Fibroids are the primary reason for surgical removal of the uterus, accounting for most of the hysterectomies performed. At present, two surgical procedures available to remove uterine fibroids are myomectomy (fibroid removal from the uterus) and hysterectomy (uterus removal).
Uterine fibroids can become such a major health problem for women suffering from it that performing their routine tasks at the workplace and at home becomes very difficult. There have also been many instances where the presence of fibroids has hampered the proper formation and growth of the foetus in the womb.
Worryingly, up to 80% of women with uterine fibroids show no symptoms. However, if they do, it will involve heavier menstrual flow or menstrual period for a longer duration, increased menstrual cramping, backache, irregular or unpredictable bleeding, lower abdominal pressure, constipation, abdominal bloating, infertility and miscarriage.
One new treatment for fibroid removal takes place with the patient lying on the table inside the MR scanner. The energy causes the temperature of the cells to rise high enough to cause thermal ablation (killing of the cells) without impacting other tissues. The procedure is repeated with pulses of energy until the entire area is treated.
Importantly, this advanced medical treatment is conducted in an outpatient setting, without the need for general anaesthesia or hospitalisation — greatly reducing recovery time and the risks of side effects. Following the treatment, the symptoms are relieved as the body gradually expels the treated tissue over a period of months. Within one-three days, you can return to your daily routine and begin the road to improved quality of life without distressing symptoms.
Although doctors are still waiting for more data on its efficacy, the new treatment promises a radical change in the way the problem has been addressed till now and may provide an easy and most convenient option for removing fibroids.
Another minimally-invasive procedure has been shown to successfully treat uterine fibroids while requiring little downtime for the patient and preserving the woman’s uterus.
“This is another treatment option for women to consider,” says Dr Yvonne Gomez-Carrion, an OB/GYN at Beth Israel Deaconess Medical Center in Boston and an assistant professor of obstetrics and gynaecology at Harvard Medical School. “It’s a great option for a woman who is an appropriate candidate and doesn’t want to have surgery.”
Called uterine fibroid embolization (UFE), this non-surgical procedure is performed while the patient is conscious but sedated, and typically requires only an overnight hospital stay. An abdominal hysterectomy, the traditional treatment for fibroids, typically requires a 2-3 day hospital stay and a recovery period of about six weeks. Also, a total hysterectomy removes the entire uterus, while UFE does not.
In UFE, also referred to as uterine artery embolization, the doctor makes a small incision (usually in the groin area) and inserts a thin, flexible tube. Tiny pellets of glycerin are injected through the tube into the arteries that feed the fibroids. The pellets block the vessels supplying blood to the fibroids, cutting off their blood supply and causing them to die.
While this procedure does preserve the uterus, it is not recommended for women who wish to get pregnant. “It’s not advised for women who want to have children,” says Dr Gomez-Carrion. “It could change the wall of the uterus, which could create an area of weakness that could potentially rupture with a pregnancy.” The medical literature shows that approximately one-third of women who have had UFE and then gone on to become pregnant have had pregnancy issues.
The procedure has other risks as well. “UFE can put you into an earlier menopause, though that can be a positive for some women who have been experiencing extreme symptoms with their fibroids,” says Dr Gomez-Carrion. And, though small, there is also the risk of infection.
Dr Gomez-Carrion points out that UFE is not an option for every patient. If you suffer from uterine fibroids, she advises that you discuss all of the options with your doctor.
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