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Which Surgical Treatment for Fibroid is best?
Discussion in 'All Categories' started by Harmukgnandi Shekhwani - Nov 26th, 2011 11:31 pm.
Harmukgnandi Shekhwani
Harmukgnandi Shekhwani
Dear Doctor
I am 45 year old female with 4 inch X 6 inch big fibroid. I want to get surgery done. I want to ask which type of surgery will be better.
re: Which Surgical Treatment for Fibroid is best? by Dr M.K. Gupta - Nov 26th, 2011 11:33 pm
#1
Dr M.K. Gupta
Dr M.K. Gupta
Dear Harmukgnandi Shekhwani

THERE ARE FOLLOWING SURGICAL FIBROID TREATMENT

Your physician might recommend a surgical procedure for fibroids if:

You have fibroid-related heavy menstrual bleeding, pain, or pressure that doesn't get better with treatments
You are trying to get pregnant and fibroids might be interfering
There is a concern you could have cancer or precancer rather than fibroids

Myomectomy - Myomectomy is really a surgery done to remove fibroids and reduce heavy menstrual bleeding. Most women who've myomectomy can have children afterwards. However, there's a risk that fibroids will come back after myomectomy; between 10 and 25 percent of women who have myomectomy will require another fibroid surgery. For this reason, myomectomy isn't the best choice for women who do not desire to be pregnant later on.

There are several methods to perform myomectomy; the "best" way depends on where your fibroids are located, Vaginal myomectomy for any prolapsed uterine leiomyoma (fibroid) and Abdominal myomectomy

Abdominal myomectomy - This surgery requires an incision (cut) in the lower stomach to remove the fibroids.
Laparoscopic or robotic myomectomy - This surgery uses several small incisions within the lower stomach. A doctor uses thin instruments along with a camera (laparoscope) to get rid of the fibroids. Robotic myomectomy is a variation of laparoscopic myomectomy where the surgical treatment is aided having a surgical robot.
Hysteroscopic myomectomy - If the fibroids are within the opening of the uterus, a doctor can insert instruments through the cervix to get rid of the fibroids.

Endometrial ablation - Endometrial ablation destroys the lining from the uterus with heat. The therapy does not shrink the fibroid(s) but can help to reduce heavy menstrual bleeding brought on by fibroids. Actually, some women who have endometrial ablation stop having menstrual periods.

Ablation can be achieved in the office or as a day surgery. It can be done in combination with other treatments, such as myomectomy. Endometrial ablation is not a form of birth control, but pregnancy isn't recommended after treatment. You will have to use some type of contraception to prevent pregnancy after ablation.

Uterine artery embolization - Uterine artery embolization (also known as UAE or uterine fibroid embolization, UFE) is really a treatment that blocks the circulation to fibroids. This will cause the fibroid to contract within weeks to many months following the treatment.

The treatment is conducted within the hospital after you are given anesthesia. A doctor will insert a little tube into a large circulation system within the inner thigh. The tube is threaded up to arteries near a fibroid (figure 3A-B). A doctor injects tiny particles in to the circulation system, which stops blood circulation towards the fibroid.

To minimize pain following the treatment, most women stay in a healthcare facility overnight. Pregnancy isn't usually recommended after uterine artery embolization, although it can be done to become pregnant. Some form of contraception is usually recommended if you do not wish to become pregnant.

Magnetic resonance guided focused ultrasound - Magnetic resonance guided focused ultrasound surgery (MRgFUS or FUS) (eg, ExAblate® 2000) is really a more recent fibroid treatment option. This noninvasive treatment takes place in a MRI machine which guides the therapy. Multiple waves of ultrasound energy go through the abdominal wall and converge on the small volume of tissue, which results in thermal destruction of the fibroid. Women do receive sedation throughout the procedure also it can be practiced as an outpatient procedure.

Hysterectomy - Hysterectomy is really a surgery that removes the uterus. The ovaries and cervix are occasionally removed, along with the uterus.

Hysterectomy is really a permanent treatment that cures heavy menstrual bleeding. However, it's major surgery, and you will need as much as six weeks to fully recover. More in depth details about hysterectomy can be obtained separately.

WHICH TREATMENT IS RIGHT FOR ME?

There are lots of treating fibroids, also it can be tough to choose which one is right. You should select a treatment based upon your fibroid-related symptoms.

If you're bothered by heavy menstrual bleeding, you are able to first try the medical treatments. Hormonal contraception, nonsteroidal antiinflammatory drugs (NSAIDs), or antifibrinolytic medicines are more effective than other medical treatments.

Some women can also be given endometrial ablation to reduce bleeding (see 'Endometrial ablation' above).

If medical treatment or endometrial ablation aren't good choices for you, you can look at uterine fibroid embolization, myomectomy, hysterectomy or focused ultrasound surgery.

If you're having trouble getting pregnant and fibroids could be the cause, myomectomy is the standard surgical option. Speak to your doctor to make sure that other possible causes of infertility have been addressed.

With regards
M.K. Gupta
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