Minimally Invasive Fibroid Treatment in Turkey
Uterine fibroids can cause heavy menstrual bleeding, pelvic pain, pressure, abdominal enlargement, urinary or bowel symptoms and anaemia. However, having fibroids does not automatically mean that hysterectomy or conventional surgery is necessary.
For appropriately selected patients, minimally invasive treatments can target symptomatic fibroids while preserving the uterus.
Two important treatment options are:
- Uterine Artery Embolization (UAE), also called Uterine Fibroid Embolization (UFE)
- Radiofrequency Ablation (RFA) of uterine fibroids
These treatments work in different ways. UAE reduces the blood supply feeding the fibroids, while RFA uses controlled thermal energy to destroy fibroid tissue.
Neither procedure is appropriate for every patient. The choice between UAE, RFA, myomectomy, hysterectomy, medication or observation should be based on the patient’s symptoms, imaging findings, fibroid characteristics, age and reproductive plans.
What Are Uterine Fibroids?
Uterine fibroids, also called leiomyomas or myomas, are benign growths arising from the smooth muscle of the uterus.
They are extremely common and many women have fibroids without experiencing any symptoms.
Treatment is generally considered when fibroids cause clinically significant problems such as:
- Heavy or prolonged menstrual bleeding
- Iron-deficiency anaemia
- Pelvic pressure
- Pelvic or lower abdominal pain
- Abdominal enlargement
- Frequent urination
- Bladder pressure
- Constipation or bowel pressure
- Pain during intercourse
- Fertility or pregnancy-related concerns in selected cases
The presence of a fibroid on ultrasound or MRI alone is not necessarily an indication for treatment.
The important question is whether the fibroid is causing symptoms or affecting reproductive or pelvic function.
Why Consider Minimally Invasive Fibroid Treatment?
Traditional surgical treatment for fibroids includes myomectomy and hysterectomy.
Myomectomy removes individual fibroids while preserving the uterus.
Hysterectomy removes the uterus and provides definitive treatment for uterine fibroids, but pregnancy is no longer possible afterwards.
Minimally invasive fibroid procedures provide additional options for selected patients who may wish to preserve the uterus or avoid major surgery.
Potential advantages can include:
- Preservation of the uterus
- Smaller or no surgical incisions
- Shorter hospital stay
- Faster initial recovery compared with major abdominal surgery
- Treatment of fibroid-related symptoms without hysterectomy
However, “minimally invasive” does not mean that the procedure is automatically preferable to surgery.
Some fibroids are better treated with myomectomy. Some patients may ultimately benefit more from hysterectomy. Others may not require an intervention at all.
The correct treatment depends on the individual case.
Uterine Artery Embolization – UAE / UFE
Uterine artery embolization is a minimally invasive procedure usually performed by an interventional radiologist.
It is also commonly called uterine fibroid embolization when performed specifically to treat fibroids.
Rather than surgically removing the fibroids, UAE targets their blood supply.
How Does Uterine Artery Embolization Work?
Fibroids require blood flow to maintain their tissue.
During UAE, the interventional radiologist introduces a thin catheter into an artery, commonly through an arterial access point in the groin or wrist depending on the technique and operator.
Using X-ray guidance, the catheter is advanced into the uterine arteries.
Very small embolic particles are then delivered through the catheter into vessels supplying the fibroids.
This reduces blood flow to the fibroid tissue.
Over the following weeks and months, treated fibroids undergo degeneration and generally decrease in volume. The purpose is not necessarily to make every fibroid disappear completely, but to reduce fibroid-related symptoms and shrink the treated tissue.
ACOG describes UAE as an alternative to hysterectomy or myomectomy for selected patients with symptomatic fibroids.
Who May Be Suitable for UAE?
UAE may be considered for women experiencing symptoms such as:
- Heavy menstrual bleeding
- Fibroid-related anaemia
- Pelvic pressure
- Bulk-related symptoms
- Abdominal enlargement
- Urinary pressure
- Pain related to fibroids
It may be particularly relevant for women who wish to preserve their uterus or avoid conventional surgery.
