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Surgical vs
Non-Surgical Fibroid Treatment

Which Is Better For Me?

When it comes to fibroid treatment, we believe that less is more. A less invasive fibroid procedure means less trauma, less risk, and shorter recovery time. Our Fibroid Specialists explain why we opt for UFE, the least invasive treatment for uterine fibroids.

Woman discussing surgical vs. non-surgical fibroid treatment options with Fibroid Specialist

Clinical studies have repeatedly shown that surgical and non-surgical fibroid treatment approaches are equally effective when it comes to fibroid symptom relief [1]. However, these treatments differ significantly when it comes to patient experience and longer-term health considerations. When we consult with patients about their options, we tend to focus on these differences:

• Invasiveness – how much trauma is involved in the procedure?
• Hospital Stay – how many nights will I be hospitalized after the procedure?
• Recovery Time – how long until I can return to my daily activities?
• Safety – what side effects and complications can occur?
• Pregnancy – am I able to become pregnant afterwards?
• Fibroid Recurrence – will the fibroids come back?
• Reintervention – will I need another procedure for my fibroids in the future?

Throughout this review, we cover each of these decision points and provide more detail on how surgical and non-surgical treatment options compare. This review is based on the highest quality clinical data available at the time of writing this, but does not necessarily describe every individual’s experience with these therapies.

Non-Surgical Fibroid Treatment Specialist Dr. Michael Lalezarian in Los Angeles, California

Fibroid Care
Focused On You

At ProFibroidMD, we believe that your fibroid treatment plan should work for you without compromise. You can live a life free of pain and heavy bleeding, you can keep your uterus, and you can get back to your normal life faster. Dr. Michael Lalezarian is a double-board certified, fellowship-trained physician in Los Angeles that specializes in minimally invasive treatment for uterine fibroids. Where other doctors might hastily push you into an irreversible surgery, Dr. L takes the time to understand your unique needs and what treatment makes the most sense for you.
Non-Surgical Fibroid Treatment 5-Star Rating
“He is truly dedicated, and an extraordinary physician who’s really concerned with his patients!” Adrianne S, October 2018

Surgical & Non-Surgical Fibroid Treatments Explained

Surgical Hysterectomy

Hysterectomy is a major surgical procedure most-commonly performed by a gynecologist or a general surgeon in a hospital setting. The goal of the procedure is to partially or completely remove the uterus. By removing the uterus, fibroids within the uterus are also removed. Visit our hysterectomy page to learn more.

Surgical Myomectomy

Myomectomy is another major surgical procedure, but instead of completely removing the uterus, a gynecologist or surgeon selectively cuts out the fibroids while preserving the rest of the uterus. Visit our myomectomy page to learn more.

Non-Surgical Uterine Fibroid Embolization (UFE)

Uterine fibroid embolization (UFE) is a non-surgical, minimally invasive treatment. Rather than cutting into the uterus to remove the fibroids, micro sized beads are injected into the arteries that feed the fibroids. When injected, the beads block blood flow to the fibroids, causing the fibroids to ‘starve’ and shrink. Uterine fibroid embolization is usually performed by a Vascular and Interventional Radiologist (IR) that specializes in vascular anatomy and minimally-invasive, image-guided procedures.
Scar on stomach after surgical fibroid treatment

Scar from invasive surgical hysterectomy.

Invasiveness

A medical procedure’s invasiveness describes the level of trauma that’s associated with the procedure. A procedure is more invasive when it involves larger incisions, more cutting to access the surgical target, or the insertion of larger medical instruments into the body. Generally, the more invasive that a procedure is, the greater the risk of major complications. Another rule of thumb is that more invasive procedures typically require a longer recovery period before patients can resume their normal activities. A major surgery like hysterectomy is highly invasive as it requires incisions to access the uterus and extensive cutting to remove it. Myomectomy is equally invasive, even though the uterus is left intact. Up to 15% of patients that undergo hysterectomy [2] and nearly 5% of patients that undergo myomectomy [3] require a blood transfusion to replenish blood that’s lost during the procedure, which is not ideal, and speaks to the level of trauma involved. In stark contrast to its surgical counterparts, UFE, is a non-surgical, minimally invasive, image guided procedure. The procedure is performed through a single puncture in the leg with no major incisions and no cutting, making it the least invasive option available for fibroids.
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Hospital Stay

Most patients (and physicians) would agree that it’s ideal to spend as little time in the hospital as possible, both for patient comfort and for financial reasons. While the exact length of an inpatient surgery stay depends on the surgical technique used, surgical fibroid treatments require at least 1 to 3 nights in the hospital to ensure a safe recovery. Non-surgical uterine fibroid embolization, on the other hand, does not require a hospital stay and many UFE patients are able to return home just a few hours after their procedure. Some doctors do like to keep their UFE patients in the hospital for one night to observe recovery and ensure that patients are comfortable after the procedure.
Woman lying in hospital bed recovering from surgical fibroid treatment

Recovery Time

The recovery time of a procedure is a measure of how long it takes for patients to return to normal activities like work and exercise. Recovery time varies widely from patient to patient, but we can get a general idea of the typical recovery period by looking at clinical studies. Recovery time after surgical hysterectomy or myomectomy can take anywhere from 2 to 6 weeks, with most patients requiring 3 to 5 weeks before they’re able to resume normal activities. According to the same clinical studies, non-surgical UFE requires 1 to 2 weeks of recovery time in most cases [1]. This difference is significant, and is directly related to the amount of healing that’s required with a major surgery versus a non-surgical, minimally invasive procedure.
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Side Effects & Complications

