Category: Fibroids

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Fibroids

UFE: An Alternative to Surgery

Uterine Fibroid Embolization is a very effective, minimally-invasive procedure to remove uterine fibroids. UFE also has a shorter recovery.

Uterine Fibroid Embolization is a very effective, minimally-invasive procedure to remove uterine fibroids. It can also be an alternative to a major surgery such as a hysterectomy or a myomectomy, and has a much shorter recovery time. 

Unlike major surgery to remove fibroids which can require a few nights in the hospital and several weeks or even months to fully recover- UFE is an outpatient procedure, with a much shorter recovery time.

During UFE, a tiny catheter is inserted through a blood vessel in the leg or wrist, which is then guided to the blood vessels that feed the fibroids. Once it reaches that point, small particles are injected into the vessel to block the artery and cut off the blood flow to the fibroids.  Then, following the procedure, the patient will return to their home, where over the next few weeks and months, the fibroids will gradually shrink.

One of the many benefits of Uterine Fibroid Embolization is that it targets all fibroids in the uterus. This makes it an excellent treatment option for individuals with only a few fibroids as well as those who have many fibroids, regardless of fibroid size.

In fact, uterine fibroid embolization is so effective that most individuals who undergo the procedure have a dramatic improvement in their symptoms that is experienced when they return to their normal activities a mere 8 to 10 days after the treatment.

So what does it feel like? Does it hurt?

Good question, and we’ll do our best to answer that.

The UFE procedure itself is not painful, however light sedation medications will be administered through an IV in order to prevent any discomfort.  Some women report experiencing a feeling in their pelvis similar to menstrual cramping or heaviness. This is completely normal and is due to the decreased blood supply to the uterus.

Following the procedure, it is also normal to experience low energy, intermittent nausea, and possibly fever- as a result of the dying fibroid tissue.

These symptoms typically last a few days at most, and gradually decrease in severity. Most women report that by the fourth or fifth day following the procedure, they feel back to normal, while some might have a few more days of cramping. Fortunately, most of this discomfort can be easily ameliorated with the help of over-the-counter pain medication.

Since UFE is an outpatient procedure, it’s important to have an area in your home where you can relax and heal after.

You may wish to set up your bed with extra pillows, and your favorite blanket, and if there’s a tv in your relaxation location, having the remote control nearby can be helpful as well.

While resting at home, some cramping can be expected in the lower abdominal region for about 24 hours but will subside quickly. However, most physicians do recommend that patients plan to stay home or at least limit their activities for at least one week following uterine fibroid embolization.

Other restrictions that your doctor may ask you to follow are:

– No bathing for 2 weeks. Shower as normal.

– No tampons for at least one full cycle.

– Abstain from sex for 2 weeks.

– No heavy lifting until your strength fully returns.

– Flights and travel are not recommended for at least 2 weeks.

– Refrain from taking aspirin for at least the first week.

Though recovery times may vary, most patients can return to all normal activities after 2 weeks. Even better, they can expect to experience significant improvements in their pre-op fibroid symptoms, over the course of one to three months. This means no more heavy periods, pelvic pain and pressure, urinary incontinence, or pain during sexual intercourse.

In our next article, we will take a look at the results of the embolization, and the experience and time it usually takes for the fibroids to shrink.

In the meantime, if you are considering Uterine Fibroid Embolization treatment for uterine fibroids, or have any questions about the UFE procedure, please call us at 301-622-5360 and request an appointment at MidAtlantic Vascular and Interventional today!

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Fibroids

Medical Advancements in Fibroid Treatment

MidAtlantic Vascular and Interventional, we specialize in the removable of uterine fibroids, through an advanced medical procedure.

Fortunately for the estimated 26 million women in the United States that have uterine fibroids, huge medical advancements have been made that allow for a variety of treatment methods. These range from medication to hormone therapy, as well as both invasive and non-invasive surgical procedures to remove the fibroids completely.

Here at MidAtlantic Vascular and Interventional, we specialize in the removable of uterine fibroids, through an advanced medical procedure called Uterine Fibroid Embolization.

Unlike medications, which primarily treat the symptoms of fibroids, Uterine Fibroid Embolization, focuses on treating the condition by removing the fibroids themselves.

So what is Uterine Fibroid Embolization? And how does it work?

Good question and we are happy to answer that. But first, let’s take a quick look at what a uterine fibroid is.

Uterine fibroids are noncancerous growths of the uterus that often appear during a woman’s childbearing years. These growths are made of smooth muscle cells and fibrous connective tissue. Sometimes fibroids are solitary, but it is also common to have multiple ones.

