Fibroid Treatment Team
The Fibroid Treatment Team at Metropolitan General was established to provide guidance to women with symptomatic fibroids regarding the treatment options offered by modern Gynecology and Interventional Radiology.
The Team follows current clinical guidelines and the latest medical literature, while adopting an individualized approach for each patient, considering symptom severity and impact on quality of life, age, reproductive plans, size and location of fibroids, and personal preferences.
A detailed medical history is obtained, followed by clinical assessment and review of the necessary imaging studies (Ultrasound, Magnetic Resonance Imaging). Based on these findings, appropriate surgical or minimally invasive treatment options are proposed for each case, including their advantages and disadvantages, in accordance with the latest evidence and guidelines.
The goal is to ensure that each woman with symptomatic fibroids is fully informed about the treatment options available for her individual case and can choose the most appropriate approach. Treatment can be carried out at Metropolitan General, where the full spectrum of surgical and minimally invasive techniques is available, provided by the Fibroid Treatment Team.
In Greece, the traditional treatment commonly proposed for symptomatic fibroids is hysterectomy, a procedure that leads to immediate menopause. In recent decades, both surgical myomectomy (open or laparoscopic) and uterine artery embolization have been developed as alternative treatment options.
Uterine Fibroid Embolization
Uterine Fibroid Embolization (also known as Uterine Artery Embolization) is a minimally invasive, non-surgical treatment method for fibroids. The procedure is performed by Interventional Radiologists in Interventional Radiology Departments. In the United States and the United Kingdom, this method is widely used for the treatment of symptomatic fibroids.
During the procedure, the blood supply to the fibroids is interrupted, resulting in their shrinkage and cessation of bleeding. In most women, results are observed soon after the procedure.
Unlike hysterectomy, uterine fibroid embolization preserves the uterus and ovaries while effectively treating fibroid-related bleeding and pain. During the procedure, a small catheter (approximately 1.5 mm in diameter) is inserted into the arteries supplying the fibroids. Microparticles (approximately 0.5 mm in size) are injected into the arteries, occluding the vessels and stopping blood flow to the fibroids.
Once the blood supply is interrupted, bleeding ceases and the fibroids gradually shrink over the following weeks. Most women experience reduced pain, bloating, and bleeding.
The procedure lasts approximately one hour, is performed under local anesthesia with mild sedation, and requires an overnight hospital stay for optimal pain management. Patients typically return to their normal daily activities within a few days.
Myomectomy
Myomectomy (also referred to as enucleation of fibroids) is a surgical procedure that removes fibroids from the uterus. It can be performed either via laparotomy or laparoscopically. The procedure is always carried out under general anesthesia, and the patient typically returns to normal daily activities within a few weeks.
An advancement of the laparoscopic approach is the use of robotic systems, which guide the camera and surgical instruments, offering high precision, enhanced flexibility of movement, and three-dimensional visualization within the body, even in hard-to-reach areas. Myomectomy is recommended for women who wish to preserve fertility, and its outcome also depends on the location of the fibroids within the uterus.
Another treatment option that has developed significantly in recent decades for symptomatic fibroids is transvaginal radiofrequency ablation under ultrasound guidance. It provides optimal results in small (<5 cm) fibroids and in women who wish to conceive.