and Laparoscopic Myomectomy
Hysteroscopic Myomectomy

Refer to Myomectomy Comment Section

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da Vinci Robotic Surgery - Myomectomy and Hysterectomy
Refer to FAQs.

Treatment Guide continued on Page 2:  Myolysis, Endometrial Ablation, Uterine Artery Embolization UAE/UFE, Medical Therapy, Watchful Waiting