This article is part ofUterine Fibroids and Black Women, a destination in our Health Divide series.
Uterine fibroids are growths in the uterus that can occur in people of childbearing age.
Some procedures only take out the fibroid and leave the uterus (myomectomy).
There are also treatments that can be applied to a fibroid to shrink it.
Uterine artery embolization blocks the artery that supplies blood to a fibroid.
When its blood supply is cut off, it can no longer grow.
The most extensive surgery for fibroids is surgery to remove the uterus (hysterectomy).
Verywell Health: Why would a hysterectomy be considered when there are less invasive options available for fibroids?
There are some patients who feel the hysterectomy would be best for them.
In that case, hysterectomy is curative.
When we counsel patients who have an issue, we definitely look into what they want.
What are the outcomes that they’re looking for?
For example, fertility is one.
If a patient really desires fertility in the future then we need to be able to offer them options.
Verywell Health: What are other factors that might go into the decision to have a hysterectomy?
Dr. Shepherd:Patients may not want a procedure with a long recovery period.
A hysterectomy has a recovery time as long as 12 weeks, depending on the extent of the surgery.
Many people cannot take that long off from work or from other obligations like caring for their families.
Other treatments may have recovery times of a few days to one or two weeks.
Verywell Health: Are there different types of hysterectomy?
Many gynecologists are trained to perform laparoscopic hysterectomies with the assistance ofrobotic devicesthat they can control.
A 2014 study found that about 13% of hysterectomies were done laparoscopically.
Verywell Health: Which procedures spare the uterus?
Dr. Shepherd:A myomectomy removes only the fibroids.
The intent is to go in and take out the fibroid(s) and keep the uterus intact.
It can be done vaginally or abdominally, and can be done laparoscopically with or without robotic assistance.
Which approach to usevaginal or abdominalmight depend onwhere in the uterus the fibroids arelocated.
While the approaches are different, both can preserve the rest of the uterus.
There are other procedures that also allow a patient to keep their uterus.
For example,uterine artery embolizationblocks blood supply to the fibroid.
There are also laparoscopicradiofrequency ablationtechniques.
These sort of deactivate the fibroid tissue so that cant thrive and therefore shrinks.
Verywell Health: What are the risks of complication with these procedures?
Verywell Health: What kind of questions should patients with fibroids be asking their doctors?
Dr. Shepherd: Patients usually come in with an idea of what they want to do.
I may have a patient who says, I want a myomectomy."
What are your specific issues?
Sometimes we can actually find better options for them.
I tell them their options from the least invasive to the most invasive.
A long recovery time can be an issue for many patients.
Interview conducted byValerie DeBenedette, health writer.
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Giuliani E, As-Sanie S, Marsh EE.Epidemiology and management of uterine fibroids.Int J Gynaecol Obstet.
2013;122(2 Pt 1):233-241. doi:10.1097/AOG.0b013e318299a6cf
