Management of Uterine Fibroids: Clinical Focus

Gynecology/Obstetrics and Neonatal

January 2001

Clinical Focus*

What are the risks and benefits of hysterectomy and myomectomy in the treatment of symptomatic and asymptomatic fibroids?
What are the risks associated with single vs. multiple myomectomies? (i.e., Do women with a solitary clinically apparent fibroid have different outcomes after surgical management than women with multiple fibroids)
Who are appropriate candidates for each procedure?
What is the incidence of need for additional treatment after myomectorny or other uterus sparing interventions?
Does additional treatment result in significantly increased morbidity? (i.e., Is the overall risk of adverse outcomes greater with uterus conserving therapy because of recurrence or persistence resulting in additional therapy with associated risks, compared with immediate definitive therapy such as hysterectomy?)
What are the risks and benefits of nonsurgical treatment?
What are the costs associated with effective surgical and nonsurgical treatments?
Do risks and benefits differ by race, ethnicity, age, interest in future childbearing, etc.?
What are the effects of surgical management of uterine fibroids, especially hysterectomy, on the aging process?

*Addressed in the summary or evidence report.

Management of Uterine Fibroids
Summary (Publication No. 01-E051, January 2001)
Evidence Report: Volume I, Evidence Report Volume II (Publication No. 01-E052, July 2001)
(File Download)

EPC: Duke University
Topic Nominator: American College of Obstetricians and Gynecologists