There are several ways to treat uterine fibroids, from minimally invasive procedures that shrink fibroids to surgeries that remove the fibroids or, in some cases, the uterus itself. The right procedure depends on your symptoms, the size, number, and location of your fibroids, your overall health, and your reproductive goals.
Importantly, fibroid removal does not always require major surgery. Some treatments physically remove fibroids, while others treat them by cutting off their blood supply, causing the fibroids to shrink over time.
Receiving a fibroid diagnosis can feel overwhelming, especially when surgery such as a hysterectomy is presented as a treatment option. However, advances in fibroid care provide alternatives, including uterine fibroid embolization (UFE), a minimally invasive procedure to shrink fibroids without removing the uterus.
Does the Removal of Fibroids Always Mean Surgery?
Not every fibroid requires treatment, as some people have asymptomatic fibroids and may only need monitoring. Treatment may be appropriate when uterine fibroid symptoms interfere with life or create other health concerns.
Treatment may be considered for fibroid symptoms such as:
- Heavy or prolonged menstrual bleeding
- Anemia
- Pelvic pain or pressure
- Abdominal enlargement or bloating
- Frequent urination or bowel pressure
- Pain during sex
- Fertility or pregnancy concerns
Deciding whether to treat uterine fibroids depends on symptom severity, fibroid size and location, future pregnancy plans, and overall quality of life.
If you think you may have fibroids, a specialist can perform an evaluation and diagnose uterine fibroids before discussing appropriate treatment options.
How to Remove Fibroids Without Surgery
Fibroid removal and treatment do not always have to involve a major operation. While procedures such as myomectomy and hysterectomy require surgery, minimally invasive options can treat uterine fibroids without a large abdominal incision.
UFE is one of the most common non-surgical fibroid removal options. Rather than removing fibroids from the uterus, UFE blocks the arteries that supply them with blood. The treated fibroids gradually shrink, which reduces symptoms such as heavy bleeding, pelvic pressure, and pain.
UFE is performed through a small catheter entry point and does not require major abdominal surgery. It also preserves the uterus and can treat multiple fibroids during a single procedure, making it an option for eligible patients who want to avoid more invasive surgery.
By comparison, myomectomy physically removes fibroid tumors from the uterus, while hysterectomy removes the uterus itself. Understanding this distinction can help patients researching non-surgical fibroid treatments determine which options may align with their goals.
At What Size Should Fibroids Be Removed?
No universal fibroid size automatically requires treatment. A small fibroid in a location that affects the uterine cavity can cause significant bleeding or reproductive concerns, while some larger fibroids may cause relatively few symptoms.
Large fibroids do not automatically require a hysterectomy or another specific procedure, as decisions about the removal of large fibroid tumors depend on more than size alone. A fibroid specialist will also consider the fibroids’ location, size, and number, the patient’s medical history, and their treatment goals.
Understanding The Different Fibroid Removal Options
Fibroid treatment does not always require surgery. Depending on your symptoms, fibroid size and location, overall health, and treatment goals, a minimally invasive option such as uterine fibroid embolization (UFE) may be appropriate. Other patients may be candidates for procedures that surgically remove individual fibroids or the uterus. The main fibroid treatment options include:
- Uterine fibroid embolization (UFE): A minimally invasive, outpatient procedure that blocks the blood supply to uterine fibroids so they shrink over time.
- Myomectomy: A surgical procedure that removes individual fibroids while leaving the uterus in place.
- Hysterectomy: The surgical removal of the uterus, which permanently eliminates fibroids and the symptoms they cause.
Other treatments, such as radiofrequency ablation and focused ultrasound, may also be appropriate for some patients.
The best treatment for removing fibroids depends on your diagnosis, symptoms, and personal treatment goals.
Uterine Fibroid Embolization (UFE)
Patients looking for fibroid removal without surgery may consider uterine fibroid embolization (UFE) as an alternative. The minimally invasive procedure does not physically remove fibroids. Rather, UFE reduces the blood supply, causing them to shrink over time.
During UFE, an interventional radiologist guides a small catheter through an entry point in the wrist or upper thigh to the arteries supplying the fibroids. Tiny embolic particles are then delivered through the catheter to block the fibroids’ blood flow.
Benefits of UFE include:
- No surgical incisions or stitches
- Outpatient procedure
- Uterus preservation
- Generally shorter recovery compared with major surgery
- Relief from fibroid symptoms for many patients
- Can treat multiple fibroids during the same procedure
UFE is an FDA-approved treatment recognized by the American College of Obstetricians and Gynecologists (ACOG) for the treatment of fibroids.
Myomectomy
A myomectomy is a fibroid removal surgery that physically removes fibroids while leaving the uterus intact. The type of myomectomy method used to remove fibroids depends primarily on their size, number, and location.
- A hysteroscopic myomectomy removes certain fibroids through the vagina and cervix without an abdominal incision.
- Laparoscopic or robotic myomectomy uses several small abdominal incisions.
- An abdominal myomectomy requires a larger incision to access the uterus.
