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Procedure
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What is it?
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Advantages
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Disadvantages
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Hysterectomy
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Surgical removal of the uterus. Expect a hospital stay and a recovery period.
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Fibroids never come back because the uterus is removed.
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Reproductive potential is lost. Other side effects possible. Recovery time is typically several weeks.
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Abdominal myomectomy
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Removal of one or more of the fibroids with open abdominal surgery.
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Preserves the uterus and cervix and allows pregnancy.
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A re-occurrence of the fibroid symptoms is possible if new fibroids grow.
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Laparoscopic or hysteroscopic myomectomy
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One or more of the fibroids are removed using laparoscopic or endoscopic techniques.
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Less invasive than open abdominal myomectomy, fibroids can be removed via abdominal endoscope or the cervix/vagina.
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Not suitable for larger, multiple, or deep fibroids.
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Hormone therapy
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GnRH drug treatment causes fibroid shrinkage.
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Non-surgical conservative method of fibroid treatment.
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Treatment is only effective for 6-12 months. Causes menopausal symptoms. May result in rapid return of symptoms after stopping treatment.
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Uterine artery embolisation
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The uterine artery is blocked with polyvinyl alcohol beads, the fibroid is starved.
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Symptom relief with shorter hospital stay than hysterectomy or myomectomy.
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Risks include premature menopause, serious infection, bleeding and occassional embolisation of structures other than the fibroid(s).
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Watchful Waiting
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No treatment. Monitoring for any progression of symptoms.
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Sometimes fibroid symptoms diminish with menopause.
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Fibroids can continue to grow with an increase in symptoms. Fibroids beyond a certain size may not be treatable with minimally invasive techniques.
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MR Guided Focused Ultrasound Surgery
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The use of focused ultrasound waves to heat and destroy fibroid tissue. MRI images are used for treatment planning and feedback.
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No surgical incision required. No radiation; quick return to normal life.
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Not suitable for persons who cannot undergo MRI scanning (due to pacemakers, aneurysm clips etc) or those with vertical abdominal scars. Reoccurrence of fibroid symptoms is possible.
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