We will develop forms for screening and preliminary data extraction. GnRH agonists typically are used for no more than three to six months because symptoms return when the medication is stopped and long-term use can cause loss of bone. Frontiers | Endometriosis and Uterine Fibroids (Leiomyomata Her blood pressure is 160/100 mm Hg. It releases a liquid contrast material that flows into your uterus. Medications for uterine fibroids target hormones that regulate your menstrual cycle, treating symptoms such as heavy menstrual bleeding and pelvic pressure. Myomectomy is the surgical removal of fibroids while leaving the uterus in place. Risk for Adverse Reaction to Iodinated Contrast Media 3. include protected health information. However, research shows that complications are similar to surgical fibroid treatments and the risk of transfusion is substantially reduced. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). 2012 Mar;206(3):211.e1-9. If you want to entertaining books, lots of novels, tale, jokes, and more fictions collections are after that launched, from The American College of Obstetricians and Gynecologists. The conditions that can also affect pregnancy are fibroids, endometriosis, ovarian cysts, cervical dysplasia and more. Menorrhagia is a largely benign condition but can be emotionally and socially debilitating. Also, complications during open surgery are more common than the chance of spreading an undiagnosed cancer in a fibroid during a minimally invasive procedure. Fibroids do not regrow after surgery, but new fibroids may develop. PMID: 11214143, Huyck KL, Panhuysen CI, Cuenco KT, et al. 1. We have limited confidence that the estimate of effect lies close to the true effect for this outcome. Also, with magnetic resonance imaging, large uterine vessels, large nodes, are noticeable. Sometimes, uterine fibroids can cause complications. Center for Devices and Radiological Health. Overdistension of the uterus (twins and fibroids); . Many women who are told that hysterectomy is their only option can have an abdominal myomectomy instead. Myoma are very small in size: on average 0.3-0.4 cm. Nonsteroidal anti-inflammatory drugs (NSAIDs), which are not hormonal medications, may be effective in relieving pain related to fibroids, but they don't reduce bleeding caused by fibroids. showed that the estimated incidence of fibroids in women by age 50 was 70% for white women and reached over 80% black women. Future reproduction. The decision of whether to partially pool a set of studies using random effects depends not on how heterogeneous their outcomes are, but rather, whether they can be considered exchangeable studies from a population of studies of the same phenomenon. The uterus is made of muscle, and fibroids grow from the muscle. Feb 29, 2016. We will provide a qualitative and quantitative synthesis of studies meeting our review criteria. This is the most common kind of hysterectomy. Acupuncture has shown promise for improving fibroid outcomes in small studies. Uterine fibroids, or leiomyomas, are the most common . They grow in and around the muscular wall of the uterus (womb). Management of abnormal uterine bleeding. This cuts off blood flow to starve the tumors. not cancerous. Technical Experts must disclose any financial conflicts of interest greater than $10,000 and any other relevant business or professional conflicts of interest. Women with uterine fibroids are more likely have pregnancies complicated by fetal malpresentation, preterm birth, preterm premature rupture of membranes (PPROM), placenta previa, placental abruption, cesarean delivery, and severe postpartum hemorrhage. After locating a uterine fibroid, your doctor uses another thin device to send several small needles into the fibroid. Monte LM ER. Other surgical and non-surgical approaches include myomectomy by hysteroscopy, myomectomy by laparotomy or laparoscopy, uterine artery embolization and interventions performed under radiologic or ultrasound guidance to induce thermal ablation of . Morcellation a process of breaking fibroids into smaller pieces may increase the risk of spreading cancer if a previously undiagnosed cancerous mass undergoes morcellation during myomectomy. Unless a woman has symptoms, it's likely she does not know she has uterine fibroids. Identification of Future Research Needs in the Comparative Management of Uterine Fibroid Disease. Accessed May 2, 2019. So far, there's no scientific evidence to support the effectiveness of these techniques. Uterine fibroids. It remains the only proven permanent solution for uterine fibroids. Management of uterine fibroids. Additionally, public comments noted the need to assess effectiveness of morcellation in addition to harms. How long have you been experiencing symptoms? This site complies with the HONcode standard for trustworthy health information: verify here. The Food and