Alternative Management to Myoma Surgical Treatment: Position of Myolysis

Because uterine artery embolization is an effective (85% of success at 5 years) treatment with low long-term morbidity, it is an option for symptomatic fibroids in women who do not want to become pregnant, and a validated alternative to myomectomy and hysterectomy that must be offered to patients.Myolysis is under assessment using focused ultrasound or radiofrequency, and research on its use is recommended. Isolated laparoscopic ligation of the uterine arteries is a potential alternative to uterine artery embolization; it also complements myomectomy by reducing intraoperative bleeding. It is possible to use second-generation techniques of endometrial ablation to treat submucosal fibroids in women whose families are complete. However ulipristal is going to change the management of fibroid, reducing surgery and maybe also myolysis. In each case, the patient need to be informed of each therapeutic option and about the benefit and risk associated.