When a woman faces a medical condition that affects her uterus, the hollow, muscular organ that holds and feeds a fertilized egg, the emotional impact can often be as challenging as the physical. These conditions include, but are not limited to, cervical and uterine cancers such as endometrial cancer, uterine fibroids, uterine prolapse, excessive bleeding and endometriosis.

Treatment options are as varied as the conditions themselves, depending on individual circumstances. A woman’s age, health history, surgical history and diagnosis (benign or cancerous), all factor into the recommended course of action. 

Endometriosis, also known as endometrial hyperplasia, is a condition in which the endometrial tissue grows outside the uterus, causing scarring, pain, and heavy bleeding. It can often damaging the fallopian tubes and ovaries in the process. A common organic cause of infertility, endometriosis can be treated with medications such as lupron for endometriosis that lowers hormone levels and decreases endometrial growths. While such medications often relieve associated symptoms, a patient should understand the potential side effects before pursuing this treatment regimen.

For endometrial cancer, also known as uterine cancer and more common among women after menopause, standard treatment options include hormone therapy, radiation therapy, chemotherapy and hysterectomy (surgical removal of the uterus). Three of these—radiation therapy, chemotherapy and hysterectomy—are also used to treat cervical cancer.

For benign (non-cancerous) conditions like menorrhagia (heavy menstrual bleeding), non-surgical treatments like hormone therapy or minimally invasive ablative therapies may offer relief. For fibroids, uterine-preserving myomectomy—a surgical alternative to hysterectomy—may be an option.

Uterine fibroids* are benign (non-cancerous) tumors occurring in at least one quarter of all women.¹ They can grow underneath the uterine lining, inside the uterine wall, or outside the uterus.

Many women don’t feel any symptoms with uterine tumors or fibroids. But for others, these fibroids can cause excessive menstrual bleeding (also called menorrhagia), abnormal periods, uterine bleeding, pain, discomfort, frequent urination and infertility.²

Treatments include uterine fibroid embolization—which shrinks the tumor—and surgery. Surgical treatment for uterine tumors most often involves the surgeon removing the entire uterus, via hysterectomy.³

While hysterectomy is a proven way to resolve fibroids, it may not be the best surgical treatment for every woman. If, for example, you hope to later become pregnant, you may want to consider alternatives to hysterectomy like myomectomy. Myomectomy is a uterine-preserving procedure performed to remove uterine fibroids.

Types of Myomectomy

Each year, roughly 65,000 myomectomies are performed in the U.S.⁴ The conventional approach to myomectomy is open surgery, through a large abdominal incision.⁵ After cutting around and removing each uterine fibroid, the surgeon must carefully repair the uterine wall to minimize potential uterine bleeding, infection and scarring. Proper repair is also critical to reducing the risk of uterine rupture during future pregnancies. Menorrhagia is extensive menstrual bleeding.

While myomectomy is also performed laparoscopically, this approach can be challenging for the surgeon, and may compromise results compared to open surgery.⁶ Laparoscopic myomectomies often take longer than open abdominal myomectomies, and up to 28% are converted during surgery to an open abdominal incision.⁷

A new category of minimally invasive myomectomy, da Vinci^® Myomectomy, combines the best of open and laparoscopic surgery. With the assistance of the da Vinci Surgical System—the latest evolution in robotics technology—surgeons may remove uterine fibroids through small incisions with unmatched precision and control.

If you would like to explore whether you are a candidate for myomectomy, ask your doctor.

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* Uterine fibroids are also called fibroids, uterine tumors, leiomyomata (singular—leiomyoma) and myomas or myomata (singular—myoma)

1. Newbold RR, DiAugustine RP, Risinger JI, Everitt JI, Walmer DK, Parrott EC, Dixon D. Advances in uterine leiomyoma research: conference overview, summary, and future research recommendations. Environ Health Perspect. 2000 Oct;108 Suppl 5:769-73. Review.
2. National Institutes of Health: Fast Facts about Uterine Fibroids. www.nichd.nih.gov/publications/pubs/fibroids/sub1.htm#where
3. Becker ER, Spalding J, DuChane J, Horowitz IR. Inpatient surgical treatment patterns for patients with uterine fibroids in the United States, 1998-2002. J Natl Med Assoc. 2005 Oct;97(10):1336-42.
4. Lumsden MA.Embolization versus myomectomy versus hysterectomy: Which is best, when? Hum Reprod. 2002; 17:253-259. Review.
5. Becker ER, Spalding J, DuChane J, Horowitz IR. Inpatient surgical treatment patterns for patients with uterine fibroids in the United States, 1998-2002. J Natl Med Assoc. 2005 Oct;97(10):1336-42.
6. Kristen A. Wolanske, MD; Roy L. Gordon, MD. Uterine Artery Embolization: Where Does it Stand in the Management of Uterine Leiomyomas? Part 2. Appl Radiol 33(10):18-25, 2004. Medscape.10/27/2004.
7. Advincula AP, Song A, Burke W, Reynolds RK. Preliminary experience with robot-assisted laparoscopic myomectomy. J Am Assoc Gynecol Laparosc. 2004 Nov;11(4):511-8.