Drug Administration (FDA) advises against the use of a device to morcellate the tissue (power morcellator) for most women having fibroids removed through myomectomy or hysterectomy. Surgical Nursing Flashcards | Quizlet This content does not have an English version. Nursing Care Plan-Uterine Fibroids Student: John Micahel C. Manaig Date: May 27,2021 Client: Aiken Manaig Age: 13 Sex: Male Room # 14 Assessment Nursing Diagnosis Nursing Plan Nursing Intervention Scientific Rational Expected Outcome SUBJECTIVE: Medical history, physical examination, and pelvic. How To Manage Uterine Fibroids (Leiomyomas or Myomas) - ARC Fertility What is the comparative effectiveness (benefits and harms) of treatments for uterine fibroids, including comparisons among and within these interventions? Differences between the reviewers will be adjudicated by a senior team member or via team discussion. In addition, the Key Questions address the potential harms associated with morcellation, as well as an exploration of patient and tumor characteristics that may predict success or adverse events in patients considered for morcellation. HHSA 290-2015-00003I from the Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. CHILD HEALTH NURSING mine1.pptx . We have listed known pharmaceutical companies (Table A-1) and device manufacturers (Table A-2) in the Appendix. We will refine our analytic approach as we gather more data on the available literature. Jun 2, 2019. Studies reporting only intermediate outcomes will not be included. Have a full discussion of the risks and benefits of these procedures with your doctor if you want to preserve the ability to become pregnant. They can grow as a . https://www.uptodate.com/contents/search. Key Informants are the end users of research, including patients and caregivers, practicing clinicians, relevant professional and consumer organizations, purchasers of health care, and others with experience in making health care decisions. We assign an overall grade (high, moderate, low or insufficient) for the strength of evidence for each key outcome (Table 4). A care plan is nothing more than the written documentation of the nursing process you use to solve one or more of a patient's nursing problems. We will use the search strategies presented in Tables A-3 and A-4 of the Appendix. Randomized controlled trials are best suited to provide data for comparative effectiveness and there has been substantial growth in the variety and sophistication of trials since the prior review. health information, we will treat all of that information as protected health Content last reviewed May 2019. In a myomectomy, your surgeon removes the fibroids, leaving the uterus in place. Telephone: (301) 427-1364, Powered by the Evidence-based Practice Centers, https://effectivehealthcare.ahrq.gov/products/uterine-fibroids/research-protocol, Comment on Key Questions and Draft Reports, 25 Years of the AHRQ Evidence-based Practice Center Program, http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm424443.htm, http://www.pcori.org/research-results/2014/comparing-options-management-patient-centered-results-uterine-fibroids-compare, Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment in Children and Adolescents, Diagnostic Errors in the Emergency Department: A Systematic Review, Strategies for Patient, Family and Caregiver Engagement, Impact of Community Health Worker Certification on Workforce and Service Delivery for Asthma and Other Selected Chronic Diseases, Maternal and Fetal Effects of Mental Health Treatments in Pregnant and Breastfeeding Women: A Systematic Review of Pharmacological Interventions, U.S. Department of Health & Human Services, Women who are being treated for uterine fibroids (KQs 1-4). If you are a Mayo Clinic patient, this could We believe that the findings are likely to be stable, but some doubt remains. Alternatives to hysterectomy: Management of uterine fibroids. Mayo Clinic is a not-for-profit organization. July 2001, Wegienka G, Baird DD, Hertz-Picciotto I, et al. Analysis of subgroups will be done formally, within a statistical model, or by stratifying results and organizing the report in such a way that end users are provided with overall outcomes data and information specific to subgroups defined by factors such as menopausal status or fibroid size that can be easily identified and stand alone as needed. https://effectivehealthcare.ahrq.gov/topics/uterine-fibroids/research-2017. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Our caring team of Mayo Clinic experts can help you with your uterine fibroids-related health concerns, What are uterine fibroids? TAHBSO is usually performed in the case of uterine and cervical cancer. This review will include studies evaluating medical and surgical treatments to treat fibroids (asymptomatic or symptomatic) in women of any age. They are much smaller in size than polyps, and they also do not have a pedicel. In women undergoing hysterectomy for treatment of uterine fibroids, the least invasive approach possible should be chosen. 