uterinesparing

Uterine-sparing describes approaches in gynecology that treat disease while preserving the uterus, rather than performing a hysterectomy. The goal is symptom relief and, when possible, retention of reproductive potential and hormonal function. Uterine-sparing can be pursued with surgical or non-surgical methods and is considered when the patient desires future fertility, when uterine removal would carry undue risk, or when organ preservation is medically appropriate.

Common indications include symptomatic fibroids (leiomyomas) that cause heavy bleeding or pressure, adenomyosis or endometriosis causing pain, and other uterine conditions where uterine preservation is feasible. Surgical options include myomectomy (abdominal, laparoscopic, or robotic) and hysteroscopic removal of submucosal fibroids. Non-surgical/uterus-sparing options include uterine artery embolization, MR-guided focused ultrasound, and conservative therapies such as endometrial ablation or hormonal regimens to control bleeding while keeping the uterus.

Outcomes vary by condition and method. Myomectomy can relieve symptoms and preserve fertility, but fibroids may recur and pregnancy requires careful planning. UAE can reduce symptoms but has mixed data regarding fertility and may affect ovarian reserve. MRgFUS is less invasive and effective in selected patients but may not treat all fibroids. Endometrial ablation and hormonal therapies are generally not options for women desiring future pregnancy but can be effective for bleeding control while preserving the uterus. Complications can include surgical risks and adhesions, infection, or pain.

Decision-making for uterine-sparing care depends on anatomy, patient age, fertility goals, and risk tolerance, requiring multidisciplinary assessment and informed consent.