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No Treatment
Minimal or no symptoms
  • Regular follow-up
  • With or without pelvic ultrasound
Medical Treatments
Heavy/painful periods

Non-hormonal

  • Tranexamix acid
  • Mefenamic acid

Hormonal

  • Combined oral contraceptives
  • Progestogens
  • IUS (Intra Uterine System)
Medical Treatments
Before surgery
  • GnRH analogues
  • Ulipristal acetate
Surgical Treatments
  • Myomectomy
  • Hysteroscopic resection
  • Endomertrial ablation
  • Hysterectomy
Radiological Treatments
  • Uterine fibroid emolisation
  • MRI guided focused ultrasound

As can be seen above there are different surgical treatments for fibroids.

The treatment that is offered depends on the size and location of the fibroids.

Fibroids that are within the cavity of the womb – sub-mucosal – may be removed through the cervix by hysteroscopic resection.

 

Hysteroscopic resection is usually performed under general anaesthetic.

The cervix is dilated and an operating telescope is inserted into the womb under direct vision. The fibroid is located and cut away in pieces and removed. If the fibroid is small then it may be removed using the Myosure device.

 

The product video animation can be viewed using the following link. https://youtu.be/WOogprU-0qM

We are pleased to be able to offer this technique.

When fibroids are larger and more within the muscle of the womb they can be resected with bipolar diathermy. 

  

This technique may be used in fibroids up to 5cms in diameter.

Bleeding may occur during the operation. Women are normally able to go home the same day. They may expect bleeding and discharge for a few weeks following the op.

Fibroids deep in the muscle of the womb and outside the womb – intramural, sub-serosal and pedunculated – may be removed by an operation called a Myomectomy.

This operation can be performed laparoscopically (key-hole surgery) in experienced hands. Only when the fibroids are very large, multiple or in a difficult location, is it necessary to perform and open operation.

Where surgery is required we are able to offer keyhole surgery of the highest possible standard thus maximizing the success of surgery and minimizing possible complications, even in fibroids up to 12cms in diameter. 

 

  

A laparoscopy is performed.

The womb is opened over the fibroid and the fibroid is then removed. The womb is stitched together and covered with a thin layer of adhesion prevention material.

The fibroid is morcellated in order to remove it. There has been recent significant concerns regarding the safety of this. Therefore to ensure the safety of morcellation we now carry this out using an intra-corporeal bag to minimise the risk of tissue contamination.

 

Christian Barnick is a consultant at OBGYN Matters and is an expert in keyhole surgery. He works privately, but, is also the lead for Laparoscopic surgery at the Homerton University Hospital NHS trust in East London. He has been managing fibroids for over 20 years. He has three operating lists every week on which he performs keyhole surgery for fibroids, endometriosis and also other benign gynaecological conditions.