9 Bleeding in Pregnancy (Prenatal Hemorrhage) Nursing Care Plans Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018. The EPC solicits input from Key Informants when developing questions for systematic review or when identifying high priority research gaps and needed new research. In fact, the whole uterus decreases in size after menopause. Your doctor views your abdominal area on a monitor using a small camera attached to one of the instruments. Nursing Management. Risk for Ineffective Activity Planning 2. Since fibroids are hormonally responsive growths, most people do experience a decrease in fibroid size and fibroid-related issues as they get closer to menopause and beyond. Maintain frequent Additionally, because these supplements are not FDA regulated, they may be dangerous to your health. Fibroid Clinic - Overview - Mayo Clinic Rockville, MD: Agency for Healthcare Research and Quality; January 2014. www.effectivehealthcare.ahrq.gov. Compared with total laparoscopic hysterectomy or laparoscopically assisted vaginal hysterectomy, vaginal hysterectomy is associated with shorter operative time, less blood loss, shorter paralytic ileus time, and shorter hospitalization. that would be palgeurism. nursing care plan for uterine fibroids. Hysterectomy ends your ability to bear children. Provide information about the nursing care plan. Uterine Fibroids - Gynecology and Obstetrics - MSD Manual Professional Accessed May 1, 2019. We anticipate performing a meta-analysis to describe the effects of treatment decisions on outcomes including likelihood of maintaining fertility or needing additional treatment, including, ultimately, hysterectomy. The quantity and quality of research on fibroid management has steadily improved in recent years. A similar procedure called cryomyolysis freezes the fibroids. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. The American College of Obstetrics and Gynecology (ACOG) has just released updated guidelines on management of symptomatic uterine fibroids (leiomyomas). Limited data does not support the use of herbal supplements like black cohosh or vaginal steaming. Methods Guide for Effectiveness and Comparative Effectiveness Reviews. Preventing an increase in skin reactions, lowering the . Nursing Diagnosis For Uterine Fibroids fibroids treatment options Technical Experts constitute a multi-disciplinary group of clinical, content, and methodological experts who provide input in defining populations, interventions, comparisons, or outcomes and identify particular studies or databases to search. Obstetrics and Gynecology Clinics of North America. In the presence of predisposing factors, monitor maternal labor pattern closely for hypertonicity or signs of weakening uterine muscle. If the fibroids are few in number, you and your doctor may opt for a laparoscopic or robotic procedure, which uses slender instruments inserted through small incisions in your abdomen to remove the fibroids from your uterus. Am J Obstet Gynecol. Are the fibroids located on the inside or outside of my uterus? privacy practices. Lancet. Among these instruments is the laparoscope, which contains fibre-optic camera heads or surgical heads (or both). When symptoms are present, they can include: Abnormal vaginal bleeding, such as heavier, longer periods or bleeding between periods. The destroyed fibroid immediately changes consistency, for instance from being hard like a golf ball to being soft like a marshmallow. 87% (45) 87% found this document useful (45 votes) The specific meta-analysis or meta-regression will depend on the data available. The TOO and the EPC work to balance, manage, or mitigate any potential conflicts of interest identified. Key Informants are not involved in analyzing the evidence or writing the report and have not reviewed the report, except as given the opportunity to do so through the peer or public review mechanism. information and will only use or disclose that information as set forth in our notice of MRI-guided focused ultrasound surgery (FUS) is: Small particles (embolic agents) are injected into the uterine artery through a small catheter. We will assess reporting bias of randomized controlled trials by examining outcomes of trials as reported in resources such as ClinicalTrials.gov to determine if prespecified outcomes are not reported in the published literature. We will extract additional information, when reported, to assess whether the effectiveness of interventions differ by patient or fibroid characteristics. Best Practice and Research. We will deposit data used in a meta-analysis into the Systematic Review Data Repository (SRDR). This permits us to account for "outlier" studies in the meta-analytic model without either discarding them unnecessarily or allowing them to influence meta-estimates disproportionately. Here are 9 nursing care plans and nursing diagnoses for bleeding during pregnancy ( prenatal hemorrhage ): ADVERTISEMENTS. PMID: 25555855. The Complete list of NANDA Nursing Diagnosis for 2012-2014 with 16 new diagnoses. No evidence is available or the body of evidence has unacceptable deficiencies, precluding reaching a conclusion. https://effectivehealthcare.ahrq.gov/products/uterine-fibroids/research-protocol. 