However, suitability cannot be determined simply by confirming that fibroids are present.
The number, size, location and vascularity of the fibroids need to be assessed together with the patient’s symptoms and reproductive goals.
NICE recommends that patient selection for UAE involve multidisciplinary assessment including both a gynaecologist and an interventional radiologist.
What Happens Before UAE?
Assessment normally starts with a detailed medical and gynaecological history.
The specialist will want to understand:
- Menstrual bleeding pattern
- Severity of symptoms
- Pelvic pressure or pain
- Previous fibroid treatments
- Previous pelvic surgery
- Current medication
- Anaemia
- Pregnancy history
- Future pregnancy plans
- Other gynaecological conditions
Pelvic ultrasound is commonly used to evaluate the uterus and fibroids.
MRI may be recommended when more detailed information is required about the number, location, size, vascularity and characteristics of the fibroids or when treatment planning requires more detailed anatomical assessment. NICE specifically recommends ultrasound assessment before UAE or myomectomy, with MRI considered when further information is needed.
What Happens During UAE?
The procedure is performed using image guidance.
A small arterial access is created, and a catheter is guided through the blood vessels to the uterine arteries.
Embolic particles are then delivered to reduce blood supply to the fibroids.
Because there is no large abdominal incision, UAE is fundamentally different from myomectomy or hysterectomy.
Depending on the patient’s condition and the treatment protocol, UAE may be performed with local anaesthesia and sedation.
Some patients can leave the hospital the same day, while others may remain overnight for observation and pain management.
What Happens to the Fibroids After UAE?
The fibroids do not usually disappear immediately.
Instead, they progressively shrink after their blood supply has been reduced.
Symptom improvement also develops gradually.
ACOG notes that patients may begin noticing changes in symptoms after approximately two to three months and that fibroids may continue shrinking for a year or longer.
The amount of shrinkage and degree of symptom improvement varies between patients.
The objective is successful control of symptoms rather than achieving a specific percentage reduction in fibroid size.
Radiofrequency Ablation – RFA for Fibroids
Radiofrequency ablation is another uterus-preserving treatment available for selected uterine fibroids.
Instead of blocking the blood vessels supplying the fibroid, RFA treats the fibroid tissue directly.
Controlled radiofrequency energy produces heat within the targeted fibroid tissue.
The treated tissue subsequently undergoes degeneration and gradually decreases in volume.
ACOG recognises RFA as a treatment option for uterine fibroids and notes that it can be performed using different approaches.
How Is Fibroid RFA Performed?
There is not just one RFA technique.
Depending on the technology, fibroid location, available expertise and individual anatomy, radiofrequency ablation may be performed using different approaches.
These can include:
Transcervical RFA
A specialised device is passed through the cervix into the uterus.
Integrated ultrasound can be used to identify and target appropriate fibroids before radiofrequency energy is delivered.
This approach does not require an abdominal incision.
Laparoscopic RFA
Small abdominal incisions are used to introduce a laparoscope and treatment instruments.
Ultrasound can help the surgeon locate the fibroids, after which radiofrequency energy is delivered directly into the targeted tissue.
Other Image-Guided Approaches
Depending on available technology and clinical circumstances, selected fibroids may also be treated using other image-guided ablation approaches.
The appropriate technique depends on fibroid anatomy and the experience and equipment of the treating centre.
What Is Transcervical Radiofrequency Ablation?
Transcervical RFA is specifically designed to treat selected fibroids through the natural cervical route.
An ultrasound-guided treatment device is introduced through the cervix.
The fibroid is visualised, targeted and treated with radiofrequency energy.
The intention is to create controlled thermal ablation within the fibroid while preserving surrounding uterine tissue.
Because the procedure is performed transcervically, there is no abdominal surgical incision.
NICE reports no major safety concerns with transcervical ultrasound-guided RFA but states that the quality of evidence regarding efficacy remains limited and recommends specific governance, consent and audit arrangements. This uncertainty should be discussed transparently with patients considering the procedure.
UAE and RFA Are Not the Same Treatment
Although both procedures are minimally invasive and preserve the uterus, their mechanisms are different.
