Myolysis: Everything You Need to Know

Myolysis is a procedure that shrinks uterine fibroids by destroying the muscle fiber that they are made of. This is done either by using a laser, extreme cold, an electric current, or high-frequency ultrasound.

Myolysis is less invasive than other ways of treating uterine fibroids, including myomectomy or hysterectomy, but it is not recommended for people who want to be pregnant in the future since it can cause uterine scarring. It's also not a permanent solution—most women who have myolysis will need surgery again in the future.

Here’s what you should know about myolysis surgery, including how to prepare, what to expect from recovery, how the procedure will affect your long-term health, and whether myolysis is a good fit for you. 

prepping for surgery
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What Is Myolysis?

Myolysis is the process of removing muscle fiber. In this case, the term refers to the removal of the muscle fiber that fibroids are made of. During a myolysis procedure, patients are usually under general anesthesia. A small incision is made through the abdomen or the vagina, and the surgeon will use a camera to conduct the surgery through laparoscopy. During the procedure, an instrument is inserted into or near the fibroid to kill off the muscle tissue.

This is done using various means, including:

  • Laser: A laser can be used to entirely remove the fibroid or to block its blood supply, causing it to shrink.
  • Cold: Liquid nitrogen freezes the fibroid, killing the muscle fiber.
  • Electricity: An electric current kills the fibroid and destroys its blood flow.

There is also a new type of myolysis that is even less invasive. It's called magnetic resonance-guided focused ultrasound (MRgFUS). Studies are underway on this new type of myolysis.

During this procedure, a doctor uses magnetic resonance imaging (MRI) to guide a high-frequency ultrasound beam, which kills the fibroid through heat.

Unlike traditional myolysis, this is an outpatient procedure that takes about three to four hours. However, like myolysis, it’s not recommended for people who want to have children in the future.

Who Should Have Myolysis?

Myolysis is a good treatment option for people who:

  • Have a few small fibroids
  • Have no more than four fibroids
  • Don’t have any fibroids that are larger than 10 centimeters

Myolysis and Pregnancy Plans

Myolysis should not be used for people who want to carry a pregnancy in the future. The procedure can create scar tissue in the uterus that can make it difficult to conceive or carry a pregnancy to term. In addition, the procedure can weaken the wall of the uterus, increasing the risk of pregnancy complications.

Does Myolysis Work?

Studies have shown that myolysis is effective at shrinking fibroids and reducing symptoms. This includes MRgFUS.

Compared with other fibroid treatment options, myolysis is less invasive and less likely to lead to complications. Still, since fibroids are likely to recur in women who have a history of them, roughly 59% of women who have myolysis will need additional surgery within five years.

Understanding This New Procedure

Despite the promise of myolysis, this is a relatively new procedure. Myolysis was first developed in the 1990s, and there is a need for more research concerning outcomes and side effects. Because of this, myolysis—especially MRgFUS—is considered experimental.

You should check with your insurance company to ensure that the procedure is covered if your doctor recommends it. 

Myolysis Alternatives

If you are not comfortable with the idea of myolysis, you might consider these alternative treatments for fibroids:

  • Endometrial ablation: An ablation destroys the lining of the uterus, where many fibroids form. It also helps relieve heavy bleeding as a symptom of fibroids. This is a minor outpatient procedure and can result in lighter periods. You cannot sustain a pregnancy after an ablation. 
  • Myomectomy: During a myomectomy, fibroids are surgically removed from the uterus, and the walls of the uterus are repaired. This is a good treatment option for people who want to be able to get pregnant following fibroid-removal surgery. A fibroid resection is a type of myomectomy in which the uterus is accessed through the vagina.
  • Hysterectomy: A hysterectomy is a surgery to remove the entire uterus. It is the only foolproof way to stop uterine fibroids. 

Frequently Asked Questions 

Is ablation or fibroid resection more painful?

Both an ablation and a fibroid resection are considered minimally invasive procedures, and neither should be particularly painful. Things to consider include:

  • An ablation does not remove fibroids, so you may experience future pain if fibroids twist.
  • A resection does remove fibroids and can help you avoid future pain from twisted fibroids. 

Why do I have fibroid tumors after ablation?

An ablation does not remove fibroids. It is designed to reduce heavy bleeding, which is a common and disruptive symptom of fibroids. If you want your fibroids removed entirely you should consider a procedure other than an ablation. 

What are the treatment options for fibroids?

Treatments for fibroids range from medications to surgery. The only surefire way to remove fibroids is to have a hysterectomy. Oftentimes, fibroids recur with other treatment options, although most people also experience reduced symptoms following any procedure.

Which nonsurgical fibroid treatment works best?

The different nonsurgical fibroid treatments have different benefits and drawbacks. To determine which will work best for you, you should talk to your doctor about the specifics of your case. 

A Word From Verywell

Uterine fibroids can be uncomfortable and frightening. However, they are very common. If you are experiencing fibroids, your doctor can guide you through the treatment options that are best for you. Your treatment plan will take into consideration whether you want to get pregnant in the future and the types of symptoms that your fibroids are causing.

Myolysis is a less-invasive procedure that shrinks fibroids to lessen symptoms. It is a good option for people who want to reduce the symptoms of their fibroids, without undergoing a more invasive procedure like myomectomy or hysterectomy. However, myolysis is not recommended for people who want to get pregnant in the future. 

Since treating fibroids can be complicated, it’s best to have a candid conversation with your doctor. If you don’t feel confident in your treatment plan, never hesitate to seek a second opinion. 

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Article Sources
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  1. New York Department of Health.Uterine fibroids. Updated May 2013.

  2. Office on Women’s Health. Uterine fibroids. Updated April 1, 2019.

  3. Brigham and Women’s Hospital. Uterine fibroids.

  4. Goldfarb, Herbert. Myolysis revisited. Journal of The Society of Laparoscopic and Robotic Surgeons.