Uterine fibroids range in size. Some are so tiny that they are undetectable by the human eye alone. While others can be large enough to distort and enlarge the uterus.

How can I tell if I have a fibroid?

When a woman has a fibroid, it is most often discovered during a routine pelvic exam or imaging procedures performed for other reasons. If the fibroid or fibroids do not cause any symptoms, pain, or discomfort, and are not affecting fertility- then they usually do not require treatment. However, when symptoms are present, these can be managed with medications, surgery, and by using minimally invasive techniques.

Some of the symptoms associated with fibroids are:

• Unusually heavy period
• Long than normal periods
• Bleeding in between periods
• Pressure and pain in the pelvis
• Frequent urination
• Lower back pain
• Pain during intercourse
• Difficulty conceiving

Ok, so back to the original question: What is Uterine Fibroid Embolization?

Uterine Fibroid Embolization is a non-invasive procedure to remove uterine fibroids. Rather than requiring general anesthesia, the procedure uses conscious sedation ( an IV of a light sedative) to help you to relax and remain pain-free during the UFE procedure.

Once the sedating medicine has been administered, our expert radiologist will begin the procedure.

The UFE procedure commences with our expert Interventional Radiologist, Dr. Rishi Sood, making a teeny tiny nick in the skin (about the size of the tip of a pencil). He will then thread a tiny 2mm catheter through the groin or wrist. Using moving X-ray technology (fluoroscopy), Dr. Rishi will then guide the catheter through the blood vessels until it reaches the artery that supplies blood to the fibroids.

Once the catheter reaches the artery that supplies blood to the fibroids, tiny gelatin beads are released through it, which travel into the artery, creating a blockage. This blockage cuts off the blood supply to the fibroids. And, without the fibroids being able to receive vital nutrients through the blood, they can not survive.

A blockage? Isn’t that dangerous?

No, in this case, it is not. Unlike a blockage to the heart or other vital organs, this particular blockage is only cutting off the blood supply to the fibroid. The results are remarkable, for, without the fibroids being able to receive vital nutrients through the blood, they shrink until they are altogether eliminated.

Does this sound too good to be true?

Maybe, but rest assured it is not. In fact, according to the New England Journal of Medicine, the success rate of uterine fibroid embolization is estimated to be upwards of 95%.

This is great news to the millions of women that are suffering from the pain and discomfort that comes with having uterine fibroids.

In our next article, we will take a look at what you can expect during the UFE procedure. What does it feel like? How long does it take? And what does the recovery period look like?

In the meantime, for more information on Uterine Fibroid Embolization, or to make an appointment for your consultation, please reach out to us at 301-622-5360.

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Fibroids

Recovery Time of Fibroid Treatment

When it comes to the different procedures that can remove uterine fibroids, the recovery time of each method is something to keep in mind.

When it comes to the different procedures that can remove uterine fibroids, the recovery time of each method is something to keep in mind.

Some surgeries like a hysterectomy will require a few nights of hospitalization following the procedure, and take several weeks or even months of rest in order to fully recover.

Other fibroid removal procedures like Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional, can be performed as an outpatient procedure, allowing for the patient to go home the same day. Not only that, but most women find they can resume their normal activities in a few days.

Really?

Yes! The average recovery period from Uterine Fibroid Embolization is about 1-2 weeks!

Though UFE is a ground-breaking non-invasive treatment that is efficient, effective, and has a much shorter recovery period- some women are still opting to have their fibroids removed through the surgical procedures of a hysterectomy or a myomectomy. The reason for this, in some cases, is that many women are unaware of the other options available, and therefore are still opting to have a more invasive procedure. Therefore a myomectomy still remains one of the most common treatment methods for removing fibroids.

As we’ve covered in previous articles about the surgical removal of fibroids, a myomectomy is a surgical procedure that removes uterine fibroids while keeping the uterus intact and is a treatment option for women who wish to have children after the fibroids are removed, or who wish to keep their uterus for other reasons.

There are three main types of myomectomies: laparoscopic myomectomy, abdominal myomectomy, and hysteroscopic myomectomy.

Today let’s take a look at the expected length of recovery following each type of myomectomy.

The first approach is a standard open surgery, while the second and third options are less invasive.

1. Laparotomy, also known as an Abdominal Myomectomy:

A laparotomic myomectomy is performed as open surgery, by way of an abdominal incision.

A laparotomic myomectomy is usually necessary when there are several very large fibroids that are located in a difficult area of the uterus to reach using other surgical methods. It is also oftentimes the best approach to removing intramural fibroids, which are fibroids that are located primarily within the width of the uterus.

