There are many options to treat uterine fibroids; the one to treat you is selected depending on the symptoms, fibroid location, size, and number of fibroids, the age of the patient, side effects and her reproductive plans in the future.
Surgical Procedures for Uterine Fibroids Performed at Marina del Rey Hospital
Surgery is considered if your symptoms are severe or moderate. You can discuss with your gynecologist the right surgical treatment approach, risks involved, potential side effects and the recovery time for the chosen surgical procedure.
Based on the type of uterine fibroids, the surgical procedure will be performed under general anesthesia. Some procedures will be performed through minimally invasive approach, and do not require a hospital stay, whereas a few procedures require a stay of 48 hours at the hospital. Recovery may take about 2 – 6 weeks.
Surgical approaches for the treatment of uterine fibroids include:
Endometrial Ablation: This procedure is used for small fibroids inside the uterus. Using a heated balloon or a microwave the lining of the uterine wall is destroyed. Chances of getting pregnant after this procedure are very small. Women who get pregnant after this procedure have higher chances of miscarriages and other problems.
Myomectomy: During this procedure the surgeon only removes the fibroids and leaves the healthy part of the uterus intact. After this procedure, women can bear children. Myomectomies have more than 80% chances of successful treatment of fibroids. Once the fibroids are removed they do not grow back in the same location, but there are possibilities of fibroids growing in a different location.
Based on the location, size, and the number of fibroids, myomectomy can be performed through any of the following surgical methods:
Hysteroscopy: In this procedure, the surgeon inserts a long thin telescopic instrument through the vagina and cervix to reach the uterus. With the help of electrical or mechanical devices, the fibroids are excised and destroyed. To have a clear visibility of the fibroids, a fluid is injected into the uterus.
Laparotomy: An incision is made in the abdomen to remove the fibroids from the uterus.
Laparoscopy: In this procedure, the surgeon makes two small cuts on the abdomen through which telescopic instruments are inserted, one for visualizing and the other with attached mechanical devices to remove the fibroids from the uterus.
Hysterectomy: In conditions in which the fibroids are large or numerous, when there is heavy bleeding or when the woman is close to menopause or has crossed menopause, gynecologists suggest this surgical method. In this method, the whole or a portion of the uterus is removed. Hysterectomy is the only assured surgical method to remove uterine fibroids completely. After this procedure, you will not be able to bear children.
Types of Hysterectomy:
Partial hysterectomy: In this procedure, only a part of the uterus is removed.
Total hysterectomy: Complete uterus, cervix, and sometimes ovaries and fallopian tubes may also be removed.
Radical hysterectomy: In this procedure, the uterus, the tissue on the sides of the cervix, and the upper part of the vagina are removed.
Uterine artery embolization (UAE): In this surgical procedure, small beads of a compound called polyvinyl alcohol are passed through a catheter into the arteries that feed the uterine fibroids. These beads block the supply of blood and oxygen to the fibroid, and thereby destroy it by starvation. This method is not extensively used as there are more chances of the reappearance of fibroids.
Uterine artery occlusion (UAO): In this approach, the arteries supplying blood and oxygen to the uterine fibroids are blocked using clamps, resulting in the destruction of the uterine fibroids through starvation.
Drugs and Other Treatment Needed for Uterine Fibroids
Treatment of uterine fibroids using medication involves hormonal drugs, which can change the hormonal levels in the body. These are usually given orally, or in the form of injections or through an intra-uterine device.
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