UAE/UFE works by reducing the arterial blood supply to the fibroids.
RFA applies controlled thermal energy directly to selected fibroid tissue.
UAE can potentially treat multiple fibroids supplied through the uterine arterial circulation during the same procedure.
RFA requires individual fibroids to be identified and targeted, and suitability depends considerably on their size, number and anatomical position.
For this reason, one procedure should not automatically be considered superior to the other.
The imaging and clinical presentation determine which approach is technically and medically appropriate.
RFA or Myomectomy?
Myomectomy physically removes one or more fibroids while preserving the uterus.
RFA does not surgically remove the fibroid. Instead, it destroys targeted fibroid tissue, which subsequently shrinks.
This distinction is important.
A patient with a particular intracavitary, submucosal, very large, numerous or anatomically complex fibroid pattern may require a different treatment strategy from a patient with several appropriately positioned fibroids suitable for ablation.
Therefore, the decision should be based on detailed imaging rather than simply choosing the least invasive procedure.
UAE or Myomectomy?
UAE and myomectomy can both preserve the uterus, but they are very different procedures.
Myomectomy removes fibroids surgically.
UAE leaves the fibroids in place but reduces their blood supply so that they shrink.
Myomectomy may be particularly relevant when removal of a specific fibroid is important, including certain situations involving the uterine cavity or reproductive planning.
UAE may be particularly attractive to selected patients who wish to avoid surgery and whose fibroid distribution is appropriate for embolization.
Neither approach is universally better.
What About Future Pregnancy?
This is one of the most important considerations when choosing minimally invasive fibroid treatment.
Pregnancy can occur after both UAE and RFA, but the evidence regarding subsequent fertility and pregnancy outcomes remains less established than for some more traditional fertility-preserving approaches.
NICE specifically states that patients considering pregnancy should be informed that the effects of UAE on fertility and pregnancy remain uncertain.
ACOG similarly notes that more research is needed regarding pregnancy after RFA.
Therefore, a woman who wishes to become pregnant in the future should not simply choose UAE or RFA because the uterus is preserved.
Her fertility goals should be discussed explicitly with the gynaecologist, and when necessary a fertility specialist, before deciding on treatment.
For some women planning pregnancy, myomectomy may remain the preferred treatment depending on fibroid location, number, size and reproductive circumstances.
Preserving the uterus and preserving fertility are related concepts, but they are not identical.
Which Fibroids Can Be Treated?
Suitability depends on more than fibroid diameter.
Assessment may consider:
- Number of fibroids
- Size of each fibroid
- Location
- Relationship to the endometrial cavity
- Relationship to the outer uterine surface
- Fibroid vascularity
- Presence of pedunculated fibroids
- Overall uterine size
- Previous treatment
- Coexisting adenomyosis
- Symptoms
- Age
- Pregnancy plans
This is why imaging review is essential before treatment is recommended.
Is MRI Necessary?
Not every patient automatically requires MRI.
Pelvic ultrasound is usually an important first investigation.
However, MRI can provide much more detailed mapping when multiple fibroids are present or when treatment planning requires precise information regarding their location, size and characteristics.
MRI can also help identify other uterine pathology that may affect the treatment decision.
For international patients who already have a recent pelvic MRI, the actual imaging files are particularly useful and should ideally be reviewed together with the radiology report.
Could My Symptoms Be Caused by Something Other Than Fibroids?
Yes.
Heavy menstrual bleeding, pelvic pain and pressure are not specific to fibroids.
Similar symptoms can occur with conditions such as:
- Adenomyosis
- Endometriosis
- Endometrial polyps
- Ovarian pathology
- Endometrial disorders
- Other gynaecological conditions
Before an interventional procedure is planned, the clinical team should confirm that the fibroids are likely to be responsible for the patient’s symptoms.
This is particularly important because treating an incidental fibroid will not necessarily improve symptoms caused by another condition.
What Are the Potential Benefits of UAE?