Recovery Period:

Though effective, due to its invasiveness, a laparotomic myomectomy has a higher risk for blood loss and scarring and involves the longest recovery period among the different types of myomectomies.

An abdominal myomectomy is usually followed by a 2-3 day hospital stay. Once back at home, the average post-surgical recovery period is around 6 weeks, which includes avoiding exercises, such as biking, jogging, and aerobic exercise. It also requires complete abstinence from lifting anything that could cause strain on the body.

During the recovery period, most women will need to take at least 2-3 weeks off from work so that they can rest and recover, depending on the type of work that they do and how they feel during the weeks following the procedure.

2. Laparoscopy:

During a laparoscopic myomectomy, the surgeon will make four incisions of about a half-inch each into the lower abdomen. Through these, a laparoscope and other small instruments are inserted into the uterus to remove uterine fibroids.

A laparoscopic myomectomy is most appropriate for fibroids located on the outer layer of the uterus, known as the serosa. Known as subserosal fibroids, this particular type of fibroid grows toward the outside of the uterus. And, similar to an abdominal myomectomy this method of fibroid removal requires general anesthesia.

Recovery Period:

Though a laparoscopic myomectomy is less invasive than an abdominal myomectomy, the amount of time it takes to recover post-op is still significant.

A laparoscopic myomectomy operation is usually followed by at least one night in the hospital. After that, the general restrictions are the same as those after an abdominal myomectomy, however, most women find they can resume some normal activities within about 4 weeks.

3. Hysteroscopy:

During a hysteroscopic myomectomy, fibroids are removed using a surgical instrument called a hysteroscopic resectoscope which is inserted through the vagina and cervix and into the uterus. Then, a wire loop is used to shave off and thereby remove the fibroids.

A hysteroscopic myomectomy is typically the most appropriate type of myomectomy for fibroids that bulge into the uterus, called submucosal fibroids.

Recovery Period:

A hysteroscopic myomectomy involves general or local anesthesia and most women are able to go home the same day as the procedure, following a few hours of observation. However, in rare cases, a night of recovery in the hospital can be necessary.

The Bottom Line:

A hysterectomy and any type of myomectomy procedure to remove uterine fibroids will result in a longer period of post-op recovery, especially when compared to a non-invasive procedure like Uterine Fibroid Embolization.

In some cases, the recovery may take a few weeks, in other cases, it could take months. In fact, some women might experience less post-surgery pain than others, while some may need to take prescription pain relievers and limit their activities for quite some time. However, regardless of the rate of recovery, all women will experience a period of recovery and will need to take certain precautions and adhere to the restrictions set forth by their doctor, to have the safest, shortest, recovery period possible.

In our next article, we will take a look at the recovery time of the fibroid removal procedure, Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional.

Unlike a myomectomy, UFE addresses and eliminates all types of uterine fibroids, allowing for a fully functional uterus post-surgery, without risks and complications from fibroid surgery. UFE has a recovery time of about a week allowing a woman to quickly return to their normal daily life.

To learn more about UFE and to set up a consultation, please call us today.

 

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Fibroids

Short or Long Recovery

The recovery from fibroid surgery can take months. Uterine Fibroid Embolization has a recovery period of about 1-2 weeks.

When it comes to procedures to remove fibroids, some result in shorter recovery periods than others.

Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional, has a recovery period of about 1-2 weeks, with most women finding they can resume their normal activities after a few days. This is remarkable considering that most fibroid removal procedures are done surgically with a post-operation recovery period of several weeks or even months.

Not only that, but these surgeries such as a hysterectomy or a myomectomy, often require a few nights in the hospital following the procedure. This is not the case with Uterine Fibroid Embolization.

In order to get a better understanding of how groundbreaking UFE is as an outpatient fibroid removal procedure with a much shorter recovery period, we’re going to take a look at what can be expected following another common fibroid removal procedure: a myomectomy.

When it comes to the recovery period after electing to remove uterine fibroids through a major surgery such as a myomectomy, the recovery timeline varies. Unlike a hysterectomy, which can take weeks and even months to recover from and requires a hospital stay following the procedure, a myomectomy recovery depends on the severity of the fibroids and the approach taken to remove them while keeping the uterus intact.

As we’ve covered in previous articles about the surgical removal of fibroids, a myomectomy is a surgical procedure that removes uterine fibroids while keeping the uterus intact and is a treatment option for women who wish to have children after the fibroids are removed, or who wish to keep their uterus for other reasons.

As a quick recap- let’s take a look at the three main types of myomectomies, which are: laparoscopic myomectomy, abdominal myomectomy, and hysteroscopic myomectomy.

