Fibroma surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maneesha Nandimandalam, M.B.B.S.[2]

Overview

Benign fibromas can be removed or left alone. A physician should examine the fibroma and determine whether it may be malignant. If there is any question as to whether it may be cancer-related, it should be removed. This is usually a brief outpatient procedure. For most fibromas the definitive treatment is complete excision.

Surgery

Benign fibromas can be removed or left alone. A physician should examine the fibroma and determine whether it may be malignant. If there is any question as to whether it may be cancer-related, it should be removed. This is usually a brief outpatient procedure. For most fibromas the definitive treatment is complete excision.

Uterine fibroma

Fibroids are removed by the following procedures

Hysterectomy

• The standard treatment for uterine fibroids include uterus resection (hysterectomy) either transabdominal or transvaginal and sometimes even resection of the ovaries.
• For young women who wish to preserve their fertility, hysterectomy is not a desirable therapeutical option.
• Furthermore it has lots of risks and complications like:
  • Postoperative bleeding
  • Hectic syndrome
  • Low sexual desire
  • Depression
  • High risk of cardiovascular illness

Segmentary myomectomy

• It is a conservative surgical procedure that consists of resecting the tumor, with the preservation of uterus and, therefore the reproductive function.
• It is also associated with increased blood loss, pain and prolonged operative time.

Uterine artery embolization

• Bilateral uterine artery embolisation is used as an alternative approach to surgery.
• Embolisation of uterine arteries causes lack of blood supply(devascularisation) of all fibroma structures in the uterus.
• The normal uterine elements remain unaffected, while the fibroma suffers an ischemia, necrosis.
• Young females with multiple fibromas who wish to have children are the appropriate ones for embolization, also patients with symptomatic uterine fibroma who refuse to have a hysterectomy, blood transfusion, or general anesthesia
• The embolisation performed a few days before surgery has numerous advantages:
  • Less surgery bleeding, as a result eliminates the necessity for blood transfusion
  • Reduces the duration of the surgery
  • It allows resection of very large fibromas or of those inaccessible areas (the posterior side of the uterus, the inferior side close to the cervix)
  • Eliminates the risk of relapse

Grigoriu C, Dumitrascu M, Grigoras M, et al. Combined endovascular and surgical therapy of uterine fibroma. J Med Life. 2008;1(1):60–65.,https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5607786/

Contraindications

There are no contraindications for surgery of uterine fibroma