For appropriately selected patients, potential advantages include:
- Preservation of the uterus
- Avoidance of major abdominal surgery
- Treatment of multiple fibroids
- No large surgical incision
- Short hospital stay in many cases
- Improvement in heavy bleeding
- Improvement in pressure-related symptoms
- Gradual reduction in fibroid volume
NICE concludes that UAE provides short- and medium-term symptom relief for a substantial proportion of appropriately selected patients and identifies no major general safety concerns when standard governance arrangements are followed.
What Are the Potential Benefits of RFA?
Depending on the approach and individual case, potential advantages can include:
- Preservation of the uterus
- Targeted treatment of fibroid tissue
- Limited or no abdominal incisions
- Shorter initial recovery compared with major surgery
- Reduction in fibroid volume over time
- Improvement in fibroid-related symptoms
However, treatment success depends heavily on appropriate patient and fibroid selection.
What Are the Risks of UAE?
Possible complications include:
- Pelvic pain and cramping
- Nausea
- Fever
- Infection
- Vaginal discharge
- Passage of fibroid tissue
- Vascular access complications
- Failure to adequately improve symptoms
- Recurrence or persistence of symptoms
- Need for further treatment
- Effects on ovarian function in some patients
ACOG notes that ovarian problems or premature menopause can occur, particularly in older patients.
Patients should also understand that UAE does not guarantee permanent symptom resolution.
NICE specifically recommends informing patients that symptoms may fail to improve or may recur and that additional procedures may eventually be required.
What Are the Risks of RFA?
Potential complications vary according to the technique but can include:
- Pain or cramping
- Bleeding
- Infection
- Injury to surrounding structures
- Uterine perforation with some approaches
- Incomplete treatment
- Persistent symptoms
- Need for additional treatment
The treating specialist should explain the risks specific to the proposed RFA technique and the patient’s anatomy.
What Is Recovery Like After UAE?
Pelvic cramping and pain are common during the early period after embolization.
Some patients also experience fatigue, nausea or a temporary low-grade fever.
Pain management is therefore an important part of the treatment pathway.
Many patients are discharged on the same day or after an overnight stay depending on their recovery and local protocol.
Recovery is individual, and international travel should not be planned solely around the earliest possible discharge date.
What Is Recovery Like After RFA?
Recovery depends partly on whether treatment was performed transcervically, laparoscopically or using another image-guided technique.
Because RFA does not involve removal of the uterus and some techniques require no abdominal incision, recovery may be considerably shorter than after open hysterectomy or abdominal myomectomy.
However, patients can still experience cramping, discomfort, discharge or fatigue following treatment.
The treating team should provide individual instructions regarding activity, medication, warning symptoms and travel.
Will My Fibroids Disappear Completely?
Not necessarily.
Both UAE and RFA are primarily designed to control symptoms by reducing or destroying fibroid tissue.
After UAE, fibroids usually shrink progressively because their blood supply has been reduced.
After RFA, treated tissue undergoes degeneration and is gradually reduced in volume.
A fibroid can therefore remain visible on future ultrasound or MRI even when treatment has successfully improved the patient’s symptoms.
Treatment success should not be judged only by whether the fibroid remains visible.
Can Fibroids Come Back?
Treatment does not necessarily prevent every future fibroid-related problem.
After myomectomy, removed fibroids do not regrow, but new fibroids can develop.
After UAE or RFA, symptoms may persist or recur in some patients, and additional treatment can occasionally be necessary.
This possibility should be included in the treatment discussion before choosing a uterus-preserving procedure.
UAE, RFA, Myomectomy or Hysterectomy?
There is no single best fibroid treatment for every woman.
The options address different clinical situations.
UAE/UFE
Reduces the blood supply to fibroids and is performed by interventional radiology.
RFA
Uses controlled thermal energy to ablate selected fibroid tissue.
Myomectomy
Surgically removes fibroids while preserving the uterus.
Hysterectomy
Removes the uterus and provides definitive treatment for uterine fibroids.
For some women, medication or observation may be more appropriate than any procedure.
The correct pathway depends on what the patient is trying to achieve as well as the anatomy of the fibroids.
How We Determine Which Treatment May Be Appropriate
For international patients, the first step should ideally be a case review rather than choosing a procedure from a website.