Abdominal Myomectomy

This is the most invasive method of performing a myomectomy and involved the administration of general anesthesia. During this procedure, the doctor will make an incision that starts at the lower abdomen and reaches the uterus. Then, using this incision, the doctor will remove the fibroids and then proceed to close the wound with stitches.

Laparoscopic Myomectomy

Similar to an abdominal myomectomy, though less invasive, this procedure also requires the use of general anesthesia. After making several small cuts in the lower abdomen, the stomach is filled with carbon dioxide gas in order to provide the doctor with a better look inside the abdomen. The doctor will then insert a thin lighted tube with a camera on top, called a laparoscope. Then, using special tools, the fibroids are removed, the gas is released, and the incisions are stitched up.

Hysteroscopic Myomectomy

This is the least invasive of the myomectomies and may use general or local anesthesia. It begins with the doctor putting a liquid inside of the uterus in order to make it widen, and therefore make the fibroids more visible. Then, using a lighted scope and a wire loop, which are entered through the vagina and cervix, the fibroids are shaved off of the uterus. Once finished removing the fibroids, the liquid is also removed, which gets rid of any fibroid fragments that remain.

Since a hysteroscopic myomectomy doesn’t involve any external incisions, the recovery time is much shorter than the other types of myomectomies.  And in general, women who have a hysteroscopic myomectomy generally experience fewer complications, while also experiencing a shorter recovery time than that of the other types of myomectomies. However, regardless of the type of myomectomy, it will still take a few weeks for the body to heal.

In our next article, we are going to look at exactly what is to be expected following a myomectomy in regards to the recovery time, so as to compare it to the recovery time that is to be expected following the non-invasive fibroid removal procedure, Uterine Fibroid Embolization. 

To learn more about Uterine Fibroid Embolization as a treatment for uterine fibroids, please call us today to set up a consultation. A myomectomy or a hysterectomy is not the only option. So call us today to find out more.

 

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Fibroids

Putting an End to Fibroids

There are many medications that can help relieve the symptoms of uterine fibroids. However, they provide a temporary solution.

There are many medications that can help relieve the symptoms of uterine fibroids, such as pelvic discomfort and heavy menstrual bleeding. However, these medicines do not remove the fibroids and only provide a temporary solution. Once the medication is stopped, the relief it provided from fibroid symptoms is stopped as well. Therefore the only way to successfully put an end to fibroid symptoms is to remove the fibroids.

There are several surgical approaches to removing uterine fibroids. One excellent option is a non-invasive procedure, called Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional. Another option is a major surgery such as a hysterectomy, or a uterine sparing surgical procedure, such as a myomectomy.

A myomectomy is usually offered as a treatment recommendation for women who wish to have children after the fibroids are removed, or who wish to keep their uterus for other reasons. Whereas a hysterectomy is typically an option for women with fibroids that would like to avoid having to take medication and experience the side effects associated with them, as well as avoid the risk of fibroids returning following some of the other treatment procedures available. A hysterectomy is also oftentimes the preferred method of treatment of uterine fibroids for women that do not plan to have children.

Both a hysterectomy and a myomectomy are major surgery and come with their own risks of complications and side effects. Therefore it’s important to work with your doctor in preparation for either of these surgeries.

A myomectomy, in particular, has the potential complication of injury to internal organs and excessive bleeding. There is also the risk of the uterus becoming weaker after surgery, which carries its own set of problems.

Fortunately, there are certain things that can be done in preparation for surgery, that can help decrease the risks of complications, and lend themselves to a safer, more successful operation.

To minimize the risks during myomectomy surgery, your doctor may recommend:

Iron supplements and vitamins

Sometimes the fibroid side effect of heavy menstrual bleeding can lead to iron deficiency and anemia. In order to build up a patient’s blood count, your doctor might recommend taking iron supplements and vitamins for a period of time before the procedure.

Hormonal treatment

Some of the medications used to treat the symptoms associated with uterine fibroids, including anemia, can be an effective treatment to prepare the body for surgery. These medications include gonadotropic-releasing hormones ( GnRH agonists), and certain hormone-containing birth control pills. By blocking the production of estrogen and progesterone, and in some cases stopping menstruation entirely, these medications can help the body to rebuild hemoglobin and iron stores for a more successful surgery and recovery.

Medication to Shrink Fibroids

GnRH agonists are sometimes used to shrink fibroids prior to surgery. By shrinking the fibroids in preparation for surgery, the patient may not have to have an open procedure, and can instead have a minimally invasive surgical approach to remove the fibroids.

