NYU Langone gynecologists, including the team at the Center for Fibroid Care, offer several nonsurgical treatment options that shrink fibroids without removing them. This reduces or eliminates symptoms, including heavy and painful periods, without the need for surgery.
Our nonsurgical treatment options include transcervical radiofrequency ablation, endometrial ablation, and uterine fibroid embolization. Because some procedures can affect fertility, it is important to discuss your future pregnancy plans with your doctor to help determine which nonsurgical or surgical treatment is the best option.
Transcervical radiofrequency ablation, known by the brand name Sonata, is an incision-free procedure used to shrink fibroids and lessen symptoms. During treatment, an instrument with a tip that can emit ultrasound waves and radiofrequency energy is passed through the vagina and cervix into the uterus. Ultrasound waves are used to locate the tumors, and radiofrequency energy is used to shrink the fibroids. This procedure is most effective for people who have a few fibroids up to 5cm with symptomatic bleeding. Patients can get pregnant post-procedure, but more clinical data is needed. Your doctor discusses therapies that reduce discomfort during the procedure, such as sedation and different forms of anesthesia.
During endometrial ablation, also known as NovaSure, heat energy is used to remove the lining of the uterus, which is the source of the heavy menstrual bleeding that accompanies fibroids.
The procedure, which takes less than five minutes, starts with your doctor placing an ablation device through the vagina and into the uterus. The device expands to the shape of the uterus and then delivers heat energy that causes the endometrium to break down. The best candidates for this procedure are those who are not interested in becoming pregnant in the future, and those with medical conditions that may increase the risk of surgical complications.
After the procedure, some women experience a watery or slightly bloody discharge. These problems typically last one to two weeks. Endometrial ablation may be done on an outpatient basis using a local anesthesia.
Your doctor may recommend a type of minimally invasive procedure called embolization to treat fibroids. This nonsurgical procedure is often performed on an outpatient basis by an interventional radiologist.
Uterine fibroid embolization works by cutting off the blood supply to the fibroids, causing them to shrink. During the procedure, your doctor inserts a small tube called a catheter into an artery in the wrist or groin, and then threads it to the blood vessels that supply the fibroids. The doctor then injects small particles into the vessels. This blocks the blood supply, causing the fibroids to shrink.
Uterine fibroid embolization is performed with sedation and a local anesthetic. In most cases, a hospital stay is not required, and you go home immediately after recovering from the procedure. Pelvic cramping may occur for up to 24 hours. Light activity may be resumed in a few days, with a return to normal activity within 5 to 10 days. Your doctor prescribes pain medication as needed.
Uterine fibroid embolization is safe and effective for multiple fibroids or very large fibroids.
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