Gone for Good? The Real Risk of Recurrence Following Fibroid Removal

Once removed or destroyed, a fibroid does not grow back, though new fibroids may develop. A study by Hanafi provides deeper insight into the role the number fibroids plays in determining the likelihood of their future appearance. Results showed an 11 percent rate of recurrence in patients who had only one fibroid removed and a significantly larger instance of recurrence —74 percent— in patients who had multiple fibroids removed through myomectomy.3

Another treatment option is radiofrequency ablation (RFVTA), which utilizes the Acessa System. The Acessa procedure uses ultrasound for identification of all fibroids throughout the surgery, along with heat from a small probe to shrink the individual fibroids, leading to their reabsorption. The procedure does not require uterine incisions, so recovery time is minimal. A multi-center study on the Acessa method revealed that —in the three years following the procedure—11% percent of patients required surgical re-intervention for fibroid-related symptoms.4

A third surgical method for the removal of fibroids is Uterine Fibroid Embolization (UFE), also known as Uterine Artery Embolization (UAE). Performed by an interventional radiologist, the procedure works by blocking blood flow to the individual fibroids, causing them to die. UFE has proven generally successful in improving patients’ quality of life, and recovery time for the procedure is typically short, though patients often experience significant post-operative pain and require short-term hospitalization. The reintervention rate with UFE is particularly high: studies have demonstrated that nearly 37% of patients required surgical re-intervention within three years of receiving UFE.5

Hysterectomy, or removal of the uterus, is the most common surgical procedure to treat uterine fibroids. It is the only fully curative method, (because without the uterus, fibroids cannot occur), but it is highly invasive, involves a longer recovery period, and carries the risk of serious side effects.6 Moreover, removing of the uterus initiates early menopause, so it is an unfavorable option for women who wish to preserve their uterus.

Patients who have been diagnosed with uterine fibroids or are experiencing symptoms associated with fibroids should consult with a medical professional in order to determine the best course of treatment.


  1. http://health.usnews.com/health-conditions/sexual-health/fibroids/treatment
  2. Yoo, E. et al. Predictors of leiomyoma recurrence after laparoscopic myomectomy, Journal of Minim. Invasive Gynecology. Nov-Dec 2007; 14(6): 690-7
  3. Hanafi, M. Predictors of leiomyoma recurrence after myomectomy, Obstetrics and Gynecology. April 2005; 105(4): 877-81
  4. http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/MedicalDevicesAdvisoryCommittee/ObstetricsandGynecologyDevices/UCM404148.pdf
  5. Mara, M. “Uterine fibroid embolization versus myomectomy in women wishing to preserve fertility: preliminary results of a randomized controlled trial,” European Journal of Obstetrics & Gynecology and Reproductive Biology, June 1, 2006 i9i
  6. Cardozo, E.R. et al. “The estimated annual cost of uterine leiomyomata in the United States,” American Journal of Obstetrics & Gynecology, December 12, 2011.

Clinical Pros and Cons with a Hysterectomy


One of the main pros of having a hysterectomy is relief from cancer. For a woman with cancer in her reproductive system, removing the affected organs can stop cancer symptoms and give a woman peace of mind again. In some cases, a hysterectomy can be lifesaving.

A hysterectomy is also beneficial for women who experience heavy bleeding during menstruation or due to fibroids. While the procedure is generally considered a last resort, it can stop the symptoms if other methods prove unsuccessful.


There are many factors to consider before choosing to undergo a hysterectomy. Because it is major surgery, there is a long recovery period, of at least six weeks in many cases. Infection is another side effect of surgery to think about. Because women who have a hysterectomy have their uterus removed, they are unable to become pregnant, and some may face emotional issues associated with this loss. Some women may have symptoms related to changes in hormonal balance and hormone therapy must be used to counteract the loss of reproductive organs.

A 2009 study published in the journal, Obstetrics and Gynecology reports that women who have their ovaries removed face a higher incidence of developing other health problems that lead to death, including heart disease and lung cancer. The study also indicates that removal of the ovaries doesn’t have much impact on survival, so it may become an unnecessary procedure in most instances. That doesn’t mean that a hysterectomy isn’t the right choice, but simply that preserving the ovaries is the best option for most women.

It’s best to discuss the pros and cons of a hysterectomy with a doctor extensively and consider the procedure for some time rather than making an impulsive decision to have it done. That way, a woman can be absolutely sure the choice is the right one for her.