Though the research on this is mixed, there is some clinical evidence to support the effect that GnRH therapy can have on shrinking fibroids and decreasing heavy bleeding, to the point where surgery is no longer required. However, due to the side effect profile of these medications such as hot flashes, vaginal dryness, night sweats, and other symptoms of menopause, some women wish to avoid these GnRhH agonists altogether.

Other common pre-surgery recommendations may include:

  • Take a bath or shower before coming in for your surgery.
  • Abstain from applying any lotions, perfumes, deodorants, or nail polish.
  • Do not shave attempt to shave the surgical site yourself ( This may not be required by all doctors, however, it’s worth asking about).
  • Make sure to have someone that can drive you home, as the anesthesia and pain medication administered will make it unsafe to drive after the operation.
  • Be sure to remove any jewelry and piercings.

Lastly, and most importantly, make sure that you understand exactly what method of surgery is planned, as well as the risks, side effects, benefits, and potential complications involved.

If your doctor has suggested the use of medications that can shrink fibroids and reduce bleeding during surgery, make sure to ask about potential risks and side effects associated with these medications, as these medications aren’t necessarily the best option for everyone. In some cases, fibroid medications can shrink and soften fibroids so much so, that they become harder to detect and surgically remove.

It’s also important to be aware of all of the treatment options available to you because in some cases, a hysterectomy or a myomectomy might not be the best option, and your doctor may recommend a less invasive procedure such as Uterine Fibroid Embolization, which we specialize in here at our office.

If you are interested in finding out more about Uterine Fibroid Embolization as a treatment procedure for uterine fibroids, please feel free to call us today to set up a consultation.

There are many ways to treat uterine fibroids, call today and let us help you find the best one for you.

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Fibroids

Risks and Side Effects of a Myomectomy

There are several ways to remove fibroids. A myomectomy is a surgical procedure to remove uterine fibroids while keeping the uterus intact.

When fibroids are causing troublesome symptoms, and pain, and interfere with your normal activities, it is important to be aware that there are many treatment options available to relieve this burden. These treatment options can result in a decrease in symptoms, and in the case of a hysterectomy or a myomectomy, remove the fibroids completely.

Unlike a hysterectomy, which removes the fibroids by removing the entire uterus that contains them, a myomectomy is a surgical procedure to remove uterine fibroids, while keeping the uterus intact. Though it is actually more invasive than a hysterectomy, a myomectomy is an alternative to a hysterectomy for women that plan to bear children, or whose fibroids may be the cause of fertility issues.

As with all major surgeries, a myomectomy procedure does come with its own set of side effects and risks.

Some of which are:


Blood Loss:

Many women who undergo a myomectomy report an improvement in fibroid symptoms such as pelvis pressure and heavy bleeding. However, a myomectomy is still major surgery, and though it has a relatively low complication rate, the procedure still comes with its own unique set of challenges and risks.

One of the biggest risks involved in a myomectomy is the risk of excessive blood loss.

Many women with fibroids already have low blood counts and even anemia due to the fibroid symptoms of abnormally heavy menstrual bleeding. This, therefore, puts them at a much higher risk of problems due to blood loss.


Scar Tissue:

Due to the incisions that are done inside the uterus in order to remove fibroids, there is a risk of developing bands of scar tissue after surgery.


Pregnancy and Childbirth Complications:

Women of childbearing years may opt to have a myomectomy, especially over the option of a hysterectomy. However, a myomectomy can cause an increase in some risks during the delivery of a child. Though this is rare, it does happen and may result in a cesarean delivery to avoid rupturing the uterus during labor.


Increased Chance of a Hysterectomy:

Depending on the size, number, and location of fibroids, sometimes the surgeon may have to remove the uterus completely. Though this rarely happens, if the bleeding during a myomectomy becomes uncontrollable or there are additional abnormalities found in the uterus, sometimes the uterus needs to be removed as well.


Spread of Cancer:

During a myomectomy surgery, there is a very rare chance of a cancerous tumor being mistaken for a fibroid. As a result of trying to remove an unknown to be cancerous fibroid, there is the risk that it could lead to the spread of cancer.


Other potential risks and complications of a myomectomy are:

  • Hemorrhage
  • Injury to the uterus
  • Damage to the nearby organs of the urinary system
  • Infection
  • Blood clots
  • Eventual re-growth of fibroids

Though these risks and complications may be rare, they do happen. Therefore it’s important to be aware of them before deciding on any treatment plan.

In the end, you may find that both a hysterectomy and a myomectomy come with too many side effects and risks, and you may wish to learn more about a much less invasive procedure to remove fibroids, such as Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional.