Since the uterus remains after myomectomy, new fibroids can develop later. Recovery and surgical risks vary considerably depending on which myomectomy technique is required.
Hysterectomy
Hysterectomy is a procedure involving the complete removal of the uterus. It provides a definitive treatment for uterine fibroids because fibroids cannot recur without a uterus. However, pregnancy is no longer possible after a hysterectomy.
There are two types of hysterectomy: a partial and a total hysterectomy.
- A partial hysterectomy removes the uterus while leaving the cervix.
- A total hysterectomy removes the uterus and the cervix. The ovaries may also be removed, depending on the patient’s circumstances.
Since hysterectomy is a major surgery, it involves greater recovery considerations than minimally invasive outpatient treatment. While it is the only treatment that prevents uterine fibroids from recurring, it does not preserve the uterus, so pregnancy is no longer possible.
Comparing Fibroid Removal Options
Understanding what actually happens to the fibroids can make it easier to compare uterine fibroid removal options.
| Comparison | Uterine Fibroid Embolization (UFE) | Myomectomy | Hysterectomy |
| What happens to the fibroids? | Blood flow to the fibroids is blocked, so they gradually shrink over time | Fibroids are surgically removed from the uterus | The uterus is surgically removed |
| Is the uterus preserved? | Yes | Yes | No |
| Type of procedure | Minimally invasive, non-surgical procedure | Surgery | Surgery |
| Incision | Small catheter entry point | Varies by approach; may involve no abdominal incision, small incisions, or a larger abdominal incision | Varies by surgical approach |
| Can multiple fibroids be treated? | Yes, multiple fibroids can be treated during the same procedure | Potentially, depending on the number, size, and location of the fibroids | Yes, because the uterus is removed |
| Recovery | Generally shorter than major surgery | Varies by hysteroscopic, laparoscopic, robotic, or open approach | Generally longer than minimally invasive UFE |
| Can new fibroids develop afterward? | New fibroids may develop because the uterus remains | Yes, new fibroids may develop because the uterus remains | No |
| Key considerations | Uterus-preserving option that avoids major surgery; candidacy depends on individual factors | Physically removes fibroids while preserving the uterus; surgical approach depends on fibroid characteristics | Definitive treatment for uterine fibroids but permanently removes the uterus |
How Doctors Determine the Best Uterine Fibroid Removal Option for You
There is no single most effective way to remove fibroids for every patient. Similarly, the “best” procedure depends on what needs treatment and what the patient wants to preserve.
When determining which treatment may be appropriate, doctors may consider:
- Severity and type of symptoms
- Fibroid size
- Number of fibroids
- Fibroid location
- Age and overall health
- Previous fibroid treatment
- Desire to preserve the uterus
- Future pregnancy goals
- Preferences regarding surgery and recovery
Imaging, medical history, and a specialist evaluation help determine the best options. Patients can then compare the benefits, risks, and recovery process for each treatment.
Is It Worth Getting Fibroids Removed?
Whether getting fibroids treated is worth it depends on your symptoms and how much they affect your health and quality of life. Fibroids that do not cause symptoms may not require treatment, while treatment may be worth considering when symptoms interfere with daily activities or cause other health concerns.
For patients experiencing heavy or prolonged periods, anemia, pelvic pain or pressure, frequent urination, abdominal enlargement, pain during sex, or other disruptive symptoms, treating the fibroids may provide meaningful symptom relief. Your future pregnancy goals, desire to preserve your uterus, and preferences regarding surgery and recovery can also influence whether treatment is right for you.
A fibroid specialist can evaluate your symptoms, imaging, and treatment goals and help you weigh the potential benefits and considerations of your available options.
Explore UFE as a Fibroid Removal Option Without Surgery
USA Fibroid Centers specializes in UFE for eligible patients. This minimally invasive treatment preserves the uterus, requires no major abdominal surgery, and can target multiple fibroids during a single procedure.
UFE offers an alternative for eligible patients who want to treat fibroids without undergoing major surgery. Our interventional radiologists perform the outpatient procedure using a small catheter entry point to target the blood vessels supplying the fibroids, causing them to shrink over time.
If fibroid symptoms are affecting your life, one of our expert fibroid specialists can evaluate your symptoms to determine whether UFE may be an appropriate option for your needs and treatment goals.
USA Fibroid Centers accepts most major insurance plans. Our team can help verify your insurance coverage for UFE and explain your benefits before treatment. You can also verify your insurance instantly through our online scheduling tool or by calling (855) 615-2555.
FAQs About Fibroid Removal
Can fibroids grow back after removal?
New fibroids can return after removal. Uterus-preserving treatments may remove or shrink existing fibroids, but they cannot prevent new fibroids from developing. Fibroids cannot recur after a hysterectomy because the uterus is removed.
How painful is fibroid removal?
The pain associated with fibroid removal depends on the procedure and the individual. Your care team will discuss what to expect and options for managing discomfort before and after treatment.
Can you have fibroids removed more than once?
Fibroids can be treated more than once, as the uterus remains after uterus-preserving treatments and new fibroids can develop. Discuss any new or recurring symptoms with a fibroid specialist before considering additional treatment.