Uterine fibroids are non-cancerous growths that can cause pain and problems with periods and urination. Treatment options include uterine artery embolization, endometrial ablation, myomectomy, and hysterectomy. The procedures are minimally invasive and can cause permanent damage to the uterus. Fibroids can return, and a hysterectomy may be necessary to stop the pain and bleeding.
Uterine fibroids are small growths that can develop within the lining of the uterus in women of reproductive age. They are usually not cancerous, although they can be painful and cause problems with periods and urination. Gynecologists typically avoid treating very small, asymptomatic fibroids, although large or persistent growths may need to be removed via one of many different methods of surgical excision. The most common techniques for fibroid removal include uterine artery embolization, endometrial ablation, and myomectomy. Also, some patients undergo partial or complete hysterectomies if other methods of removing the fibroid are unsuccessful.
Uterine artery embolization is a minimally invasive procedure that is administered by a radiologist to cut off blood flow to the small fibroids. The doctor makes a small incision in the upper groin and inserts a catheter into the femoral artery. A tiny piece of plastic is injected through the catheter and directed to the blood vessels that feed the fibroids. There is one femoral artery on each side of the groin, so the procedure is usually repeated. With the blood supply cut off, the growths shrink and fall off within a few days.
Endometrial ablation, another option for fibroid removal, is usually done when the masses are very close to the surface of the uterine lining. A surgeon inserts a long wire into the uterus and delivers an electric current to burn the surface tissue. Other versions of the procedure involve using concentrated liquid nitrogen to freeze the fibroids or a high-intensity laser to cauterize them. Ablation is generally a very effective means of removing fibroids, but surgery can cause permanent damage to the walls of the uterus. A woman may not be able to get pregnant after having the procedure.
Sporadic, large, well-defined fibroids can often be removed via classic surgical procedures, where they are simply removed with a scalpel. Modern technology allows surgeons to perform most myomectomies without the need to make large incisions in the abdomen or groin. Instead, an instrument called a hysteroscope is inserted through the vagina. A hysteroscope is essentially a long tube with a camera that allows the surgeon to locate fibroids and monitor the procedure. The surgeon manipulates small scalpels and other equipment through small incisions in the groin region to cut away the fibroids.
It is possible for the growths to return even after a successful fibroid removal procedure. A woman experiencing repeated episodes may need to have a hysterectomy to stop the associated pain and bleeding. The surgery can be done through the vagina or through incisions in the abdomen, and a woman can expect to be hospitalized for several days so that doctors can monitor her recovery. By removing her uterus, she can be sure that her fibroids will never grow back.
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