2014 Dec 23PMID: 25542564. An observational study of 26 women treated with uterine artery embolization and 40 treated with hysterectomy found no difference in live birth rates.42 In a retrospective study with five years of follow-up in women who received uterine artery embolization for fibroids, 27 (4.2%) had one (n = 20) or more (n = 7) pregnancies after uterine artery embolization.64 Of these pregnancies, there were 15 miscarriages and 19 live births, 79% of which were cesarean deliveries because of complications. Laughlin-Tommaso SK. There are some small studies looking into possible dietary and environmental factors that may promote fibroid growth. Uterine fibroids. NICHD Uterine Fibroids Research Information Myomectomy - Better Health Channel We will use the same screening forms and inclusion/exclusion criteria to assess eligibility of citations recommended by peer and public reviewers and for the literature retrieved by updated literature searches. Nursing Diagnosis Of Uterine Fibroids fibroid changes Because a woman keeps her uterus, she might still be able to have children. Independent: Review patient's previous experience with cancer. Papadakis MA, et al., eds. 11-EHC023-EF. Obstet Gynecol. Management of uterine fibroids (Evidence Report/Technology Assessment No. Deficient Fluid Volume. The dye traces the shape of your uterine cavity and fallopian tubes and makes them visible on X-ray images. Gonadotropin-releasing hormone (GnRH) agonists and selective progesterone receptor modulators (SPRMs) are options for patients who need temporary relief from symptoms preoperatively or who are approaching menopause. Also, uterine artery embolization and radiofrequency ablation may not be the best options if you're trying to optimize future fertility. Accessed April 24, 2019. Prior reviews have reported on the effectiveness preoperative adjunctive treatments such as gonadotropin-releasing hormone (GnRH) agonists or cell savers. In: Current Medical Diagnosis & Treatment 2019. Medical therapy to reduce heavy menstrual bleeding includes hormonal contraceptives, tranexamic acid, and nonsteroidal anti-inflammatory drugs. When differences between the reviewers arise, we will err on the side of inclusion. If you're having bothersome symptoms now, getting them removed before pregnancy is possible. Fibroids can reoccur in about 60% of people who have them. American College of Obstetricians and Gynecologists. ); patient characteristics (e.g., age, race/ethnicity, symptom status, treatment history); operational definition of fibroid; diagnostic modality (e.g., imaging, symptom record); intervention description and characteristics; outcomes of interest reported; operational definition of each outcome; results; and length of followup. ACOG committee opinion number 770: Uterine morcellation for presumed leiomyomas. Uterine Fibroids Nursing Care Plan For Uterine Bleeding Because of their unique clinical or content expertise, individuals are invited to serve as Technical Experts and those who present with potential conflicts may be retained. . PMID: 3199853 No abstract available . pain or pressure in the pelvic area. Ferri FF. Uterine atony nursing diagnosis Free Essays | Studymode [Nursing plan for a patient with uterine myoma] [Nursing plan for a patient with uterine myoma] [Nursing plan for a patient with uterine myoma] Kurinikaru Sutadi. Rockville MD: Agency for Healthcare Research and Quality; March 2012. www.effectivehealthcare.ahrq.gov/. Each article will be reviewed for eligibility independently by two members of the investigative team. Nursing Care Plan: Uterine Myoma - Free download as Word Doc (.doc), PDF File (.pdf), Text File (.txt) or read online for free. Kellerman RD, et al. New England Journal of Medicine. the Cumulative Index to Nursing and Allied Health (CINAHL), EMBASE, May 20, 2015. Nursing Diagnosis Infertility If you ally dependence such a referred Nursing Diagnosis Infertility book that will pay for you worth, get the completely best seller from us currently from several preferred authors. 