Is a hysterectomy the only way to treat fibroids?

March 10, 2015

Depending on their size and number, uterine fibroids can cause symptoms that range from bothersome to severe. These benign tumors, which can grow in your uterine wall, inside your uterus or on the external portion of your uterus, are relatively common in menstruating women and may require treatment in the event that heavy bleeding, cramps, frequent urination or swelling occur due to their presence. If you have this condition and are considering fibroid surgery, you may be under the impression that a hysterectomy is the only solution to your problem. The good news is that these uterine tumors can be treated in other ways that are less surgically invasive.

Hysterectomy Risks and Benefits

One reason why your doctor may recommend a hysterectomy is that this type of surgery for fibroids provides a permanent cure for the condition. Because the uterus is removed during a hysterectomy procedure, uterine fibroids do not have a place in which to grow back, and any symptoms caused directly by the fibroids should cease. However, due to the nature of this surgical procedure, a hysterectomy is generally not the first course of action unless uterine fibroids are causing major health issues. Some of the complications associated with a hysterectomy include a prolonged recovery period - typically 4 to 8 weeks – if the ovaries are removed during hysterectomy, hormone fluctuations brought about by early menopause, pelvic discomfort and bladder problems.

Uterine Fibroid Embolization

The procedure known as uterine fibroid embolization is another treatment method that your doctor may offer. This option is technically not a fibroid surgery as it is performed via catheter by a radiologist. The purpose of a uterine fibroid embolization is to cut off the blood supply to the tumors so that they will shrink significantly or disappear. The catheter used in this process is fed from your thigh into your uterine artery, upon which time an injected solution blocks the fibroids’ blood source. Embolization is a non-invasive uterine fibroid treatment that provides many women with symptom relief and does not involve a difficult recovery. Potential complications include the onset of premature menopause, infection and the need for subsequent procedures in the event that fibroids return.

Myomectomy Procedures

A myomectomy is a surgery for fibroids that involves removal of the tumors themselves while leaving the uterus in place. You may consider this option if you are hesitant to experience the menopausal symptoms that arise due to a hysterectomy but are suffering from pain due to fibroids. Myomectomies can be performed in several ways, either abdominally, laparoscopically (“keyhole surgery”) or hysteroscopically (through the vagina). Less invasive types, such as hysteroscopic myomectomies, may be outpatient, while other types require a brief hospital stay. The most common risks associated with this procedure for treating uterine fibroids include blood loss, formation of scar tissue and the need for a hysterectomy down the line.

The Acessa Procedure

The Acessa procedure is a new treatment option for uterine fibroids that has great promise due to its innovative technology, non-invasive nature and high success rate. The FDA-cleared Acessa Procedure is comprised of a handpiece with electrodes on the tip and a generator. Both of these are involved in the utilization of radiofrequency energy that shrinks or destroys each fibroid one at a time. During the procedure, a laparoscopic ultrasound probe is used to locate all of the fibroids. Though the procedure does require general anesthesia and two small laparoscopic incisions, Acessa is outpatient and involves little downtime. Acessa targets each fibroid directly so that surrounding uterine tissue stays healthy and functional. There are many risks involved in laparoscopic procedures, such as post-operative infection; to learn more you should consult an Access-trained gynecologist.




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