Radiofrequency Ablation vs. Myomectomy: Which Treatment Option is Right for Women with Fibroids?

Radiofrequency ablation is an effective treatment option for women with up to five medium-sized intramural fibroids causing severe symptoms and heavy bleeding. A study conducted on 74 ethnically diverse women who underwent this procedure found that Black women, who had twice as many fibroids as white women before treatment, experienced similar improvements in size and reductions in bleeding three years later.

Alternatively, physicians can opt to surgically remove fibroids through a procedure known as myomectomy. Gynecologists are capable of performing myomectomies, but large fibroids require the expertise of physicians specializing in minimally invasive gynecologic surgery (MIGS). These specialists have experience handling complex cases without resorting to open abdominal surgery.

However, a concern raised by MIGS surgeons from reputable universities is the lack of discussion around treatment options with patients. Financial incentives or inadequate training may prevent some physicians from providing critical information about medical, radiological, and surgical options. Some physicians may even perform procedures that could impact a woman’s fertility without considering her desire to have children in the future.

Unfortunately, fibroids have a tendency to return in the years following treatment, especially in younger individuals with multiple fibroids, an enlarged uterus or other pelvic conditions. Hysterectomy remains the only definitive treatment option that eliminates both the fibroids and the uterus they inhabit. Studies have shown that a percentage of women who previously underwent myomectomy or uterine fibroid embolization (UFE) ultimately required a hysterectomy, highlighting the need for more permanent solutions for fibroid treatment.

In conclusion, radiofrequency ablation is an effective treatment option for women with up to five medium-sized intramural fibroids causing severe symptoms and heavy bleeding. However, it is essential for physicians to discuss all available treatment options with their patients thoroughly and consider their desire to have children in the future before performing any procedures that could impact their fertility. Additionally, more permanent solutions are needed for treating fibroids as they tend to return after some time regardless of the type of procedure used.