If fibroids require treatment, hysterectomy is usually the therapy of choice. Myomectomy is best reserved for women who wish to preserve their uterus and have a single large fibroid tumour; it is not normally recommended for either abnormal uterine bleeding or infertility. The blood supply of leiomyomas is from the periphery and is such that degeneration frequently ensues. Degeneration, in particular the acute degeneration that may occur in pregnancy, is rarely an indication for operation. Myomectomy has been associated with considerable blood loss intraoperatively and prolonged morbidity postoperatively. The former can be avoided by limiting the uterine circulation during surgery with a uterine tourniquet and vascular clamps. Atraumatic intracapsular removal of the tumour and perfect hemostasis will minimize the latter.
如果子宫肌瘤需要治疗，子宫切除术通常是首选的治疗方法。肌瘤切除术最适合那些希望保留子宫且只有一个大的肌瘤肿瘤的女性；对于异常子宫出血或不孕症，通常不推荐使用。平滑肌瘤的血液供应来自周边，因此经常会发生变性。变性，尤其是妊娠期间可能发生的急性变性，很少是手术的指征。肌瘤切除术与术中大量失血和术后长时间发病有关。前者可通过在手术中使用子宫止血带和血管夹限制子宫循环来避免。肿瘤的无创伤性囊内切除和完美止血将使后者降至最低。
