Uterine Fibroids - Surgery

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Surgery for fibroids

There are many ways of managing uterine fibroids. Surgical methods are the mainstay of treatment when treatment is necessary. Possible surgical interventions include hysterectomy, or removal of the uterus (and the fibroids with it). Myomectomy is the selective removal of just the fibroids within the uterus. Myomectomy can be done through a hysteroscope, laparoscope or with the standard open incision on the abdominal wall. Some treatments have involved boring holes into the fibroid with laser fibers, freezing probes (cryosurgery), and other destructive techniques that do not actually remove the tissue but try to destroy it in place. Surgery is necessary if there is suspicion of malignancy in any case of a leiomyoma or uterine mass.

Another technique for treating fibroids is known as uterine artery embolization (UAE). This technique uses small beads of a compound called polyvinyl alcohol, which are injected through a catheter into the arteries that feed the fibroid. These beads obstruct the blood supply to the fibroid and starve it of blood and oxygen. While this technique has not been in use long enough to evaluate long-term effects of UAE versus surgery, it is known that women undergoing UAE for fibroids have a shorter hospital stay than those having surgery but a greater risk of complications and readmissions to the hospital. Studies are underway to evaluate the long-term outcomes of UAE as opposed to surgical treatment. Uterine artery occlusion (UAO), which involves clamping the involved uterine arteries as opposed to injecting the polyvinyl alcohol beads, is currently under investigation as a potential alternative to UAE.

Return to Uterine Fibroids (Benign Tumors of the Uterus)

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Comment from: NKT, 35-44 Female (Patient) Published: January 21

At age 38, I had surgery to remove a "sea of fibroid cysts" (per my doctor) and to remove a larger cyst that had attached itself to my left ovary. My doctor had suggested a hysterectomy since I have a 10 year old son, but I was just not ready and thought that seemed a little drastic. She did say that she may need to remove the left ovary altogether if the cyst can't be removed. On surgery day, after surgery I woke up with horrible cramping and debilitating pain and asked the attending nurse if the ovary was removed. She said that they did the surgery as planned and removed the fibroid cysts, loaded me up with pain medications and sent me home. It wasn't until 3 days later that I found out about the ovary being removed. I know she warned me that it was a possibility but it would have been nice to know what caused the extreme cramping and pain all the way to my back. The pain was so bad that I couldn't stand up straight for 5 days. One and a half years later, I had a CT and it shows fibroids in my uterus and one that is growing on my right ovary. It is 3.2 x 2.6 cm and it looks like my need to save my uterus and an ovary was a painful waste of time. I am in agony and I pay for my decision every month, sometimes all month. It was not worth it for me.

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Comment from: JG, 45-54 Female (Patient) Published: May 14

I had a laparoscopic assisted vaginal hysterectomy 4 days ago. Ten years ago I had surgery to remove the fibroids from my uterus. This time it wasn"t an option for me. I"m doing great with my recovery. I spent 1 night in the hospital and have been home resting since then. I feel better now than I did in the months before this procedure. My fibroids were ruining my life. The pain and bleeding was too much to take. Find a doctor who is experienced with this method. So much better than the big incision some doctors do.

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