Fibroid Surgery Facts You Should Know
Uterine fibroids are very common non-cancerous tumors that grow in and on the uterus. Many women will experience uterine fibroids before the age of 50. Some women have either no symptoms or may experience only mild discomfort due to their fibroids which can be treated with medications.
Unfortunately, many women suffer painful debilitating symptoms including abdominal pain, heavy and prolonged bleeding, anemia, and more! For these women, the only option to obtain relief from their symptoms is to eliminate the fibroids.
Women Are Routinely Offered Uterine Fibroid Surgery As The Only Option In Treating Fibroids
Most women who have chronic fibroid symptoms eventually seek treatment from their OB-GYN and are told they need to have fibroid removal surgery. There are two uterine fibroid removal surgery options; myomectomy and hysterectomy but patients should carefully consider the short and long-term risks as well as the recovery involved in each fibroid surgery type.
Video: Why You Don’t Need a Surgery for Uterine Fibroids
Fibroid Surgery Options
Myomectomy
The technique used to perform a myomectomy is largely dependent on the type of fibroids being removed, where they are located, and other patient-specific criteria.
The three types of myomectomy techniques used include:
- Hysteroscopic Myomectomy
- This fibroid removal surgery gets its name from the instrument that is used to remove the fibroids. A hysteroscopic resectoscope is a tool that has a camera, a light, and a wire loop that is used to remove small fibroids located inside the uterus. Submucosal fibroids are the least common type of fibroid and the only fibroid tumors that can be removed using this technique.
The hysteroscopic resectoscope is inserted through the vagina and up through the cervix. When it is in the correct position, the doctor sends an electrical current through the wire loop that carefully cuts the fibroid away from the wall of the uterus while simultaneously cauterizing the area to prevent bleeding.
This is normally done as an outpatient procedure and patients can usually go home after a few hours. There are no external scars associated with this procedure however the cauterization process can potentially decrease fertility.
- Open Myomectomy
- An open, or abdominal, myomectomy is considered invasive surgery and is used to remove fibroids from the uterus. During an abdominal myomectomy, the surgeon makes an incision similar to that of a C-section or what is typically called a bikini cut. The incision is made in the lower abdomen and through the uterine wall for the surgeon to gain access and to cut out each fibroid one at a time.
An open myomectomy requires at least an overnight stay in the hospital and possibly up to three or four days. The recovery is quite extensive and can last up to 3 months.
- Laparoscopic Myomectomy
- A laparoscopic myomectomy is performed through several smaller incisions that are strategically made in the abdomen. Usually, an incision is made near the belly button and is used to insert a laparoscope which is a special thin tube-like instrument that is outfitted with a light and a tiny camera. The abdomen is pumped up with gas to give the surgeon better access to the uterus.
Guided by the image projected by the laparoscope onto a video monitor, the surgeon inserts other instruments into the other incisions and accesses the fibroids cutting them into smaller pieces if necessary before removing them.
The surgeon repeats this process to remove as many of the fibroids as possible. Oftentimes, small fibroids or fibroids embedded deep within the muscular wall of the uterus can not be removed or are only partially removed.
- Robotic Myomectomy
- The technique and procedure are identical to laparoscopic fibroid removal surgery except the surgeon requires additional specialized training to control a set of robotic arms that are used to perform the surgery. Robotic arms are able to move in ways that the human hand can not and may offer an advantage in accessing a hard-to-reach fibroid.
Robotic myomectomy surgery is more expensive than laparoscopic myomectomy and often increases surgery times.
Laparoscopic and open myomectomy surgery are both completed with several layers of stitches to close up and repair the uterus. Both procedures compromise the uterus and create scar tissue that decreases fertility rates. After a myomectomy, a woman who becomes pregnant must deliver via C-section.
Hysterectomy
A hysterectomy is a surgical procedure that removes some or all of a woman’s uterus. Other reproductive organs such as ovaries, fallopian tubes, or the cervix may be removed depending on the circumstances. The recovery time for a hysterectomy can be anywhere from six to twelve weeks depending on the technique and type performed.
In recent years, several studies have identified a link between many women’s health issues and the removal of their uterus. The function of the uterus is not only for reproduction as historically believed, but it has been associated with mental health, heart health, sexual function, the aging process, and many other serious health issues. A hysterectomy should only be considered in extreme cases such as cancer when there are no other options.
The different types of hysterectomies include:
- Total Hysterectomy
- The most common type of fibroid uterus removal surgery performed. The woman’s entire uterus, including the cervix and upper portion called the fundus, are removed. The ovaries may be retained or removed.
- Partial Hysterectomy
- The whole uterus is removed but the cervix is left in place (supracervical hysterectomy).
- Radical Hysterectomy
- This is normally only done in cases of cancer. The uterus, cervix, and upper part of the vagina are eliminated. Sometimes, additional tissue from the uterus and lymph nodes are also removed.
Sometimes as part of the hysterectomy, one or both ovaries may be removed (oophorectomy) and in some cases, the fallopian tubes are also removed (salpingectomy).
Endometrial Ablation
Endometrial ablation is a procedure that can be performed to help stop heavy bleeding caused by fibroids and is often called “fibroid ablation surgery” but it is not a surgery, and it will not eliminate fibroids.
Using one of several techniques available, the lining of the uterus is destroyed which may successfully alleviate heavy bleeding but will eliminate any possibility of future fertility.
Consider the Risks Of Uterine Fibroid Removal Surgery
One of the top reasons cited for a hysterectomy is uterine fibroids. In the United States alone over 600,000 hysterectomies are performed and only 10% of those are medically necessary.
During a myomectomy, the integrity of the uterus is compromised and other complications can arise. The majority of women who have a myomectomy experience the re-growth of fibroids and require additional surgery to remove them within 5 years.
Fibroid removal surgery can result in bleeding, infection, scars, the need for an additional operation, bowel or urinary problems, fertility issues, and other complications.
Before deciding on a surgical procedure, make sure that you have evaluated all available types of treatment. You have options! There is a very safe, non-surgical procedure that will not compromise your uterus called uterine fibroid embolization (UFE).
Avoid Uterine Fibroid Removal Surgery
Uterine Fibroid Embolization (UFE) Is an alternative to fibroid or uterus removal surgery and should be considered by any woman suffering from fibroid symptoms.
Unlike surgery, UFE is a fully outpatient, non-surgical procedure with only 3 – 7 days of recovery time. It does not require a hospital stay, stitches, or cutting through the abdominal wall or into the uterus. UFE allows women to have pregnancies and full-term births after the procedure as well as preserving their uterus which plays a significant part in a woman’s physical and mental health.
UFE is not often presented as a treatment option for fibroids by typical OB-GYNs because they do not offer or perform it. UFE is performed by an Interventional Radiologist like Dr. John Lipman or Dr. Mitchell Ermentrout at the Atlanta Fibroid Center. To learn more about UFE and how it can help you become fibroid free contact The Atlanta Fibroid Center today at (770) 953-2600 or book an appointment online.
