Hysterectomy (partial or full surgical removal of the uterus) is a common procedure in the United States. The most frequent reason for hysterectomy is to remove fibroid tumors, which account for 30 percent of all hysterectomies. A partial hysterectomy is the preferable procedure because it removes the least amount of tissue (i.e., the opening to the cervix is left in place).
Alternatives to hysterectomy include:
Fibroid embolization is a less-invasive procedure in which blood vessels that feed the fibroids are blocked, causing the growths to shrink. The blood vessels are accessed via a catheter inserted into the femoral artery (in the upper thigh) and injected with tiny particles that block the flow of blood. The fibroids subsequently decrease in size and the patient's symptoms improve.
Myomectomy refers to the surgical removal of uterine fibroids, also known as myomas. In contrast to a hysterectomy, the uterus remains preserved and the woman retains the ability to have children in the future.
A myomectomy can be performed in a number of ways, depending on the location and number of lesions and the experience of the surgeon. Typically a myomectomy is performed via a laparotomy, using small, specialized equipment that can help the surgeon visualize the inside of the body without making large incisions.
Some fibroids may be accessible via hysteroscopic removal. A hysteroscope (a viewing instrument inserted through the vagina for a visual examination of the canal of the cervix and the interior of the uterus) can transmit an image of the uterine canal and cavity to a television screen.
The hysteroscope equipment used by gynecologists are so thin that they can fit through the cervix with minimal or no dilation. Hysteroscopy often can be performed in an office setting, though more complex hysteroscopy procedures are done in an operating room setting.