Fibroids: Is hysterectomy the only option?
Fibroids are the non-cancerous growth of muscle cells or connective tissues that develop in or on the uterus. It is known that approximately 20 million Indian women of age between 30yrs to 40yrs are at risk of developing
fibroids(reference for the statistics?)
If a woman is developing symptoms like prolonged periods, heavy bleeding or pelvic pain, she must consult the doctor immediately. Fibroid patients would be glad to know that doctors have been able to find suitable ways to deal with it, over the years. Hysterectomy i.e. removal of the uterus could be avoided for sure now.
There are several non-invasive or minimally invasive procedures available for treatment of fibroids.
1. Simple medication: Fibroids generally shrink after the menopause. Therefore, after suitable tests, the doctor could suggest simple medicines to treat the problems like heavy bleeding caused due to fibroids.
2. Non-invasive procedures:
MRI-HIFU Technique: The MRI-guided High-Intensity Focused Ultrasound technique is a non-surgical procedure to burn out the uterine fibroids tissues. While the patient is inside the MRI scanner, the fibroid is located on the screen. The high-frequency ultrasound beam is targeted on the fibroid to destroy it. The procedure requires 2-3 hours only. It is done on outpatient basis. Researchers have found this procedure to be effective and safe too.
3. Minimally Invasive Procedures: In such procedures, only a small incision (cut) is made, or instruments are inserted through body cavities for the surgery to treat fibroids.
A) Uterine Artery Embolization: In this procedure, suitable embolic agents like small particles are injected into the arteries that supply blood to the fibroid. These particles block the blood supply to starve the fibroid, restraining its growth. Eventually, the fibroid shrinks after some time.
B) Myolysis: This is a laparoscopic procedure performed under local anesthesia. Fibroids are destroyed using laser or electric current. It also shrinks the blood vessels to fibroids stopping its growth anymore. A similar procedure known as Cryomyolysis is used to freeze the fibroids for stopping their growth.
C) Laparoscopic Myomectomy: It is a technique used to remove the fibroid leaving the uterus in place. When the fibroids are suitably small and few in numbers, robotic instruments are inserted through minute incisions in the abdomen and fibroids are removed. If the fibroids are inside the cervix (tunnel between vagina and uterus), they are removed through the vagina.
D) Endometrial Ablation: It is a procedure in which lining of the uterus is destroyed using microwave energy, radio waves, and heat. This minimizes or stops the menstrual flow.
4. Traditional method: Traditional methods of dealing with Fibroids are helpful only if the fibroids are too large or multiple in number. Such methods include Hysterectomy and Abdominal Myomectomy which require major surgery.
A) Abdominal Myomectomy: In this procedure, the doctors reach out to the uterus through the abdomen, cut opened in the surgery. The fibroids are then, removed leaving behind the uterus in place.
B) Hysterectomy: This is a surgical procedure where the entire uterus is removed.
It is advisable to take the proper medical advice to identify the type and size of fibroids before deciding to undergo surgery.