Some women have small fibroids that may be accessible from the inside of the uterine cavity. A minor surgery known as hysteroscopy may be used with an instrument to cut out the tumor(s). This simple approach is usually an outpatient procedure, does not require an incision, and fertility may be maintained.
In some cases, as long as there is no future plan to try to become pregnant, noninvasive surgical procedures may also be used to permanently thin the lining of the uterus, or reduce its blood supply (i.e, a procedure known as endometrial ablation). While this procedure does not eliminate the fibroids, the most bothersome symptom (bleeding) is often markedly improved. This procedure requires no incision or stitches, and in some instances may be performed in the office setting under local anesthesia.
Another conservative treatment method is called uterine artery embolization (UAE). This minimally invasive procedure is usually performed by a radiologist and involves injecting tiny beads in the uterine blood vessels by way of an artery in the upper thigh (similar to a heart catherization) in order to block the blood supply to the fibroid. The dramatic reduction in the uterine blood flow will cause the fibroids to shrink, often reducing period bleeding as well. The procedure usually does require an overnight hospital stay, but only requires a very small incision.
There is a growing interest in using MRI and ultrasound imaging to locate and treat fibroids with almost any imaginable energy source, such as ultrasound energy or microwaves. Most of these relatively non-invasive procedures are very early in their development and are not yet commonly performed.