  1. http://www.hystersisters.com/vb2/view_trials.htm
  2. http://www.medicalnewstoday.com/releases/146710.php
  3. http://www.womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.html#g
  4. http://www.healthstatus.com/health_blog/wellness/the-pros-and-cons-of-hysterectomy/2/

5 Benefits of outpatient fibroid treatment

Minimally invasive

Fibroids can be removed through a form of minimally invasive, laparoscopic outpatient surgery that uses radiofrequency ablation. Laparoscopic surgery is often called “band aid surgery” because it consists of only two tiny incisions. This fibroid treatment destroys fibroids using a small needle through a technology known as radio frequency ablation. The surrounding tissue is unaffected while the destroyed tissue is reabsorbed. This minimally invasive procedure is performed under general anesthesia. This specific fibroid treatment targets only the fibroids, preserving the uterus.

Allows for rapid recovery

Once they have recovered from the anesthesia, patients typically go home on the same day as their surgery. They typically take mild anti-inflammatories after the procedure and can return to work within three to five days.

Has a low rate of recurrence

By treating all of the fibroids, there is little chance that the symptoms will recur again. Once the fibroid is eliminated, it is not likely that it will grow back. In fact, there have been a very low number of patients that have required further treatment following this procedure.

Alternative to a hysterectomy

Physicians often recommend that women with fibroids get hysterectomies, which is a complete removal of the uterus. But hysterectomies aren’t always necessary. Hysterectomies remove the uterus and often lead to complications, which include increased pain and long recovery times. Outpatient surgery removes the individual fibroids without having to remove the uterus.

Undergoing surgery can be a frightening experience. To prepare one’s body for outpatient surgery, it’s a good idea to stop smoking and/or drinking, exercise regularly and eat a well-balanced diet. Whichever method a woman chooses to treat fibroids, it should be one that is safe, effective and improves the quality of life.


  1. http://www.healthywomen.org/condition/preparing-surgery
  2. http://www.ucsfhealth.org/conditions/fibroids/treatment.html
  3. http://obgyn.med.miami.edu/migs/fibroid-clinic/treatment-options
  4. http://www.doctoroz.com/videos/1-surgery-women-dont-need-hysterectomy
Alternatives to a Hysterectomy

Fibroids and Hysterectomies | Alternatives to a Hysterectomy

Fibroids-of-the-Uterus-and-Hysterectomies--What-You-Need-to-Know_blog-pic_LI-00-0242-AFibroids of the Uterus and Hysterectomies: What You Need to Know

Doctors don’t fully understand why many women develop a condition called uterine fibroids, where tumors develop within the uterus. What is known though is that the tumors are benign and unlikely to develop into cancer at a later time. Also, when discussing symptoms of fibroids, areas of the uterus may be examined as well, because a range of symptoms can occur depending on how close the tumors are to nearby organs.

If you’ve been diagnosed with the disorder, one of the first questions on your mind is likely whether it’s necessary to pursue treatment now or if you can wait until a later time. If problematic symptoms are not currently making your life miserable, you may be advised to simply see if the condition worsens. However, if the doctor advises you that an intervention is necessary as soon as possible, don’t be surprised if they recommend a hysterectomy, otherwise known as a complete removal of the uterus.

Risks of Hysterectomies

Although hysterectomies are widely recommended, they come with several risks including:
• Fatigue
• Personality/Mood Change
• Infertility
• Increased cancer risk
• Bone density issues
• Excessive bleeding
• Fatal blood clots
• Urinary incontinence
• Premature menopause
• Pain during intercourse
• Bowel problems
• A decreased desire to engage in sex

In addition to the risks of a hysterectomy, recovery time may be as long as six weeks and patients are often required to stay overnight in the hospital. And the incisions from a hysterectomy can be large and unsightly. Understandably, reading those side effects and realizing that a hysterectomy is a very drastic procedure could be enough to make you wonder if there’s a better way to get the treatment you need. Fortunately, there are other solutions and if you’re committed to being as informed as possible about your health, it’s a good idea to pursue them and get information to help you make a smart decision about your future. One innovative alternative is called the Acessa Procedure and you can read about it below.

The Acessa Procedure as a Worthwhile Alternative

The Acessa Procedure is a minimally invasive alternative to hysterectomies. Because it only targets the fibroids, areas of the uterus that are not affected remain intact and unharmed. The technology uses a process called radio frequency thermal ablation delivered through a hand piece to manage existing tumors. Patients can generally go home the same day as the procedure and return to work four to five days later. The Acessa Procedure is performed laparoscopically, which greatly reduces scarring. And, the chance of having recurring issues is very small.

Although there’s not a single treatment approach that works for every woman, it’s necessary to understand that hysterectomies are no longer the only option to pursue for someone who’s been diagnosed with uterine fibroids. If you’re facing that issue, check out alternatives such as the Acessa Procedure to see if it might better meet your requirements by helping you stay healthy without resorting to procedures that are very invasive, such as hysterectomies.

