Contents
Uterine fibroids is a benign neoplasm that arises from the muscular uterine layer. A variety of reasons can provoke the development of neoplasms, ranging from hereditary predisposition to abortion and problems with menstrual cycles. But all the doctors in the world came to the same conclusion that the main reason for the development of a benign formation in the uterine cavity is hormonal instability in a woman’s body.
Is the problem always solved with surgery?
If the formation is small, they do not touch it, but only observe it for at least two years. If there are no rapid indications of growth, and the woman has no plans to become pregnant, doctors prescribe drug therapy. Hormonal-type drugs often help stop the growth of fibroids. Most often, the basis of drug therapy includes several different hormonal drugs.
Surgical intervention is prescribed when the size of the neoplasm has reached critical levels and when the fibroid begins to interfere with the full life of a woman. In almost 100 percent of cases, they try to perform a conservative myomectomy, in other words, only fibroids are removed, and the uterus and other organs are preserved (especially this type of operation is performed for women who have plans to have a baby). It is important to understand that this method of surgery does not exclude the re-growth of the formation, therefore, additional treatment may be necessary.
Indications and contraindications for surgery
Women are prescribed surgery in the presence of: the rapid growth of education; size of fibroids according to 12 weeks; uterine bleeding; severe pain syndrome; concomitant gynecological diseases; suspicion of malignancy; changes in the tumor (necrosis or infection); fibroids on long legs; nodes in the cervix; habitual miscarriages or infertility; significant impairment of the functionality of adjacent organs.
This procedure is contraindicated in women with a depth of the uterine cavity of more than twelve centimeters, in the presence of infectious diseases of the genitourinary system. In addition, among the contraindications it should be noted: the presence of serious diseases in the body; the presence of adenocarcinoma; suspicion of leiomyosarcoma or endometrial hyperplasia.
Preparation before operation
Before proceeding with the surgical intervention, the woman must be thoroughly examined. The gynecologist prescribes: an ECG, a chest x-ray, an analysis to determine the Rh factor and a blood group, a blood coagulation test, an analysis for biochemistry, OAM and OAC. Also mandatory are:
- Ultrasound of the pelvic organs to determine the exact localization of the neoplasm and its size;
- diagnostics of the rectum;
- smear from the vagina on the flora;
- blood test for hormones.
After a thorough examination of the woman, based on the results obtained, the doctor can determine the cause of the disease and the method of how to get rid of it with minimal risk to the woman’s health. Usually they resort to the complete removal of the uterus – the most effective method of treatment. However, they tend to this method if the woman is aged 40+.
Hysteroscopic (hysteroresectoscopic) myomectomy
Hysteroscopic (hysteroresectoscopic) myomectomy is a minimally invasive type of surgery that involves the removal of fibroid nodes through the vagina, without opening the abdominal cavity. It is important to understand that this kind of surgical intervention is only suitable for fibroids with small sizes and with a submucosal location. Hysteroscopic myomectomy can also be performed on an outpatient basis in the first days of the menstrual cycle. Local anesthesia or general anesthesia is used as anesthesia. This method is used for submucosal localization of a benign tumor, metrorrhagia, menorrhagia, which contribute to the development of anemia, as well as in cases where fibroids interfere with the onset and bearing of pregnancy.
In medicine, there are three types of submucous myomas (nodes): type 0 (the neoplasm has a thin stalk), type 1 (the formation protrudes into the uterine cavity by ½), type 2 (the formation is located in the myometrium by ½). The doctor before the operation without fail determines the type of neoplasm, its location, size, in order to be able to think out the strategy for further actions with maximum accuracy.
Advantages
Among the advantages, it is worth noting the minimum duration of surgical intervention; no need to use special equipment for working in a liquid medium; high level of efficiency of the procedure; absence of violations of the reproductive system of a woman after surgery; minimal blood loss; there are no incisions or scars on the abdomen.
But this procedure should be carried out by an experienced and highly professional specialist, since during the operation other organs of the small pelvis can be damaged and cause a number of serious complications. For maximum effect, the gynecologist can perform the procedure under ultrasound control.
Recovery after surgery
It is important to follow all the indications and recommendations of the doctor after the operation. The recovery period lasts an average of 14 days. After hysteroscopic myomectomy on the second day, the woman is allowed to get up. Three months after the operation, it is important to avoid serious heavy exertion, to avoid constipation or diarrhea.
It is important to closely monitor hygiene, preventing the reproduction of pathogenic and infectious bacteria. Pregnancy can be planned no earlier than six months later. The sexual partner must be constant to avoid the possibility of infection with sexual diseases. Sexual intimacy is allowed only by a doctor after examination and ascertaining the full recovery of the body.
It is important to understand that each woman’s body is special, and the recovery process for some will last 2 weeks, and for some it will take months.