Vials of blood on a table with stethoscope and a sticky note saying, "Uterine Fibroid"

Ablation vs. Hysterectomy for fibroids

Not all uterine fibroids require treatment. But if patients are suffering due to fibroid-related symptoms like heavy periods, frequent urination, pain, and bloating,1 the good news is you can help them find relief. 

Knowing which treatment to recommend is not always a straightforward decision, and individual patient preferences and circumstances should be considered. Let’s compare two uterine fibroid treatments: radiofrequency ablation (or RFA) versus hysterectomy.

About the procedures

In this article, we’ll discuss the Acessa® procedure, a laparoscopic radiofrequency ablation (or Lap-RFA) procedure. The Acessa procedure uses controlled radiofrequency energy (heat) to cause coagulative necrosis of the fibroid tissue, and the treated tissue softens and shrinks over time. The procedure is minimally invasive and uses laparoscopic ultrasound and guidance mapping to target the fibroids.

As you know, hysterectomy is a surgical procedure that involves removing the uterus, thereby removing the fibroids. Hysterectomy can be performed through an abdominal incision, through the vagina, or using laparoscopic or robotic-assisted techniques.

How the two treatments compare on some important factors


Both procedures are considered to be effective treatments for symptomatic uterine fibroids.

The Acessa procedure is supported by clinical data demonstrating significantly reduced fibroid volume across a broad range of fibroid types, favorable reintervention rates, and significant improvements in fibroid-related quality of life.2

Hysterectomy has historically been the tried-and-true procedure for the treatment of uterine fibroids and remains the only proven permanent solution.3


Although both procedures are effective fibroid treatments, their methods differ.

The Acessa procedure is minimally invasive and only targets the uterine fibroids, leaving healthy uterine tissue intact. The procedure shrinks the fibroids (but does not remove them), which relieves the fibroid symptoms.

Hysterectomy is a major, invasive, irreversible surgery that completely removes the uterus and any fibroids growing in the uterus.

Recovery time

The Acessa procedure is an outpatient procedure. Most patients get cleared to go home the same day and are usually ready to return to work after 4-5 days.4

Abdominal hysterectomy can require a patient to stay in the hospital for a few days.3 Recovery time after hysterectomy is usually about 4-6 weeks.5

Make sure patients understand the recovery times for each procedure and the potential impact on their family, work, and social commitments.


Neither procedure is recommended for women who wish to have children in the future.

Insufficient data exists on which to evaluate the safety and effectiveness of the Acessa procedure in women who plan future pregnancy; therefore, the procedure is not recommended for those women.

Hysterectomy is a bit more straightforward—removal of the uterus results in permanent infertility.

When discussing uterine fibroid treatment options, it’s so important to encourage patients to deeply consider their future plans. And if pregnancy is a possibility for your patient, steer her toward other options.

So…Lap-RFA or hysterectomy?

Or maybe another option altogether? It all depends on your patient and her individual situation. And these are just some of the factors to consider. By talking openly to your patients, you can help them find relief from their fibroid symptoms with the most appropriate solution.

To learn more about Lap-RFA for fibroids, visit the webpage for the Acessa procedure. Also check out last month’s blog, which discussed the psychological effects of hysterectomy for fibroids.

REFERENCES: 1. U.S. Department of Health & Human Services Office on Women’s Health. Uterine fibroids. Accessed March 15, 2023. 2. Bradley LD, Pasic RP, Miller LE. Clinical performance of radiofrequency ablation for treatment of uterine fibroids: systematic review and meta-analysis of prospective studies. J Laparoendosc Adv Surg Tech A. 2019;29(12):1507-1517. doi:10.1089/lap.2019.0550 3. Mayo Clinic. Uterine fibroids. Accessed March 15, 2023. 4. Chudnoff SG, Berman JM, Levine DJ, Harris M, Guido RS, Banks E. Outpatient procedure for the treatment and relief of symptomatic uterine myomas. Obstet Gynecol. 2013;121(5):1075-1082. 5. Cleveland Clinic. Hysterectomy. Accessed March 15, 2023.

Important Safety Information

Acessa ProVu System

The Acessa ProVu system is indicated for use in percutaneous, laparoscopic coagulation and ablation of soft tissue, including treatment of symptomatic uterine fibroids under laparoscopic ultrasound guidance. The Acessa ProVu system is contraindicated for patients who are not candidates for laparoscopic surgery and/or patients with a uterus adherent to pelvic tissue or viscera. The Acessa ProVu system’s guidance system is not intended for diagnostic use. Please read all instructions for use of the Acessa ProVu system prior to its use. Safe and effective electrosurgery is dependent not only on equipment design but also on factors under control of the operator. Rare but serious risks include, but are not limited to, infection, injury to adjacent structures, blood loss and complications related to laparoscopy and/or general anesthesia. Insufficient data exists on which to evaluate the safety and effectiveness of the Acessa ProVu system in women who plan future pregnancy, therefore the Acessa ProVu system is not recommended for women who are planning future pregnancy.