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| Procedure | Hysterectomy | Myomectomy | Uterine artery embolization (UAE) | MRgFUS |
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| Description | Surgical removal of the uterus with or without the cervix. There are several different surgical approaches: vaginal hysterectomy (performed through an incision in the vagina), abdominal hysterectomy (through a horizontal incision on the lower abdomen), and laparoscopic hysterectomy (through four tiny incisions on the abdomen). | Surgical removal of one or more fibroids from within the uterus. It can be performed through several different ways: abdominal myomectomy, laparoscopic myomectomy, and hysteroscopic myomectomy (only for women with submucosal fibroids). | UAE involves blocking, with small particles injected through a catheter, the blood vessels that supply the fibroids, causing them to shrink. | High intensity focused ultrasound waves heat and destroy
fibroid tissue. The MRI allows
guiding treatment and
monitoring tissue temperature in realtime. |
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| Return to normal activities | 7 to 56 days. | 1 to 44 days. | 3 to 10 days, | 1 day. |
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| Hospital days | 1 to 5 days. | 0 to 3 days. | 0 to 1 day, | Outpatient procedure; no hospital stay. |
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| Procedure time | 1.5 to 3 hours. | 1 to 3 hours. | 30 minutes to 1.5 hours, | 1.5 to 4 hours. |
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| Advantages | Fibroids will not recur because the uterus is removed. The ovaries may be removed or spared. | Only the fibroids are removed; reproductive potential is spared. | Most fibroids can be treated. Incision is small and uterus is retained. Hospital stay is short (1 day) and in some cases may be performed as an outpatient procedure. Recurrence of treated fibroids is very rare. Return to normal activity within 10 days. | Day care procedure requiring no hospitalization, no incisions, no ionizing radiation, no general anesthesia. Severe complications virtually absent. Return to daily activities from the next day of treatment. Fertility is preserved. |
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| Disadvantages/risks | Reproductive potential is lost. Side effects may include early menopause and a reduction in libido. Removal of the ovaries in a premenopausal woman can lead to hot flashes, vaginal dryness, and osteoporosis. Possible surgical risks include bleeding, infections, adhesions, injury to the intestines, or bladder. | Fibroids can regrow and/or new fibroids can develop resulting in recurrent symptoms and additional procedures. The younger the woman is and the more the fibroids are present at the time of myomectomy, the more likely she is to develop fibroids in the future. Possible surgical risks include bleeding, adhesions, and infections. | Low risk of menopause and blockage of blood supply to ovaries. Possible surgical risks include bleeding, uterine infection, blood clots, and injury of the ovaries and to the uterus, potentially leading to a hysterectomy. | Not all type of fibroids can be treated. Fibroids may recur with time. It is a safe procedure with minimal risk; infrequent complications are abdominal pain/cramping, back or leg pain, urinary tract infection, vaginal discharge, skin injury (burns), and transient nerve damage. |
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| Future fertility | Reproductive potential is lost. | Possibility of pregnancy after adequate healing time. A cesarean section may be required for delivery. | Unpredictable effect on fertility. | Fertility is preserved. |
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