Surgery

Abdominal Hysterectomy

Picture
Traditional surgery.  Uterus is removed through an incision in the abdomen.

Pros: 
  • Fibroids will not recur because the uterus is removed.

Cons: 
  • Hospital stay up to 5 days.  
  • Recovery from surgery takes 4-8 weeks.
  • Requires general anesthesia.
  • Can no longer bear children.

Vaginal  Hysterectomy

Picture
Uterus is surgically removed through the vagina.  

Pros:
  • Fibroids will not recur because the uterus is removed. No abdominal scar. 

Cons:
  • Hospital stay up to 3 days.
  • Recovery from surgery takes 3-4 weeks.
  • Requires general anesthesia.
  • Not an option for an enlarged fibroid uterus.
  • Can no longer bear children.

Laparoscopic Hysterectomy

Picture
Uterus is removed using a laparoscope, which is a tube with a lighted camera, and surgical tools inserted through several small cuts made in the belly.

Pros: 
  • Fibroids will not recur because the uterus is removed.

Cons: 
  • Hospital stay for up to 3 days.
  • Recovery from surgery takes 2-4 weeks.
  • Requires general anesthesia.
  • Not an option for an enlarged fibroid uterus.
  • Several small abdominal scars.
  • Can no longer bear children.

Robotic Hysterectomy

Picture
Similar to laparoscopic hysterectomy, except the surgeon controls the instruments using a robotic system.

Pros:
  • Fibroids will not recur because the uterus is removed.

Cons: 
  • Hospital stay for up to 3 days.
  • Recovery from surgery takes 2-4 weeks.
  • Requires general anesthesia.
  • Not an option for an enlarged fibroid uterus.
  • Several small abdominal scars.
  • Can no longer bear children.

Laparoscopic Myomectomy

Picture
Individual fibroids are removed using a laparoscope, which is a tube with a lighted camera, and surgical tools inserted through several small cuts made in the belly.

Pros
  • Childbearing is preserved.

Cons
  • Hospital stay for up to 2 days.
  • Recovery from surgery takes 2-3 weeks.
  • Requires general anesthesia.
  • Not an option for large fibroids.
  • Several small abdominal scars.
  • Fibroids can recur because the entire uterus is not removed.

Hysteroscopic Myomectomy

Picture
Individual fibroids are removed using a hysteroscope, which is a tube with a lighted camera, placed through the vagina and cervix.

Pros
  • Childbearing is preserved.
  • No abdominal scars.

Cons
  • Hospital stay for up to 2 days.
  • Recovery from surgery takes 1-2 weeks.
  • Requires general anesthesia.
  • Not an option for large fibroids.
  • Fibroids can recur because the entire uterus is not removed.

Radiofrequency Ablation (Acessa)

Individual fibroids are ablated using heat from a probe (large needle) during laparoscopic surgery.

Pros
  • Minimally invasive; 2-3 small abdominal scars.
  • No surgical incision of the uterus.
  • Recovery takes 1 week.

Cons
  • No long-term data on childbearing
  • Hospital stay for up to 2 days.
  • Requires general anesthesia.
  • Not an option for large fibroids.
  • Fibroids can recur because the entire uterus is not removed.