Treatment of uterine fibroids: drugs, hormones, surgery, laparoscopy

In the case of small fibroids that do not grow further and do not cause further health problems, the patient is regularly monitored by a gynaecologist. If necessary, her lifestyle is adjusted.

In some cases, the patient is given hormonal pharmacological treatment, which is used to eliminate unwanted symptoms (pain, bleeding) and to influence and limit the growth of fibroids.

However, the decision on conservative treatment depends on the examining physician. The physician must weigh all the risks, even taking into account the patient's planned pregnancy.

In case of large, numerous or risky uterine muscle growth, hysteroscopy may be recommended. Hysteroscopy is both a diagnostic and surgical examination.

It involves the insertion of a hysteroscope (a small camera and surgical instrument) through the woman's vaginal opening and the subsequent removal of the uterine fibroid. The fibroid may still reappear after surgery.

It should be noted that after a myoectomy (removal of fibroids) a certain amount of uterine wall tissue is removed.

After a myomectomy in which a large amount of tissue has been removed, a woman may give birth by caesarean section in the future. There is an increased risk of uterine wall damage during vaginal delivery.

In addition to the hysteroscope, myoectomy can also be performed laparoscopically by entering through the abdominal wall.

In some advanced cases, a hysterectomy - surgical removal of the uterus - may be indicated. This is a surgical procedure performed laparoscopically through the abdominal wall or vaginally through the vaginal entrance.

Hysterectomy may be indicated in the case of multiple myoectomies or in the case of high-risk myomas and other non-individual medical complications.

Theavailability of modern surgical, radiological and pharmacological forms of treatment increasingly allows a woman to avoid hysterectomy.