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Menorrhagia (heavy menstrual bleeding) - Management
Uterine artery embolization and myomectomy
- Uterine artery embolization and myomectomy are both techniques primarily aimed at reducing the size of, or removing, uterine fibroids, but both have benefits in reducing menstrual blood loss. Previously, hysterectomy was seen as the only viable surgical option for these women.
- Uterine artery embolization involves blocking the uterine arteries by injection of particles from a catheter inserted into the femoral artery, causing fibroids to shrink.
- Myomectomy is the surgical removal of fibroids through laparotomy, laparoscopically, or hysteroscopically. Its main disadvantage is that uterine fibroids can grow back, requiring further surgery.
- The National Institute for Health and Clinical Excellence recommends that [National Collaborating Centre for Women's and Children's Health, 2007]:
- Uterine artery embolization, myomectomy, or hysterectomy, should be considered when the woman has large fibroids and heavy menstrual bleeding with other accompanying symptoms, such as dysmenorrhoea or pressure symptoms; or the woman has large fibroids that are causing bleeding that is having a severe impact on the woman's quality of life.
- Myomectomy should be considered for women who want to retain their uterus.
- Uterine artery embolization is recommended for women who want to retain their uterus and avoid invasive surgery.
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