Fibroids –Treatment, Causes and Procedure
Non-cancerous growths in the uterus that can develop during a woman’s childbearing years. Symptoms include heavy menstrual bleeding, prolonged periods and pelvic pain. In some cases, there are no symptoms.
A hysterectomy is the surgical removal of the uterus, usually performed by a gynaecologist. It is the most commonly performed gynaecological surgical procedure.
Types of hysterectomy
- Partial (or supracervical) hysterectomy: The upper part of the uterus is removed. The cervix is left in place.
- Total hysterectomy: The entire uterus and cervix are removed.
- Radical hysterectomy: The uterus, upper part of the vagina, and tissue on both sides of the cervix are removed. This is most often done if you have cancer.
Hysterectomy is recommended for which conditions?
- Cancer of the uterus, most often endometrial cancer
- Cancer of the cervix or a precancerous condition of the cervix called cervical dysplasia
- Cancer of the ovary
- Childbirth complications, such as uncontrolled bleeding
- Long-term (chronic) pelvic pain
- Severe endometriosis that does not get better with other treatments
- Severe, long-term vaginal bleeding that cannot be controlled by medicines or other surgeries
- Slipping of the uterus into the vagina (uterine prolapse)
- Tumors in the uterus, such as uterine fibroids
- Adenomyosis, which causes heavy, painful periods
What are the treatment options?
There are many different ways to perform a hysterectomy. It may be done through a surgical cut in either the belly (abdomen) or vagina.
- Abdominal hysterectomy: The surgeon makes a 5- to 7-inch surgical cut in the lower part of your belly. The cut may go either up and down, or it may go across your belly, just above your pubic hair.
- Total Laparoscopic Hysterectomy: A laparoscope is a narrow tube with a tiny camera on the end. The Uterus cancer, abnormal uterine bleeding, genital prolapse and chronic pelvic pain are some of the common reasons that hinder the regular functioning of the uterus. This can be treated by laparoscopic removal of the uterus.
The individuals who have the following conditions are considered the right candidates for undergoing laparoscopic hysterectomy:
- Pelvic inflammatory disease
- Uterus cancer
- Prolapse of the uterus
- Abnormal uterine bleeding
- Uterine fibroids
Total laparoscopic hysterectomy is a minimally invasive surgical procedure performed for the removal of the uterus. It is used to treat the conditions that affect the female reproductive parts. The procedure is usually performed in case of uterine or cervical cancer.
A laparoscope is a narrow tube with a tiny camera on the end. The surgeon makes 3 to 4 small cuts in your belly. The laparoscope and other surgical instruments are inserted through the openings. The surgeon cuts the uterus into small pieces that can be removed through these openings.
Benefits of Laparoscopic Hysterectomy:
- Smaller incisions
- Less post-operative pain
- Quick Recovery
- Reduces the risks of complications
Laparoscopy-assisted vaginal hysterectomy (LAVH): The surgeon removes the uterus through a cut that is made inside your vagina. A laparoscopy is used to guide the procedure.
Vaginal and laparoscopic hysterectomies have been clearly associated with decreased blood loss, shorter hospital stay, a speedier return to normal activities, and fewer abdominal wall infections when compared with abdominal hysterectomies.
Laparoscopically assisted vaginal hysterectomy (LAVH) is a surgical procedure that uses a laparoscope to guide the removal of the uterus and/or Fallopian tubes and ovaries through the vagina. During LAVH, several small incisions (cuts) are made in the abdominal wall through which slender metal tubes are known as “trocars” are inserted to provide passage for a laparoscope and other microsurgical tools. The laparoscope allows the doctor see the pelvic organs. The abdomen is inflated with carbon dioxide to better view the organs and to give more room. Other small cuts are made in the abdomen. Through these cuts, instruments are inserted. A cut is also made where the uterus joins the vagina. The bladder and rectum are gently pushed off the uterus, which is removed through the cut in the vagina. The vagina is then closed to prevent infection and to keep the intestines from dropping down. The areas are then stitched. The scars, pain, and recovery time from LAVH are usually significantly less than with an abdominal hysterectomy.
What is Myomectomy?
A Myomectomy is the surgical removal of fibroids from the uterus.
What are fibroids?
Fibroids are fibrous, connective tissue tumors that form. Removal of the fibroids in this way preserves the uterus. Uterine fibroids, also known as myomas or leiomyomas, are the most common female reproductive system tumors and account for nearly 60 percent of the hysterectomies performed each year. Most fibroids are asymptomatic or cause minor symptoms, however, 1 in 4 women will develop symptoms severe enough to affect their quality of life and require treatment.
How is Myomectomy performed?
Myomectomy is the preferred fibroid treatment for women who want to become pregnant. Before a Myomectomy, shrinking fibroids with gonadotropin-releasing hormone analog (GnRH-a) therapy may reduce blood loss from the surgery. GnRH-a therapy lowers the amount of estrogen your body makes. If you have bleeding from a fibroid, GnRH-a therapy can also improve anemia before surgery by stopping uterine bleeding for several months.
Laparoscopic Myomectomy removes subserosal fibroids utilizing a laparoscope, a tiny camera connected to a long slender telescope used for viewing inside the abdomen in conjunction with long slender instruments used for performing the operation. Only 2 to 4, less than one-half inch, abdominal incisions are required to perform the surgery.
Special Note: We take pride in the fact that the world’s largest Fibroid weighing 6.5 kilos was taken out by Padmashree awardee Dr. Malvika Sabharwal at Apollo Spectra Hospitals, Karol Bagh, New Delhi in December 2010.
Hysteroscopic Myomectomy removes submucosal fibroids via the vaginal canal using a hysteroscope, a thin, telescope-like instrument that is inserted into the uterus through the vagina and cervix.
Laparotomy Myomectomy removes numerous or large fibroids. Requiring a larger abdominal incision, laparotomy allows the thorough inspection of the uterus to ensure complete uterine fibroid removal.