2015 2015-01-02 22:52:22;349:g7647. During hysterosonography (his-tur-o-suh-NOG-ruh-fee), a care provider uses a thin, flexible tube (catheter) to inject salt water (saline) into the hollow part of the uterus. Management of Uterine Fibroids - Medscape Laparoscopic or robotic myomectomy. Hysteroscopic myomectomy - the fibroids are removed via the dilated cervix, so no abdominal incisions are . Background and Objectives for the Systematic Review Topic background Most women will develop one or more uterine fibroids (i.e., leiomyomata), benign smooth muscle tumors of the uterus, during their reproductive lifespan.1 In the United States, an estimated 26 million women between the ages of 15 and 50 have uterine fibroids.1-4 More than 15 million of them will experience associated symptoms . They may be inside the uterus, on its outer surface or within its wall, or attached to it by a stem-like structure. Thanks for your time and we wish you well. How many fibroids do I have? Uterine leiomyomata, or fibroids, are benign tumors of the uterus made up of smooth muscle and the extracellular matrix proteins collagen and elastin. PMID: 19300327. PDF Impaired Urinary Elimination Nursing Care Plan Potential Peer Reviewers must disclose any financial conflicts of interest greater than $10,000 and any other relevant business or professional conflicts of interest. We may limit the report of key findings from studies assessed as high risk of bias to summary tables. They have not reviewed the report, except as given the opportunity to do so through the peer or public review mechanism. Nursing Care Plan 2021 | PDF | Childbirth | Pregnancy - Scribd pubmed.ncbi.nlm.nih.gov/23353618/ Mondelli B, et al. Encourage patient to share thoughts and feelings. 13(14)-EHC 130-EF. Such approaches are generally well accepted in practice. 2014:P20-575. Use of other treatments before hysterectomy for benign conditions in a statewide hospital collaborative. Robotic myomectomy gives your surgeon a magnified, 3D view of your uterus, offering more precision, flexibility and dexterity than is possible using some other techniques. As they grow, they can distort the inside as well . Abdominal myomectomy. Laparoscopic power morcellators. Accessed April 24, 2019. Scribd is the world's largest social reading and publishing site. Review/update the Her health care provider (HCP) tells her that she has uterine fibroids and recommends an abdominal hysterectomy. Compared with hysterectomy and myomectomy, uterine artery embolization has a significantly decreased length of hospitalization (mean of three fewer days), decreased time to normal activities (mean of 14 days), and a decreased likelihood of blood transfusion (OR = 0.07; 95% CI, 0.01 to 0.52).42 Long-term studies show a reoperation rate of 20% to 33% within 18 months to five years.24 Contraindications include pregnancy, active uterine or adnexal infections, allergy to intravenous contrast media, and renal insufficiency. If your doctor is planning to use morcellation, discuss your individual risks before treatment. The exact cause of uterine fibroids is still not known. The procedure is performed while you're inside an MRI scanner. 21. 10(14)-EHC063-EF. Nursing Intervention For Uterine Fibroids fibroid blogs We believe that the findings are stable, i.e., another study would not change the conclusions. Don't hesitate to have your doctor repeat information or to ask follow-up questions. In some cases, though, health care providers find fibroids during a routine gynecological exam. The nursing process itself is a problem solving method that was extrapolated from the scientific method used by the various science disciplines in proving or disproving theories. Figure 1 presents an algorithm for the management of uterine fibroids.4, About 3% to 7% of untreated fibroids in premenopausal women regress over six months to three years, and most decrease in size at menopause. The body of evidence has few or no deficiencies. The appearance of heterogeneous areas may indicate the process of transformation . Stewart EA (expert opinion). information submitted for this request. Nursing Care Plan & Diagnosis for Hysterectomy| Risk for Infection Nursing Care Plan Uterine Fibroids Many physicists using number of factors are plagued homeopathy in all other treatment must aim to eliminate. Subgroup analysis can be undertaken in a variety of ways, from completely separate models at one extreme, to simply including a subgroup covariate in a single model at the other, with multilevel and random effects models somewhere in the middle. For example, oral contraceptives can help control menstrual bleeding, but they don't reduce fibroid size. Rockville, MD: Agency for Healthcare Research and Quality; 2011. We believe that additional evidence is needed before concluding either that the findings are stable or that the estimate of effect is close to the true effect. See permissionsforcopyrightquestions and/or permission requests. If confirmation is needed, your doctor may order an ultrasound. Researchers Link Toxic Phthalates to Uterine Fibroid Growth - An ultrasound led to the discovery for uterine fibroids. It uses sound waves to get a picture of your uterus to confirm the diagnosis and to map and measure fibroids. 