Quick Facts
Which of the following is another name for fibroids?
myomas
leiomyomas
leiomyomata uteri
all of the above

Your Surgical Options

If you are considering surgery or other procedures, you may be interested to know that there are many options, depending on your individual situation. In general, fibroid surgery falls into two categories: conservative and nonconservative. Both categories are outlined here to help you have an informed discussion with your doctor. The procedure your doctor may recommend depends on the number of fibroids you have and where they are located.

Making the right decision for you

There is a lot to think about when deciding how to treat uterine fibroids. You and your doctor should consider your specific situation before taking the next step. The more knowledge and information you have, the more you can be a part of managing your condition. So be sure to talk with your doctor to learn more about these options, and to get the details of the surgery he or she recommends.

Preparing for surgery with Lupron Depot®

Your doctor may recommend Lupron Depot® along with an iron supplement for up to 3 months prior to surgery to help improve anemia that results from excessive bleeding due to fibroids. The use of Lupron Depot may reduce or stop the bleeding by decreasing your body's production of estrogen.

Learn more about Lupron Depot as a treatment before surgery.

Conservative surgery: myomectomy and myolysis

With conservative surgery only fibroids are removed, not the uterus. Common types of conservative surgery include:

Myomectomy

Myomectomy may be a good choice for women who want to keep the option of becoming pregnant and having children. There are different kinds of myomectomies.

Usually myomectomy results in diminished prolonged and profuse menstrual flow caused by fibroids in about 80% of women with that symptom. But it is important to realize that, with myomectomy, fibroids may return and need further treatment. For women with heavy periods myomectomy can result in reduced menstrual flow in up to 80% of the cases. But it is important to realize that even after this surgery, new fibroids can grow and may need further treatment. Studies have shown a wide range for such recurrence, from 8% up to 45%. In one study, about 7% of the women with recurring fibroids needed additional surgery; however, this usually occurred after more than 3 years.

Myolysis

During myolysis, surgical instruments are inserted through an incision in the abdomen (near the navel) and an electrical current is sent to the fibroid. This causes blood vessels to become very small or close down. Since blood flow to the fibroids is cut off, they eventually die and shrink.

Myolysis isn't as widely used as some other treatments, but it may prove to be an effective option for fibroids.

UFE: A non-surgical procedure:

Uterine fibroid embolization (UFE, also called uterine artery embolization, UAE) is a non-surgical procedure in which blood supply in the arteries feeding the fibroids is blocked off. Due to decreased blood supply, the fibroids shrink over time.

Generally women who want to get pregnant should not undergo UFE.

Nonconservative surgery: hysterectomy

Hysterectomy might be an option for a woman who is near the end of her reproductive years, or isn't concerned about fertility. It might also be considered if the fibroids are causing serious complications or especially uncomfortable symptoms.

Common procedures are:

Subtotal hysterectomy

With a subtotal hysterectomy the uterus is removed and possibly the fallopian tubes and ovaries as well. Pelvic structural ligaments and the cervix are left intact. This surgery is performed through the abdomen.

Total hysterectomy

With a total hysterectomy the entire uterus and cervix are removed, and sometimes the ovaries are also removed. This procedure may be done through the vagina (vaginal hysterectomy) or the abdomen.

It is important to understand that a hysterectomy is a permanent procedure that causes a woman to lose the ability to bear children, and she will no longer menstruate. Also, if a woman hasn't gone through menopause, and her ovaries are removed in addition to the uterus, her risk of osteoporosis and heart disease increase.

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Other Important Information:

Lupron Depot® (3.75 mg and - 3 Month 11.25 mg), in combination with iron, is used for the preoperative treatment of anemia associated with uterine fibroids. Most common side effects with Lupron Depot are generally those related to low estrogen levels, including hot flashes, headaches, and vaginal dryness. A small amount of bone loss (average 2.7% at month three) may also occur during therapy.

For further information about Lupron Depot, please see the complete Prescribing Information, as well as the Patient Product Information.