Looking For More Information On Treating Uterine Fibroids?

Call Acessa Health at 877.412.3828.

Know Your Options

If you feel you may have the symptoms or have been diagnosed with uterine fibroid tumors, it is a good idea to discuss all of the available treatments for fibroids.

Click on the Physician Finder to find an Acessa-trained physician near you to see if the Acessa procedure is right for you. Or for more information, please contact Acessa Health at 877.412.3828.

  1. http://www.news-medical.net/health/Hysterectomy-Risks.aspx
  2. http://www.haltmedical.com/
  3. http://www.mayoclinic.com/health/uterine-fibroids/DS00078

What to Expect After a Hysterectomy

LI-00-0191Hysterectomy is the removal of the uterus and is one of the most commonly performed gynecological surgical procedures. In the United States alone, almost 600,000 hysterectomies are performed every year. One of the major causes for hysterectomy is the presence of uterine fibroids.[1]

Uterine Fibroids Treatment – Hysterectomy

Uterine fibroids are non-cancerous growths of the uterus that can occur in the uterine cavity, within the muscle wall, or on the outer surface of the uterus. Symptoms often include[2]:

  • Abnormal uterine bleeding, including longer periods or bleeding between periods.
  • Severe pelvic pain, including pain during sexual intercourse.
  • Lower back or leg pain.
  • Problems with urination.

Hysterectomy is the only fibroid treatment that prevents recurrence and may provide improved quality of life for many women. What to expect after a hysterectomy greatly depends upon the woman’s clinical circumstances and the type of hysterectomy chosen.

What to Expect after a Hysterectomy

Every patient’s experience may be different, but there are some general expectations following hysterectomy[3]:

  • The recovery depends largely on the type of hysterectomy patient had. Generally, open abdominal hysterectomy results in the longest recovery times. Vaginal and laparoscopic approaches to the procedures tend to require less recovery time and may be comparatively less painful.
  • Regardless of the type of hysterectomy the patient undergoes, she may require a course of pain medication and antibiotics to prevent post-surgical infections.
  • Patients may not be able to lift anything heavy or have sexual intercourse for as long as six weeks.
  • Hysterectomy can also have long-term co-morbidities such as incontinence or pelvic organ prolapse.

Treating Hysterectomy Side Effects

If a patient has a total hysterectomy and her ovaries are removed, hormone replacement therapy (HRT) can effectively reduce hormone-induced symptoms after the surgery. However, the woman’s age and medical history are all key factors to consider before any decision about HRT is made. HRT is absolutely contraindicated in patients with breast cancer.3

Looking For More Information On Treating Uterine Fibroids Other Than Having an


Call Acessa Health at 866-402-6357 or find a physician by clicking here.

[1] US Markets for Gynecological Devices 2011. Millennium Research Group, Inc. 2010.

[2] Buttram VC Jr, Reiter RC. Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril. 1981; 36(4):433-445.

[3] WebMD LLC, http://women.webmd.com/hysterectomy-oophorectomy-directory, 2005 – 2013, May 16, 2013.

Talking with your Doctor

Advantages vs Disadvantages With Various Fibroid Treatment Options

Fibroid-Treatment_LI-00-0158-AUterine fibroid tumors may affect up to 30% of women in their childbearing years, with the risk increasing with age. Formed in a woman’s uterus, uterine fibroids may not always come with symptoms, but when symptoms are present, and especially when they are severe, fibroid treatment is important to ensure the woman’s comfort. There are a variety of options for fibroid treatment, including both medical and surgical treatments.

Gonadotropin-releasing Hormone Agonists

This method uses hormone-releasing drugs in the form of an oral treatment or IUD to help treat pain and bleeding and shrink the fibroid size, generally before surgery is performed.


  • Non-invasive method
  • Can be used before surgery to make surgery easier, lessen the recovery time needed and minimize loss of blood.


  • Expensive method to use for long-term fibroid treatment.
  • Side effects can include loss of bone density and osteoporosis as well as symptoms of menopause.
  • Fertility is preserved with this method.

Short term elimination of symptoms:

  • Up to 90% pain relief (Source)

Long term recurrence:

  • The long-term recurrence for this fibroid treatment is high, as fibroids often return to their previous state once the patient stops taking the medication. The long term recurrence depends on the surgical procedure used after treatment

Uterine Sparing

  • Yes.