6 Cystic Fibrosis Nursing Care Plans - Nurseslabs The equipment allows your doctor to visualize your uterus, locate any fibroids and destroy the fibroid tissue without making any incisions. After locating a fibroid, your doctor uses a specialized device to deploy several small needles into the fibroid. (2022). Which nursing statement would best assess the client's coping abilities?, A 39-year-old female client has been experiencing intermittent vaginal bleeding for several months. An ultrasound probe gets images of the inside of the uterus to check for anything unusual. We will use prespecified questions1 from Table 4 in "Assessing the Risk of Bias of Individual Studies in Systematic Reviews of Health Care Interventions"23 to assess risk of bias of randomized controlled trials. A Mayo Clinic expert explains, Mayo Clinic Minute: Black women and uterine fibroids, Mayo Clinic Minute: Know your uterine fibroid treatment options, Assortment Women's Health Products from Mayo Clinic Store. https://www.uptodate.com/contents/search. Many women who have uterine fibroids do not have symptoms. Uterine Atony: What Is It, Risk Factors, Treatment, and More - Osmosis UterineFibroids.org: "Homeopathic and Holistic Treatments for Uterine Fibroids." University of Maryland Medical Center: "Menstrual pain." St. Luke's: "Uterine Fibroids - Home treatment." is sometimes performed for removing fibroids while sparing the uterus. They rarely turn into cancer, and if you get them it doesn't mean you're . The Key Questions reflect the unmet need for a relevant synthesis of evidence from prospective randomized controlled trials on the relative benefits and harms of surgical, procedural, and medical interventions to manage uterine fibroids. Uterine carcinosarcoma (considered an epithelial neoplasm), Uterine sarcoma (leiomyosarcoma, endometrial stromal sarcoma, mixed mesodermal tumor), Preoperative treatment to decrease size of tumors before surgery or in women approaching menopause, Decrease blood loss, operative time, and recovery time, Long-term treatment associated with higher cost, menopausal symptoms, and bone loss; increased recurrence risk with myomectomy, Levonorgestrel-releasing intrauterine system (Mirena), Treats abnormal uterine bleeding, likely by stabilization of endometrium, Most effective medical treatment for reducing blood loss; decreases fibroid volume, Irregular uterine bleeding, increased risk of device expulsion, Yes, if discontinued after resolution of symptoms, Anti-inflammatories and prostaglandin inhibitors, Do not decrease fibroid volume; gastrointestinal adverse effects, Treat abnormal uterine bleeding, likely by stabilization of endometrium, Reduce blood loss from fibroids; ease of conversion to alternate therapy if not successful, Selective progesterone receptor modulators, Decrease blood loss, operative time, and recovery time; not associated with hypoestrogenic adverse effects, Headache and breast tenderness, progesterone receptor modulatorassociated endometrial changes; increased recurrence risk with myomectomy, Reduces blood loss from fibroids; ease of conversion to alternate therapy, Does not decrease fibroid volume; medical contraindications, Surgical removal of the uterus (transabdominally, transvaginally, or laparoscopically), Definitive treatment for women who do not wish to preserve fertility; transvaginal and laparoscopic approach associated with decreased pain, blood loss, and recovery time compared with transabdominal surgery, Surgical risks higher with transabdominal surgery (e.g., infection, pain, fever, increased blood loss and recovery time); morcellation with laparoscopic approach increases risk of iatrogenic dissemination of tissue, Magnetic resonanceguided focused ultrasound surgery, In situ destruction by high-intensity ultrasound waves, Noninvasive approach; shorter recovery time with modest symptom improvement, Heavy menses, pain from sciatic nerve irritation, higher reintervention rate, Surgical or endoscopic excision of tumors, Resolution of symptoms with preservation of fertility, Recurrence rate of 15% to 30% at five years, depending on size and extent of tumors, Interventional radiologic procedure to occlude uterine arteries, Minimally invasive; avoids surgery; short hospitalization, Recurrence rate > 17% at 30 months; postembolization syndrome, Infertile women with distorted uterine cavity (i.e., submucosal fibroids) who desire future fertility, Symptomatic women who desire future fertility, Symptomatic women who do not desire future fertility but wish to preserve the uterus, Medical treatment, myomectomy, uterine artery embolization, magnetic resonanceguided focused ultrasound surgery, Symptomatic women who want definitive treatment and do not desire future fertility, Hysterectomy by least invasive approach possible.