As important as it is to understand the benefits of a treatment, it’s equally important to understand the ‘safety profile’ of it as well. We can think about safety in terms of side effects and complications. Side effects describe unintended negative interactions between the treatment and the body. Complications, on the other hand, describe things that can go wrong during a procedure that cause some degree of harm to the patient. Side effects and complications can be divided into minor and major categories. Generally, minor side effects are those that are tolerated well enough without additional medical intervention, whereas major side effects may require medical attention to resolve or result in significant patient morbidity. Data from clinical studies suggests that major side effects and complications are more common in patients that undergo surgical hysterectomy or myomectomy than patients that undergo non-surgical UFE. On the other hand, minor side effects and complications are more common with UFE [1].
Woman consulting with physician on surgical vs. non-surgical fibroid treatment options

Pregnancy

Many women learn about their fibroids in the middle of their childbearing years, and rightfully so, are concerned about the impact of fibroids and fibroid treatment on their ability to become pregnant. By removing the uterus, hysterectomy removes the womb permanently, eliminating any possibility of pregnancy afterwards. On the other hand, UFE and myomectomy are uterus-sparing procedures, meaning that women still have a chance of getting pregnant afterwards. While it has been studied to some degree [4], it’s unknown which of the two treatments (UFE or myomectomy) is more likely to result in full-term pregnancy. The impact of UFE versus myomectomy on the health of the uterus has been hotly debated for the last two decades, especially as it pertains to bearing children [4]. While fertility is by no means guaranteed after UFE or myomectomy, women should be optimistic about the fact that there have been several reports of healthy, full-term pregnancies after either of these procedures [2].

Fibroid Recurrence

In medicine, the term “recurrence” describes the return of a symptom or a disease after previous treatment. Hysterectomy is the only treatment option that ‘cures’ fibroids and eliminates any chance of fibroid recurrence If the uterus is not removed, as is the case with UFE or myomectomy, new fibroids can develop or existing fibroids can grow back again. Evidence suggests that women who receive UFE or myomectomy procedures have an equal chance of dealing with recurrent fibroids. One clinical study that followed women for multiple years after treatment observed that women who undergo myomectomy or UFE have roughly a 10% chance of dealing with recurrent fibroids within 2 years of their first treatment [3].

Reintervention

While a permanent solution is ideal, a small percentage of women that undergo fibroid treatment will later require a reintervention. A reintervention is a follow-up procedure to address recurrence or correct for a previously failed procedure. The follow-up procedure depends on the patient’s condition and preference. After surgical myomectomy, women have about a 7% to 8% chance of undergoing a follow-up procedure within 2 years, and more recently, researchers have estimated that the risk of reintervention after myomectomy is 19% after 5 years. Reintervention rates after non-surgical UFE are only slightly higher: around 12% at 2 years and 24% at 5 years [5,6]. Even with the finality of hysterectomy, patients may have a follow-up to procedure to correct persistent abdominal pain, hernia, or prolapse. Clinical studies show that about 7% of hysterectomy patients will have a follow-up procedure within 2 years, with as many as 16% at 10 years [5,6].
Get Relief From Fibroids
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More Resources
Fibroid Symptoms: What's Normal, What's Not?
Fibroid Symptoms: What’s Normal, What’s Not?

Uterine fibroids can cause heavy bleeding, pelvic pain, weight gain, and pregnancy challenges. Our Fibroid Specialists go in-depth on the common and the not-so-common symptoms of uterine fibroids.

Uterine artery embolization
Uterine Artery Embolization
Uterine artery embolization is a minimally-invasive procedure that we offer at ProFibroidMD to relieve heavy bleeding, pain, and other symptoms in patients with uterine fibroids. Learn more about our specialty procedure.
Fibroid Specialist in Los Angeles
Fibroid Specialist in Los Angeles
Learn more about Los Angeles Fibroid Specialist Dr. Michael Lalezarian.
References [1] Gupta et al. (2014). Uterine artery embolization for symptomatic uterine fibroids (Review). Cochrane Library, (5). [2] de Bruijn, A. M., Ankum, W. M., Reekers, J. A., Birnie, E., van der Kooij, S. M., Volkers, N. A., & Hehenkamp, W. J. K. (2016). Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids: 10-year outcomes from the randomized EMMY trial. American Journal of Obstetrics and Gynecology, 215(6), 745.e1-745.e12. [3] Mara, M., Maskova, J., Fucikova, Z., Kuzel, D., Belsan, T., & Sosna, O. (2008). Midterm clinical and first reproductive results of a randomized controlled trial comparing uterine fibroid embolization and myomectomy. CardioVascular and Interventional Radiology, 31(1), 73–85. [4] McLucas, B., Voorhees, W. D., & Elliott, S. (2016). Fertility after uterine artery embolization: A review. Minimally Invasive Therapy and Allied Technologies, 25(1), 1–7. [5] de Bruijn, A. M., Ankum, W. M., Reekers, J. A., Birnie, E., van der Kooij, S. M., Volkers, N. A., & Hehenkamp, W. J. K. (2016). Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids: 10-year outcomes from the randomized EMMY trial. American Journal of Obstetrics and Gynecology, 215(6), 745.e1-745.e12. [6] Davis, M. R., Soliman, A. M., Castelli-Haley, J., Snabes, M. C., & Surrey, E. S. (2018). Reintervention Rates After Myomectomy, Endometrial Ablation, and Uterine Artery Embolization for Patients with Uterine Fibroids. Journal of Women’s Health (2002), 27(10).

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