Myomectomy

This procedure involves the removal of fibroids surgically, without uterus removal.3 Your surgeon may select to do a myomectomy using open abdominal surgery, through several small incisions (laparoscopically) or through the vagina and cervix (hysteroscopically) depending upon the size, number and location of the fibroids.2

Dilation and Curettage (D&C)

During this procedure, the doctor opens (dilates) the cervix and then scrapes tissue from the lining of the uterus. Even though this procedure is common and often treats acute and active bleeding successfully, if HMB reappears one may require repeated D&C procedures.2

Hysterectomy

This procedure involves surgically removing the entire uterus. A woman who undergoes this surgery will no longer become pregnant and will stop having her periods.1

Uterine Artery Embolisation

Women in whom heavy menstrual bleeding is caused due to fibroids, this procedure aims to shrink the fibroid in the uterus by blocking the uterine arteries and cutting off their blood supply. During this procedure, a catheter is inserted into femoral artery which is the large artery of the thigh and guides it to the uterine arteries.2 There the blood vessel is injected with polyvinyl alcohol which reduces the blood flow to the fibroid.2

Endometrial Ablation

In this procedure, the lining of your uterus (endometrium) is destroyed (ablated).2 The goal of endometrial ablation is to reduce the menstrual flow. Endometrial ablation does not require any incisions. Your doctor passes slender tools through the opening between your vagina and uterus (cervix). The tools vary, depending on the method used to ablate the endometrium. Methods might include extreme cold, heated fluids, microwave energy, or high-energy radio frequencies. Selection of the most appropriate endometrial ablation method depends on factors such as the size and condition of your uterus.5

References:
1. National Health Portal of India. Abnormal uterine bleeding. [Internet]. 2017 Jul 28 [cited 2022 Dec 23]. Available from: https://www.nhp.gov.in/disease/gynaecology-and-obstetrics/abnormal-uterine-bleeding.​
2. Bradley LD, Gueye NA. The medical management of abnormal uterine bleeding in reproductive-aged women. Am J Obstet Gynecol. 2016;214(1):31-44.​
3. WebMD. Abnormal uterine bleeding. [Internet]. 2022 Sep 07 [cited 2022 Dec 23]. Available from: https://www.webmd.com/women/abnormal-uterine-bleeding.​
4. Mayo Clinic. Uterine fibroids. [Internet]. 2022 Sep 21 [cited 2022 Dec 23]. Available from: https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/diagnosis-treatment/drc-20354294.
​ 5. The Federation of Obstetric and Gynaecological Societies of India. Abnormal uterine bleeding. [Internet]. 2020 [cited 2022 Dec 26]. Available from: https://fogsi.org/wp-content/uploads/fogsi-focus/ fogsi-focus-abnormal-uterine-bleeding-2021.pdf.​
6. Mayo Clinic. Myomectomy. [Internet]. 2022 Jun 28 [cited 2022 Dec 29]. Available from: https://www.mayoclinic.org/tests-procedures/myomectomy/about/pac-20384710.​
7. Mayo Clinic. Endometrial ablation. [Internet]. 2022 Dec 20 [cited 2022 Dec 26]. Available from: https://www.mayoclinic.org/tests-procedures/endometrial-ablation/about/pac-20393932.
​ 8. Web MD. Do I need surgery for uterine fibroids. [Internet]. 2020 Nov 10 [cited 2022 Dec 28]. Available from: https://www.webmd.com/women/uterine-fibroids/surgery-for-uterine-fibroids.
​ 9. Siskin GP, Englander M, Stainken BF, et al. Embolic agents used for uterine fibroid embolization. AJR Am J Roentgenol. 2000;175(3):767-73.​
10. Mayo Clinic. Abdominal hysterectomy. [Internet]. 2021 Apr 27 [cited 2022 Dec 26]. Available from: https://www.mayoclinic.org/tests-procedures/abdominal-hysterectomy/about/pac-20384559# :~:text=An%20abdominal%20hysterectomy%20is%20a,the%20uterus%20and%20the%20cervix.​
11. Johns Hopkins Medicine. Dilatation and curettage. [Internet]. 2021 Oct 19 [cited 2022 Dec 29]. Available from: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/dilation-and-curettage-d-and-c.