In our next article, we will look at some of the things that can be done to help prevent possible surgical complications before choosing to have a myomectomy to remove uterine fibroids.

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Fibroids

Removing Fibroids Permanently

A hysterectomy is still the only definitive treatment option for removing fibroids permanently. A myomectomy is a uterine-sparing treatment.

Even with all of the treatment options available to women with uterine fibroids, a hysterectomy is still a preferred treatment method, due to the fact that it is currently the only definitive treatment option for removing fibroids permanently. However, since the procedure removes the uterus and cervix, a hysterectomy is not an option for women that would like to have children.

Though medication can help relieve the symptoms of fibroids, and most likely will not interfere with fertility, it does so as a temporary fix and is not a solution to the fibroid problem.

The only way to successfully remove fibroids is through a non-invasive surgery such as Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional. Or through a major surgery such as a hysterectomy, as well as a uterine sparing surgical procedure called a myomectomy.

A myomectomy is a surgical procedure that removes uterine fibroids while keeping the uterus intact, thereby preserving fertility.

A myomectomy is usually offered as a treatment recommendation for women who wish to have children after the fibroids are removed, or who wish to keep their uterus for other reasons. The procedure can also help regulate abnormal uterine bleeding caused by fibroids, as well as other fibroid-related symptoms.

Remove the fibroids, and remove the symptoms.

Depending on the number of fibroids, their location, and their size, a surgeon will perform a myomectomy operation with one of three approaches.

The first approach is a standard open surgery, while the second and third options are less invasive.

Let’s take a look at what those operations are.

Laparotomy: 

A laparotomic myomectomy is performed as open surgery, by way of an abdominal incision. Though effective, due to its invasiveness, a laparoscopic myomectomy has a higher risk for blood loss and scarring, which can be problematic.

A laparotomic myomectomy is usually necessary when there are several very large fibroids that are located in a difficult area of the uterus to reach using other surgical methods. It is also oftentimes the best approach to removing intramural fibroids.

–     Intramural fibroids are located primarily within the width of the uterus. There are several types of intramural fibroids: anterior intramural fibroids, which are located in the front of the uterus, posterior intramural fibroids, which are located in the back of the uterus, and a fundal intramural fibroid, located in the upper part of the uterus.

Because intramural fibroids grow toward the outside of the uterus, if they are too large, they can cause fertility issues and pregnancy complications.

Hysteroscopy:

During a hysteroscopic myomectomy, fibroids are removed using a surgical instrument called a hysteroscopic resectoscope.

This hysteroscopic resectoscope enters the uterine cavity through the vaginal canal, and it is usually the preferred method for removing submucosal fibroids.

–     Submucosal fibroids are located near the outer layer of the uterus, however, they grow toward the internal layer of the uterus, called the mucosa, causing them to protrude into the uterine cavity. These fibroids tend to be symptomatic even at smaller sizes, and can even impact fertility. However, when caught early, these fibroids can be removed, thus preventing fibroid-related issues during pregnancy

Laparoscopy:

A laparoscopy is similar to a hysteroscopy, only it is less invasive and typically an option for women who have a small number of subserosal fibroids.

–     Subserosal fibroids are located near the outer layer of the uterus, known as the serosa. This particular type of fibroid grows toward the outside of the uterus. When they are small, they are unlikely to cause symptoms and usually do not require treatment. However, they should be monitored in case they become larger and therefore symptomatic.

Both the hysteroscopy and the laparoscopy have a much faster recovery time than a laparotomy, as they are less invasive than open surgery.

As with any surgery, a myomectomy does come with its risks.

Every reproductive organ is a very serious surgery, and none of the methods of a myomectomy are immune to their own set of risks, side effects, and complications.

In our next article, we will take a look at some of the risks of a myomectomy and provide more information on each procedure.

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Fibroids

Side Effects and Risks of a Hysterectomy

A hysterectomy is one of the treatment options for women with uterine fibroids. It comes with its own set of side effects and risks. 

As we’ve covered in our previous articles, a hysterectomy, which is the surgical removal of the uterus and cervix, is one of the treatment options for women with uterine fibroids. And, like all surgeries, it comes with its own set of side effects and risks.

One of the benefits of having a hysterectomy is that in removing the uterus, the fibroids are also removed. In doing so, not only are the fibroids eliminated but so is the possibility of them growing back. To put it frankly, no more uterus, no more fibroids.

Women that would like to avoid having to take medication and experience the side effects associated with them, as well as women who would like to avoid the risk of fibroids returning following some of the other treatment procedures available, may wish to explore this option. However, it’s important to keep in mind that a hysterectomy is a major surgery and it is not without its own side effects and risks.

