Uterine fibroids can be treated with medications if your symptoms do not bring discomfort that critically affects your quality of life. In case of pain, bleeding, anemia, etc., fibroid surgery is one of available treatment options.
There are different kinds of fibroid surgery. You should consider the risks and recovery time of uterine fibroid surgery.
Depending on the characteristics of your fibroid(s), one of three kinds of myomectomy are performed:
This procedure is suitable for women with small fibroids that are located ONLY inside the cavity of uterus. This is rarely the case, and while it is often performed in women that have fibroids inside and outside the cavity, those on the outside are not treated at all. Therefore, any symptoms caused by those fibroids outside of the cavity will need another type of procedure.
To perform this procedure, the doctor places a long, thin, lighted telescope in the uterus. Fluid connected to the sidearm of the telescope, expands the cavity, so that the doctor can see your fibroids. Then the doctor removes the fibroids using a special device.
Usually, you can go home the same day after the procedure.
This is the most common type. The surgeon makes a long incision (usually horizontal along the lower pelvic area). This procedure is performed typically as an inpatient in the hospital. You will likely have to stay for a couple of days, and a full recovery often is two months (or more).
Rather than a single long incision, several shorter incisions are made in specific spots in the belly. Metal tubes are placed through 2 or 3 of the incisions and surgical instruments (and/or a camera) are placed in the tubes to operate while watching on the video camera. Because each incision (at the skin level) is smaller than the large single incision, the patient heals quicker.
However, because the incision on the uterus is the same whether the surgery is open or laparoscopic/robotic, the negative impact to fertility due to uterine scar tissue from the surgery is the same.
After the surgery, you will likely have to stay in the hospital for a night, but the recovery process will likely be 4-6 weeks.
Exactly the same as Laparoscopic except that robotic arms hold the surgical instruments rather than the surgeon directly.
While many surgeons talk about the benefits of robotic over laparoscopic these are mainly hypothetical for gynecologic procedures (i.e. myomectomy or certainly hysterectomy). It is also important for the patient to know how many robotic procedures the surgeon has performed as there is a rather steep learning curve to perform these robotic procedures.
Finally, the cost of a robotic gynecologic procedure is several thousand dollars more to the patient than traditional laparoscopic surgery, which is itself significantly more expensive than Uterine Fibroid Embolization (UFE).
This cost savings for UFE is even more significant after one takes in to account the additional cost savings of UFE due to the much quicker recovery!
This type of uterine fibroid surgery can be performed if you have large fibroids and you do not plan to have children. A surgeon removes the uterus partially or completely (with ovaries or without). It is the only surgery that cures uterine fibroids without relapse. Recovery can take 1-2 months, the exact time varies. Hysterectomy, like any surgery, can have complications.
The procedure is done through the vagina. It removes or destroys the lining of your uterus by a laser, boiling water, electric current, freezing, and in other ways. This procedure is an option if you do not want to get pregnant in the future. Recovery usually occurs quickly.
Surgical intervention can cause bleeding, infection, scars, the need for an additional operation, bowel or urinary problems, fertility issues, and various complications. Before deciding on a surgical procedure, make sure that you have evaluated all available types of treatment.
Unlike surgery, UFE is a fully outpatient, non-surgical procedure with 1-2 days of recovery time. It does not require staying in a hospital overnight, cutting into uterus, and allows women to have pregnancies and full term births after the procedure.
If you would like a second opinion before deciding what procedure is best for you, make an appointment with Dr. John Lipman by calling Atlanta Fibroid Center at 770-953-2600 or book an appointment online.