ablation or hysterectomy for fibroid removal

I have a small fibroid, 2 cm, but it is causing bleeding to the point of anemia. Dr. said it needs to be surgically removed via ablation or hysterectomy. My questions are these:

1) I am reading about non-surgical options but none were offered-- can anyone tell me if they have had success with any non-surgical fibroid treatments; and

2) I have read horror stories from women who have had ablations and ended up in pain and then had hysterectomies anyway-- is an ablation just buying time? Has anyone had a good experience with an ablation?

3) Can anyone else share with me how their fibroid was removed and tell me your experience?

Thank you all! I go back to consult with a surgeon on 1/31/17

What type of fibroid do you have? What type of surgical removal is being recommended? The treatment is different based on the location of the fibroid.

For example, is your fibroid intramural, pedunculated, subserosal, or submucosal? Is your doctor recommending a hysteroscopic myomectomy or laparoscopic myomectomy?

In 2005 (age 35) I had heavy periods, plus a pedunculated fibroid and submucosal removed via outpatient/sedated hysteroscopic myomectomy. Very easy, in and out ... not really "surgery" since the only incision was made in my uterus (through vagina ... not through my abdomen).

I didn't have any other fibroid issues for about 5 years.

When I really started to have issues in 2010, new intramural fibroids had grown and I subsequently had UFE/UAE and surgical laparoscopic DaVinci myomectomy (general anesthesia).

No doctor over the years ever recommended ablation for me when we discussed it, as it would not resolve the fibroids at all. It just burns the lining of your uterus and in some cases can reduce your periods. I haven't heard of anyone having a good result from ablation, but this web site would be the place to look for a success story.

If you have a pedunculated or submucosal fibroid, then probably the best thing is a hysteroscopic myomectomy. If you continued to have heavy bleeding after that, then you could consider ablation. To me, it's always good to do the least amount possible and see what happens... but that's me.

If your doctor is recommending a laparoscopic myomectomy for intramural fibroid, you could ask if you're a candidate for UAE/UFE. It is minimally invasive, fast recovery, and shrinks the fibroids over time. For me and most women, it also resolves the heavy bleeding. This is performed by an interventional radiologist, not a gynecologist. Sometimes gyns don't mention it because they don't perform it (and thus, they recommend only what they do and what generates income for them).

Good luck - get second opinions and let us know what you decide!

Playacalor,

Thanks! I have no idea what kind it is because I did not know enough about fibroids to even ask questions. I have had a very light, 2 day period for a couple years and then the last few months it was heavier and came almost every other week and then, finally, would not stop bleeding and I became sick.

The only options she mentioned were ablasion or hysterectomy, which is part of my confusion-- there seem to be so many other options. And maybe I misheard "ablasion" instead of "embolization"? That seems like it makes more sense and I was so lightheaded and tired by the time I got to see a dr.

I am making a list of questions to ask the surgeon when I go back in 2 weeks. I will definitely ask about the myomectomy! Thank you!

Ablation is usually not a good choice with fibroids because the excess blood has nowhere to go but to the fibroid and they will grow huge.

Embolization will shrink your fibroids to virtually nothing due to their size. Mine has shrunk to virtually nothing and it was 4 times bigger than yours.

The best advice I can offer is to treat them now. Don't let them get bigger buying into the stupid watch and wait philosophy. They will only increase in size and bulk.

I suggest embolization because it is the least invasive and most effective. A hysterectomy for a 2 cm fibroid is over diagnosis, pure and simple. In the age of modern gynecology this is an indicator to get a more progressive doctor.

	Quote:
Originally Posted by kateky Playacalor, Thanks! I have no idea what kind it is because I did not know enough about fibroids to even ask questions. I have had a very light, 2 day period for a couple years and then the last few months it was heavier and came almost every other week and then, finally, would not stop bleeding and I became sick. The only options she mentioned were ablasion or hysterectomy, which is part of my confusion-- there seem to be so many other options. And maybe I misheard "ablasion" instead of "embolization"? That seems like it makes more sense and I was so lightheaded and tired by the time I got to see a dr. I am making a list of questions to ask the surgeon when I go back in 2 weeks. I will definitely ask about the myomectomy! Thank you!

I have 3 fibroids, each are approximately 3 cm in size. 1 is submucosal and is in the middle of my uterus. 1 is intramural and 1 is subserosal. My uterus is enlarged and I was told my endometrial cavity could not clearly be seen.

My fibroids cause me to have heavy bleeding resulting in anemia, exhaustion, unbearable menstrual cramps, frequent urination, constipation, and long periods (every 3 weeks for 9 days). My doctor told me given my age (35) an ablation will more than likely result in a hysterectomy later down the line. She recommended getting the hysterectomy now and keeping my ovaries to keep me from having 2 procedures for the same issue.

Let me add that I have 2 children, I've tried birth control pills, I've tried an IUD and I've tried hormone therapy. Neither helped my issues caused by these fibroids.

sisterduke... great advice as always!

kateky ... hopefully this site will help you have a better conversation with your doctor - definitely take notes or even record the conversation so you can process the info later. Never hesitate to get a second opinion!

Rhitch ... why not ask about alternatives to hysterectomy? Your size/location of fibroids would probably make you a good candidate for myomectomy or UAE. Of course, hysterectomy is the ultimate solution. Only you can decide if you want to try and save your uterus or not. Reading on this site should help you ... and be sure to read the threads re Pre and Post Hysterectomy so you can see what other people are talking about who already made the decision to have a hysterectomy and how they are doing. Good luck!

Thank you all! I am going to ask if myomectomy is an option. I already had a tubal and do not want more children, but I would still like to keep my uterus if possible for hormonal reasons. Plus, I am also trying to weigh in the logistics as far as costs and time off, etc.

This pretty much sucks all the way around.

Kateky - Definitely get a second opinion if your doctor is resistant to treatments other than hysterectomy. For your size fibroids and symptoms, like sisterduke said.. that's crazy over-diagnosis to recommend a hyst.

My guess is that the doc is recommending hyst because you already had a tubal so therefore (in old school thinking) you don't "need" your uterus, plus it's the ultimate solution. However, so many women have great permanent results from UAE or myomectomy that at least you should carefully consider both options. Good luck!!!

Playacalor,

Thank you for your comments and support! We are of the same mindset.