So let’s take a look at some of the potential side effects and risks of having a hysterectomy, as well as what can be expected in regard to the recovery period following the procedure.

A hysterectomy is a surgical procedure in which the uterus and cervix are removed through either an incision in the abdomen or belly button, or it is done vaginally. The procedure typically takes 1-3 hours and requires a spinal or epidural anesthetic that numbs the lower parts of the body, and it also may involve the use of a general anesthetic to put the patient to sleep during the surgery.

Once the surgery is complete, the recovery period can be rather difficult. A post-surgery hospital stay is necessary for up to five days. Then, once home, it can take roughly 6-8 weeks of rest to fully recover.

Some of the most common side effects associated with having a hysterectomy are vaginal drainage that may occur up to six weeks after surgery, and irritation at the surgical incision sites.
Other side effects may include:

– Blood clots.
– Hemorrhage.
– Infection.
– Injury to other surrounding organs including the bladder, ureter (the tube that connects the kidney to the bladder), intestines, muscles, nerves, or blood vessels.
– Formation of a fistula (an abnormal connection between the vagina and bladder).
– Allergic reactions to the anesthetic, pain medication, adhesives, or skin prep used during the procedure.

If the hysterectomy involves removing the ovaries and fallopian tubes, side effects such as menopausal symptoms are often experienced.

These include:

– hot flashes
– vaginal dryness
– loss of libido
– insomnia

It’s also important to understand that a hysterectomy is not reversible, it is permanent. After a woman has a hysterectomy, she will no longer have a period, and will no longer be able to bear children. For this reason, as well as others, many women experience emotional side effects from having a hysterectomy. The surgery has also been associated with an increased risk of long-term mental health issues. This is especially true of depression and anxiety.

The bottom line: If you are considering a hysterectomy, it is important to speak with your doctor about your concerns. In this day and age, a hysterectomy is far from the only surgical option for removing fibroids. In fact, there are several surgical procedures to remove fibroids while sparing the uterus- which is especially important for women who would like to have children, and for women that would prefer to avoid having major surgery.

In our next article, we will take a look at a uterine-sparing surgical procedure to remove uterine fibroids called a myomectomy.

 

Categories
Fibroids

Hysterectomy: Is This Treatment Option Right For You?

Depending on the severity of the fibroids and fibroid-related symptoms, some women may still opt to have a hysterectomy.

Though hysterectomy surgery was once common practice for women with fibroids, today there are many different options. However, depending on the severity of the fibroids and fibroid-related symptoms, some women may still opt to have a hysterectomy.

Therefore, today let’s dive deeper into this surgical procedure, and cover the different types of hysterectomies, as well as reasons why some women might elect to have this operation.

There are three different types of hysterectomies, and they are:

  • Supracervical hysterectomy: During this procedure, surgeons remove the uterus but not the cervix. A doctor may also refer to this procedure as subtotal or partial hysterectomy, it is most often used to treat conditions such as endometriosis.
  • Radical hysterectomy: This surgery removes the uterus, cervix, and surrounding support tissue. Doctors often recommend this type of hysterectomy for people with cancer.
  • Total hysterectomy: This surgery involves the complete removal of the uterus and cervix. This can be used to treat many conditions, such as heavy menstrual bleeding, and uterine fibroids.

It’s also important to note that depending on the circumstances surrounding the need for a hysterectomy, the surgeon may also remove the ovaries (oophorectomy) and the fallopian tubes (salpingectomy).

Though there are some promising medications available, such as the Gonadotropin-releasing hormone (GnRH) agonists Lupron, Synarel, and Zoladex which can shrink fibroids and reduce fibroid-related heavy bleeding- some women would prefer a permanent surgical procedure such as a hysterectomy, so as to avoid having to take these medications due to their side effects and risks.

In fact, it is estimated that 40% of women taking GnRH agonists experience side effects such as:

  • hot flashes
  • mood changes
  • increased sweating
  • muscle stiffness
  • vaginal dryness

And the most concerning side effect of GnRH agonist therapy,  osteoporosis.

