Treating Uterine Fibroids Without Surgery

Dr. Paul MacKoul, MD
3 min readJul 24, 2023

Uterine fibroids, also known as leiomyomas, are non-cancerous growths that develop in the uterus during a woman’s childbearing years. While these benign tumors often do not cause noticeable symptoms, some women experience discomfort, heavy menstrual bleeding, and pelvic pain, affecting their quality of life. Traditionally, surgical interventions like hysterectomy or myomectomy were the primary treatment options for uterine fibroids. However, advancements in medical technology have brought forth alternative non-surgical treatments that can effectively manage fibroids without the need for invasive procedures. In this article, we explore some of the innovative methods for treating uterine fibroids without resorting to surgery.

Ultrasound-Guided High-Intensity Focused Ultrasound (HIFU)

HIFU is a non-invasive treatment that utilizes focused ultrasound waves to destroy fibroid tissues while sparing the surrounding healthy tissue. In this procedure, a special device emits high-frequency sound waves that generate intense heat at the targeted fibroid, causing coagulation and necrosis. The procedure is performed under real-time ultrasound guidance, ensuring precision and safety. One of the significant advantages of HIFU is that it allows patients to resume their normal activities shortly after the treatment, with minimal downtime.

Magnetic Resonance Imaging-Guided Focused Ultrasound (MRgFUS)

Similar to HIFU, MRgFUS uses ultrasound waves to treat uterine fibroids. The key difference lies in the guidance system. MRgFUS employs magnetic resonance imaging (MRI) to visualize and monitor the fibroid in real-time during the treatment. This technology provides enhanced accuracy, enabling doctors to precisely target the fibroid while preserving nearby organs and tissues. MRgFUS is a non-invasive outpatient procedure that typically requires no general anesthesia, making it a safer and more convenient option for many women.

Uterine Artery Embolization (UAE)

UAE is a minimally invasive procedure performed by an interventional radiologist. During the procedure, tiny particles are injected into the uterine arteries that supply blood to the fibroids, leading to their blockage. With reduced blood flow, the fibroids shrink, alleviating symptoms over time. UAE is an effective method to manage fibroids while preserving the uterus, making it an appealing choice for women who wish to retain their fertility or avoid major surgery.

Radiofrequency Ablation (RFA)

Radiofrequency ablation is a technique that uses electrical energy to destroy fibroid tissues. During the procedure, a thin, needle-like probe is inserted into the fibroid through the skin. The probe emits radiofrequency energy, heating and ablating the fibroid cells. RFA is a minimally invasive procedure that can be performed on an outpatient basis. Patients experience less pain and have a quicker recovery period compared to surgery.

Hormonal Therapies

Hormonal therapies do not eliminate fibroids entirely but can help manage symptoms associated with fibroids, such as heavy menstrual bleeding and pelvic pain. Options include oral contraceptives, progestin-releasing intrauterine devices (IUDs), and GnRH agonists. These treatments work by regulating hormone levels and temporarily shrinking fibroids. While hormonal therapies are effective in providing relief, their effects are reversible, and fibroids may regrow once treatment is stopped.

High-Intensity Focused Ultrasound (HIFU)

Another application of HIFU is to treat fibroids by directly inserting a HIFU probe into the uterus under general anesthesia. This targeted approach allows for more precise treatment of fibroids that are challenging to reach using external HIFU methods. The procedure is typically performed as a day surgery, and patients experience reduced recovery time compared to traditional surgery.

As medical technology continues to advance, non-surgical treatment options for uterine fibroids are becoming increasingly accessible and effective. From ultrasound-guided therapies to hormonal treatments, women now have a range of choices to manage their fibroid symptoms without undergoing invasive surgery. It is essential for women experiencing fibroid-related issues to consult with their healthcare providers to determine the most suitable treatment plan based on their individual medical history and future reproductive goals. With non-surgical alternatives, women can find relief from fibroid symptoms and maintain their overall well-being without resorting to major surgery.

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Dr. Paul MacKoul, MD

Dr. Paul MacKoul, MD is an innovative and compassionate healthcare professional who puts patient needs first.