Radiofrequency Volumetric Thermal Ablation – Acessa™ System

The Acessa System is an outpatient, minimally invasive surgical procedure that uses ultrasound guidance to allow the surgeon to identify all of the fibroids present in the patient’s abdomen. The surgeon then inserts the Acessa handpiece into each fibroid to ablate the fibroid from within.


  • Treats all the fibroids while sparing the uterus
  • Minimally invasive in an outpatient setting
  • Fast recovery – patients go home the same day and return to work within 2-3 days.
  • Low recurrence rate
  • Treats fibroids in virtually all locations of the uterus
  • Lower cost than open surgery


  • Risks associated with laparoscopic surgery

Short Term Elimination of Symptoms

  • Bleeding stops right away
  • Other symptoms resolve as the body absorbs the fibroid tissue

Long term Recurrence

  • Less than 5%

Uterine Sparing

  • Yes.


The hysterectomy method of fibroid treatment consists of removing the uterus through surgery. It can be done “open” where an incision is made in the abdominal wall and the uterus is taken out through that incision. It can also be performed through the vagina, in a more minimally invasive procedure. Finally, laparoscopic hysterectomy is a popular and growing approach to hysterectomy. This is a minimally invasive procedure where the uterus is removed through the abdominal wall or vagina.


  • There is no risk of recurrence.
  • Lower blood loss and greater patient satisfaction with minimally invasive method.


  • Being major surgery, there are some risks involved such as bleeding, fever and risk of damage to surrounding organs.
  • Recovery from an “open” hysterectomy is 6-8 weeks.

Short term elimination of symptoms:

  • Because the uterus is removed, symptoms are eliminated

Long term recurrence:

  • With the uterus gone, fibroids cannot recur.

Uterine Sparing

  • No.

Uterine Artery Embolization

With this method of fibroid treatment, a radiologist targets the area around the uterus with tiny particles to cut off blood supply to the uterus arteries and shrink the fibroid.


  • Minimally invasive
  • Surgery is not necessary with this method
  • Hospital stay can be as short as 24-36 hours.


  • Higher risk of recurrence and pain after the procedure.

Short term elimination of symptoms:

  • Approximately 90%

Long term recurrence:

  • Approximately 30-50% of patients show recurrence of symptoms within 3years

Uterine Sparing

  • Yes.


A myomectomy is the removal of the fibroid from the uterus surgically. It can be done either “open” or using a minimally invasive method.


  • Resolution of symptoms initially
  • This fibroid treatment allows the preservation of the woman’s fertility


  • Higher rate of recurrence
  • This method can be complicated by how many fibroids are present and what state they are in.

Short term elimination of symptoms:

  • Up to 80% of patients are relieved of symptoms (Source)

Long term recurrence:

  • A myomectomy may allow for higher recurrence rates than other treatments, up to 45% after two years, according to some studies (Source)

Uterine Sparing

  • Yes.

With a variety of different options for fibroid treatment available, women should consider their options carefully and discuss with their doctor what method will work best for them.

Patient Information

To learn about physicians near you who use the Acessa system, please call us at 877-412-3828.

Blog-Fibroid Treatment

Fibroid Treatment – Garza Leal et al. Study

The Acessa System uses ultrasound-guided radiofrequency volumetric thermal ablation, which has been used in many other medical specialties such as cardiovascular surgery, orthopedics, general surgery, and neurosurgery because of the life-improving treatment effects. This study suggests that in fibroid treatment benefits can be found as well.

Low Re-intervention Rate – Treatment of Fibroids

Using the Acessa System for fibroid treatment, as mentioned, there was no need for further fibroid treatment in the year these patients were followed after treatment. During this time, the only reported adverse events were mild abdominal pain, not requiring treatment. Of the seven patients who had adverse reactions immediately following the procedure, four were due to abdominal pain, three in the umbilical area, and were effectively treated. Two were related to urinary tract infections, and in one patient, an abdominal wall vascular injury was discovered, but was resolved.

Significant Improvement in Quality of Life after Treatment of Fibroids

Quality of life by six months had improved from baseline to 80%. Symptom severity had also improved by 66% at six months. Reports of very heavy menstrual bleeding at baseline was 80%, and by six months had reduced

to 13%, and by twelve months no patients reported heavy or very heavy menses. Duration of menses also decreased from a baseline of 51% having menses lasting longer than six days to 13% at six months and 10% at 12 months. The study also reports a significant reduction in the rate of pad use by patients being over 15 per day at baseline at 66% to 20% at six months and only 5% at 12 months.

In conclusion, laparoscopic ultrasound-guided thermal ablation for fibroid treatment using the Acessa System significantly reduces symptoms, need for additional fibroid treatment, and improves patient quality of life significantly to at least 1 year after treatment.

Click here to read the abstract