Other medications that are used to treat fibroids are:

  • Birth control: Birth control can also be used to help with symptoms of fibroids — specifically heavy bleeding during and between periods and menstrual cramps.
    – Given that some of the most commonly prescribed birth control pills can increase estrogen and therefore increase the size of fibroids, birth control is not always the best solution.
  • Progesterone-containing agents: Pills, implants, injections, or an intrauterine device (IUD) — may also control bleeding.
    – If the fibroids are small, and the symptoms are mild, a progesterone-containing birth control pill may be beneficial in reducing symptoms. However, they come with their own set of side effects, and they can sometimes mask the severity of fibroids and other underlying conditions.
  • Elagolix: A combination of a GnRH agonist, estradiol, and norethindrone that has proven to be effective at reducing fibroid symptoms with a lower risk of adverse problems that can come from GnRH agonists alone.
    – Elagolix interacts with several other medications, and if taken long-term can cause permanent bone loss.
  • Tranexamic acid: An antifibrinolytic oral drug that’s indicated for the treatment of cyclic heavy menstrual bleeding in women with uterine fibroids.
    – Though it is a nonhormonal option to reduce menstrual blood loss, it does not affect or address the underlying cause of the bleeding- which is the fibroids themselves. It is also expensive.

Medications can be effective at managing fibroid symptoms, however, they do so, as a temporary solution. Medications do not fix the problem and sometimes they can even make things worse.

Therefore the main benefit of having a hysterectomy is that it doesn’t just manage fibroid symptoms, but by surgically removing the uterus, it removes the fibroids completely.

Not only does a hysterectomy remove fibroids and eliminate any possibility of them returning, but it also eliminates any possibility of having children.

For women that would like to have children, medication may be a good option to help manage fibroid symptoms allowing them to postpone a hysterectomy.  Or they may opt to have a uterine-sparing procedure done such as a myomectomy or Uterine Fibroid Embolization, which we specialize in here at MidAtlantic Vascular and Interventional.

The Bottom Line: For women with severe fibroids, fibroids that keep coming back, and fibroids that haven’t responded well to medication or other procedures, a hysterectomy may be an option worth considering. That being said, just like with medications, having a hysterectomy isn’t without its own set of side effects and risks. In our next article, we will take a look at what those are.

 

Categories
Fibroids

Is a Hysterectomy an Option

Treatment options for women with uterine fibroids used to be very limited. One of the first lines of treatment was a hysterectomy.

In the past, treatment options for women with uterine fibroids were very limited. In fact, more often than not, one of the first lines of treatment was a hysterectomy.

Though there are now many different treatment methods for women with uterine fibroids, a hysterectomy is still an option to consider, and sometimes it is necessary. Therefore today, let’s take a look at what a hysterectomy is, and why it can be a potential treatment option for women with uterine fibroids.

A hysterectomy is a surgical procedure that removes the uterus and the cervix. The procedure is usually done through either an incision in the abdomen or belly button, or it is done vaginally.

One of the benefits of having a hysterectomy is that in removing the uterus, the fibroids are also removed. In doing so, not only are the fibroids eliminated but so is the possibility of them growing back. To put it frankly, no more uterus, no more fibroids.

Another benefit of a hysterectomy is that because the operation removes the uterus, menstruation, and fibroid-related bleeding are stopped entirely.

Though there are several medications that can halt menstruation and stop or lessen fibroid-related bleeding, these medications are not without their issues. In fact, some women will opt to get a hysterectomy as a permanent fix to avoid having to use these medications long-term, which can increase the risk factors involved in taking them.

Some of the side effects and risks associated with medications for uterine fibroids that women may wish to avoid are:

Gonadotropin-releasing hormone (GnRH) agonists: Lupron, Synarel, and Zoladex

  • These medications are used to shrink fibroids and reduce bleeding but can cause an increased risk of osteoporosis.

Tranexamic Acid: Lysteda

  • This medication is used to ameliorate fibroid-related heavy bleeding, however, it is expensive and it interacts with several other medications which as a result, can be potentially harmful.

Birth Control Pills: Lo Loestrin FE, Norethindrone

  • Given that some of the most commonly prescribed birth control pills out there can increase estrogen and therefore increase the size of fibroids, unless the birth control is the right balance of hormones, it could make the fibroid situation much worse. Also, using birth control is known to mask the severity of fibroids and other underlying conditions.

Combination therapy of Gonadotropin-releasing hormone (GnRH) agonists and birth control: Oriahnn

  • This medication can reduce period bleeding, but its treatment is limited to 24 months due to the risk of it causing permanent bone loss. It’s also expensive and interacts with many other medications.

A hysterectomy is an option for women with fibroids that would like to avoid having to take medication and experience the side effects associated with them, as well as avoid the risk of fibroids returning following some of the other treatment procedures available.  However, a hysterectomy is a major surgery, and it is not without its own side effects and risks.

In our next article, we will take a look at some of the potential side effects and risks associated with having a hysterectomy, as well as what can be expected in regard to the recovery period following the procedure.