The clinical team may review:
- Symptoms
- Age
- Menstrual history
- Anaemia
- Previous treatments
- Previous surgery
- Ultrasound
- MRI when available
- Number of fibroids
- Fibroid measurements
- Fibroid location
- Desire to preserve the uterus
- Future pregnancy plans
- Relevant medical conditions
Depending on these findings, the case may require assessment by a gynaecologist, an interventional radiologist or both.
This multidisciplinary approach is particularly important when deciding between embolization, ablation and surgical treatment.
Can My Fibroid Case Be Reviewed Before I Travel?
Yes.
International patients can often begin the assessment remotely by providing their existing medical records.
Useful documents include:
- Pelvic ultrasound report
- Pelvic MRI report
- Original MRI images when available
- Gynaecology consultation reports
- Recent complete blood count
- Iron and ferritin results if heavy bleeding is present
- Previous operation reports
- Pathology results if relevant
- Details of previous fibroid treatment
- Current medication
- Pregnancy and fertility history
The purpose of the initial review is to identify which treatment pathways appear reasonable and which specialist expertise is required.
A definitive treatment decision may still require direct examination or additional investigations after arrival.
Minimally Invasive Fibroid Treatment in Turkey
Turkey offers access to gynaecologists, interventional radiologists, advanced imaging and minimally invasive treatment technologies.
However, international patients should not select a hospital or procedure simply because it advertises a particular fibroid treatment.
A patient with symptomatic fibroids may require a gynaecological surgeon.
Another patient may be better suited to interventional radiology and UAE.
A selected patient may be appropriate for RFA.
Another may benefit most from myomectomy, while hysterectomy may be the appropriate definitive treatment in a different clinical situation.
The important step is therefore matching the patient to the appropriate treatment and expertise, rather than matching every patient to the same procedure.
How Healing Journey Supports International Patients
Healing Journey is an independent medical coordination service.
We do not perform fibroid procedures ourselves and are not limited to a single hospital, gynaecologist or interventional radiology provider.
For patients seeking fibroid treatment in Turkey, we can coordinate:
- Review and organisation of medical records
- Review of available ultrasound and MRI findings
- Appropriate specialist selection
- Gynaecology consultation
- Interventional radiology consultation when indicated
- Hospital and treatment-centre selection
- Additional imaging when required
- Treatment-plan coordination
- Written quotation coordination
- Appointment scheduling
- Travel and accommodation support
- English-speaking patient coordination
- Hospital guidance
- Medical translation and communication
- Discharge planning
- Follow-up appointments
- Medical-document coordination
- Post-treatment communication after returning home
The objective is not to recommend the least invasive treatment automatically.
It is to identify the treatment that best fits the patient’s actual medical needs.
Choosing a Uterus-Preserving Fibroid Treatment
The development of UAE and RFA means that hysterectomy and conventional surgery are no longer the only procedural options for symptomatic uterine fibroids.
For appropriately selected patients, minimally invasive treatment can provide symptom relief while preserving the uterus.
But treatment selection matters.
UAE, RFA and myomectomy are not interchangeable procedures, and preserving the uterus does not automatically mean that every option has the same implications for future fertility.
A responsible treatment plan should answer four questions:
- Are the fibroids actually responsible for the symptoms?
- Which fibroids need treatment?
- Does the patient wish to preserve fertility or the uterus?
- Which technique provides the most appropriate balance of effectiveness, invasiveness and risk for this particular anatomy?
International patients considering minimally invasive fibroid treatment in Turkey can send their ultrasound or MRI findings, previous treatment records and relevant blood results for an initial case review.
Healing Journey can then coordinate the appropriate gynaecology and/or interventional radiology assessment and determine whether UAE/UFE, radiofrequency ablation, myomectomy, hysterectomy or another treatment pathway should be considered.
Medical disclaimer: This information is for general education and does not replace individual medical assessment, diagnosis or treatment planning. Suitability for UAE, RFA or another fibroid treatment must be determined by appropriately qualified clinicians after reviewing the patient’s symptoms, imaging, medical history and reproductive goals.
