Surgical options for Uterine Fibroids
Fibroids are benign (not cancerous) lumps that form in the uterus or on the uterus or in the tissues surrounding the uterus. They vary in size and the number of fibroid tumours can vary from patient to patient. Many times, small fibroids don’t bother much but when they start showing symptoms such as heavy menstrual bleeding, painful intercourse, pain in lower abdomen; you must see a specialist as soon as possible.
Once diagnosed with physical examination and with relevant tests, the gynecologist may take different approaches ranging from medical treatment, hormonal therapy or go for a surgery depending on the condition.
What are the surgical treatment options for fibroids?
This is a way to kill the fibroids by cutting off the blood supply to them. Once that is done, the fibroids shrink in size and eventually they die off. The blood supply is cut by freezing, heating or by using electric currents or radio frequency energy.
You will need to see only an expert gynaecologist if your doctor says that he/she wants to take this approach because, there is a chance of scarring during this procedure. If the internal organs are scarred, that can lead to infertility. So, if you are planning to get pregnant in the future, you must tell your doctor about your plans.
2. Uterine Artery Embolization
This is a non-invasive procedure where in a catheter is inserted through the radial or femoral artery after giving anaesthesia in the region. Then a substance like PolyVinyl Alcohol (PVA) is injected into the artery. (There are different substances that are used today in the place of PVA). This substance cuts off the blood supply to the fibroids effectively halting their growth and eventually killing them.
Though a non-invasive procedure, you may need to stay at the hospital for a day or two for your gynaecologist to observe you. In some cases, the fibroids may grow back and the procedure may need to be repeated. This procedure is employed to treat bothersome symptoms like heavy uterine bleeding. The result of the procedure depends on how specialised the gynaecologist is, the number of fibroids, their size and location.
3. Endometrial Ablation
Ablation means destruction. Destroying the lining of the uterus is called ‘Endometrial Ablation’. As you can guess, this procedure causes infertility. A good gynaecologist will surely ask you if you have any plans of getting pregnant in future. If he/she doesn’t ask, you can inform them about your plans. The procedure doesn’t need any incisions to be made as it is done through the vagina. Laser, electric current boiling water etc are used to destroy the uterus lining. As the uterus is destroyed, you may have very light periods or no periods at all post the procedure.
If you are having plans to get pregnant in the future and now suffering from fibroids, myomectomy is the procedure a good doctor would opt for. This procedure involves removal of fibroids leaving rest of the organs intact.
Myomectomy is performed in different ways depending on the count, size and location of fibroids.
4a. Abdominal incision
In case if you have large fibroids and more in number and if they are located deep inside the tissues, your surgeon may opt for this method of treatment. An incision is made in the abdominal area after putting you under general anaesthesia. Once the fibroids are removed, the muscles will be stitched back and the incision will be closed. You will need to be hospitalized for 2 or 3 days and a complete recovery can be expected after 6 weeks.
After the procedure, once you become pregnant, a C Section may be required instead of normal vaginal delivery. Your gynaecologist will explain this to you before surgery and you need to inform the same to your doctor before labour or during your trimester consultations.
4b. Fibroid removal using Hysterocope
If the fibroids are only inside the uterus, this procedure can be employed. A special device called hysteroscope is inserted into the uterus through the vagina. This scope will let the doctor see where the fibroids are located inside. The hysteroscope will have another device attached to it called, resectoscope using which electric current is applied to cut off the fibroids. Complications are very less and this can be done as a day care procedure. Local anesthesia may be administered before the procedure
4c. Laparoscopic Myomectomy
As the name suggests, this is done using a laparoscope. Small incisions are made on the abdomen or belly area to remove the fibroids.
To know more about Laparoscopic Myomectomy, please visit the link below:
This is a final option considered by the surgeon if the fibroids are large, recurring and if you are suffering from heavy menstrual periods AND if you are not planning to get pregnant in the future.
Hysterectomy is done either through vagina or by using advanced technology, 3D Laparoscopy. Know more about Laparoscopic hysterectomy by visiting the following link: