Pros And Cons Of Surgical Interventions For Fibroids
Fibroids are a very common occurrence for women, impacting up to 80% by the time they are 50. If you want to learn more about what a fibroid is, and what types of fibroids exist, start with the first article in this series, What’s A Fibroid?
If your fibroid symptoms have gotten excruciating, and you’ve made a trip to your doctor, you’ve most likely been recommended to either take birth control, an estrogen blocker, or to have surgery.
Let’s cover the pros and cons of the third option, considering hysterectomy is the number #2 surgery (after c-sections) for women in the US. This is the most recommended surgical option for fibroids, and yet a study found that 1 in 5 women hysterectomies are unnecessary.
Here are the biggest (not all) pros & cons of each:
Major Surgeries For Fibroids
👉Hysterectomy – the most common recommendation for fibroids. In most cases, doctors recommend keeping the ovaries and just remove the uterus and fallopian tubes.
➕Pros: Fibroids will not grow back, as they have nowhere to grow.
➖Cons: Early menopause (yes, even when they leave the ovaries, there’s a twofold increased risk for ovarian failure)
📌Increases risk for osteoporosis
📌Higher risk of heart disease
📌Possible correlation with dementia
📌Possibility of nicking the bowel or bladder during surgery, known as a perforation. This may lead to an ostomy.
📌Length of recovery depends on whether surgery is laparascopic or open, and whether complications occur
📌Learn more at the Verywell Health website
👉Myomectomy – the removal of the fibroid(s) only, leaving the uterus intact.
➕Pros: Leaves the option of having children. Lessens risk of long-term brain, heart, and bone issues as compared to hysterectomy.
➖Cons:
📌Fibroids can grow back, so some women will need multiple surgeries over time
📌More complex surgery than a hysterectomy, so higher risks are associated and there’s often longer down time than with a hysterectomy
📌As with hysterectomies, there is the possibility of nicking the bowel or bladder during surgery, which may lead to an ostomy
📌Learn more at the All About Women website
Less Invasive And/Or Non-Surgical Approaches to Fibroids
👉Uterine fibroid embolization (UFE) – cuts off blood to the fibroids via particles inserted through a catheter. Fibroids shrink over the months post-UFE.
➕Pros: no surgical incision (there’s only a small incision in the skin), no general anesthesia, minimal blood loss.
➖Cons:
📌Possibly hematoma, thrombosis, or pseudo-aneurysm
📌Radiation exposure.
📌Some women are allergic to the contrast dye.
📌Particles are plastic.
📌Although studies show between 85-90% success rate, anecdotally the rate seems to fall more between 50-60%
📌Learn more at the Yale Medicine website
👉MRI-guided focused ultrasound – ultrasound beams are used to heat and destroy the fibroids.
➕Pros: Non-invasive, so no cutting, anesthesia, or downtime.
➖Cons:
📌Still considered “experimental,” so most insurances don’t cover it
📌Not an option for larger fibroids
📌Heat can damage local tissues & organs
📌Higher risk of reoccurrence of fibroids than UFE, according to Laughlin-Tommaso et al. (AJOG, 2019)
📌Learn more at the Radiology Info website
👉Sonata – uses a handpiece with a high-resolution ultrasound tip that allows the doctor to see the fibroids from inside the uterus, and then treat each fibroid with radiofrequency energy.
➕Pros: Non-invasive, so no cutting, anesthesia, or downtime.
➖Cons:
📌Not all insurances cover it
📌Should be used with caution in patients with a known nickel allergy
📌Heat can damage local tissues & organs
📌Unknown risk to future pregnancies
📌Learn more at the Sonata website
👉Acessa – uses laparoscopic radiofrequency ablation, or heat, to change the fibroid(s) from hard to soft.
➕Pros: minimally-invasive, shorter downtime than other surgeries
➖Cons:
📌Same as a hysterectomy and myomectomy, it is surgical
📌As with any reproductive surgery, infection and injury to adjacent organs is a possibility.
📌Scar tissue formation post-surgery
📌Not all insurances cover it
📌Learn more at the Acessa website
👉Endometrial ablation – for women who suffer with heavy bleeding from fibroids. It destroys a thin layer of the uterine lining.
➕Pros: No incision, performed quickly (usually 10 minutes or less), local numbing can be used, and no surgical recovery time.
➖Cons:
📌Does not get rid of fibroids
📌Fibroids in the muscle can grow larger with a burned uterine lining
📌Can only be used for small fibroids (3 cm or less)
📌Pretty high post-ablation hysterectomy rate of 19-21% with fibroids
📌Eliminates the possibility of pregnancy
📌Learn more at the Fibroid Treatment Collective
If you do decide to go the surgical route, the risk of complications is greatly diminished with the UFE, MRI-guided focused ultrasound, Sonata, and Acessa options.
Stay tuned for natural options to working with fibroids, which will be coming out later this week. In the meantime, if you missed it, you can learn what a fibroid is, the types and symptoms, as well as what causes fibroids.
If you want to know:
- Underlying causes of fibroids
- How to approach working with fibroids through gut, liver, and adrenal health
- Nutrients and other holistic therapies for fibroid growth
- How xenoestrogens may play a major role in fibroids
- Emotional and spiritual aspects of fibroids
- Which tests and methods can help you to get fibroids under control
then check out my Fibroids 101 program, which covers all this and much more. Get 20% off the program with code 20% with code “byefibroids” at checkout.
