Uterine fibroids is a benign tumor that develops from the muscle tissue of the female reproductive organ. In some cases, it requires surgical intervention, since conservative methods do not have the desired effect.
Is an operation needed? Indications for surgery
There are specific indications for surgical intervention:
The size of the fibroid nodes or the size of the tumor itself exceeds the size of the uterus at 12 weeks of gestation;
The tumor threatens to transform into a sarcoma;
The tumor exerts pressure on adjacent organs;
Accelerated growth rates of education (during the year it grows by 4 weeks);
The fibroid node dies;
Formation of a submucosal node, or its necrosis;
Submucosal fibroids, or the presence of adenomyosis;
The occurrence of metrorrhagia, which causes anemia;
Inability to bear pregnancy or conceive a child;
Myoma has a stalk;
The tumor disrupts the process of urination.
As for the method by which the formation will be removed, the final decision is made by the doctor. It depends on a number of factors: on the location of the tumor and its nodes, on the age of the woman, on the state of her health, etc.
Operation types
As for the types of operations performed for this disease, they are divided into two large groups: operations with the preservation of the reproductive organ and the removal of only the formation (myomectomy), as well as operations with the removal of both fibroids and the uterus at the same time (hysterectomy).
With regard to hysterectomy, it is considered a radical operation, which is most often performed when a woman reaches 40 years old and if she no longer plans to conceive a child. In the process of performing a surgical intervention, the uterus can be removed along with the cervix, and with its preservation. At the same time, the cervix is a necessary element in the body of a woman, as it makes it possible for the urinary organs and intestines to function normally. Therefore, whenever possible, doctors try to preserve it. However, it is necessary to make sure that there are no fibroids and malignant cells on it. In addition, appendages can be removed or saved during the operation.
Hysterectomy
Hysterectomy is performed in several ways:
A laparotomic hysterectomy is practiced, when access to the organ is opened by making an incision in the skin with a scalpel. This method is considered obsolete and is resorted to in rare cases when the fibroid has given multiple nodes, and has grown significantly, and it is not possible to remove it through a small incision.
Laparoscopic hysterectomy, when the removal occurs using a special device – a laparoscope. To carry out the operation, several small incisions are made on the abdominal wall, special instruments are inserted through them, and the uterus along with the fibroid is removed. At the same time, the doctor monitors the progress of the operation on the monitor.
Myomectomy
As for myomectomy, this operation allows you to save the organ, and can also be performed in three ways:
An abdominal operation is performed only if it is not possible to remove the tumor by other methods. Very rarely modern doctors use this type of intervention. Most often, it is resorted to with torsion of the legs of the fibroids or with necrosis of the neoplasm. A woman will have to spend several days in the hospital, while the sutures themselves will heal for a long time. The rehabilitation period before a woman can return to her previous lifestyle lasts, on average, two months.
Myomectomy using a laparoscope. Due to the fact that this method is less traumatic, and the sutures are very small, the rehabilitation period after such an intervention lasts only a few days.
Myomectomy using a hysteroscope. It is inserted into the vagina and the neoplasm is removed. Performing this type of surgical intervention is possible with a single tumor, which is located on the wall of the uterus (anterior or posterior). The operation is most often performed on an outpatient basis and the woman, after several hours of observation, is allowed to go home.