2 The condition, current treatments and procedure

2 The condition, current treatments and procedure

The condition

2.1 Uterine fibroids (also known as uterine leiomyomas or myomas) are benign tumours of the uterus. They can be asymptomatic or can cause symptoms including heavy periods or intermenstrual bleeding. They can be associated with fertility problems and miscarriage.

Current treatments

2.2 Treatment depends on whether the fibroids cause symptoms, and if the person would like to become pregnant in the future. For symptomatic fibroids, treatment options include medication, interventional radiology and surgery. Interventional radiology treatments include uterine artery embolisation and MRI‑guided focused ultrasound. Surgery includes hysterectomy, myomectomy, endometrial ablation techniques and myolysis.

The procedure

2.3 Laparoscopic surgery with power morcellation allows uterine fibroids to be cut into smaller pieces so they can be removed laparoscopically and without the need for a laparotomy. The procedure aims to reduce symptoms caused by fibroids.

2.4 Laparoscopic removal of uterine fibroids with power morcellation is done with the patient under general anaesthesia. During laparoscopic surgery and under direct visualisation an electrosurgical morcellator is introduced through a small incision into the abdomen and used to cut the uterine fibroid into smaller pieces. If a hysterectomy is planned, morcellation can be used to also remove part or all of the uterus. The fragments are removed through the morcellation cannula. The removed tissue should be sent for histological analysis. To reduce the risk of disseminating benign and malignant uterine tissue, the tissue can be contained in an insufflated sterile bag while being morcellated within the abdomen.

  • National Institute for Health and Care Excellence (NICE)