Fibroids are a benign tumor of the uterus. They may
exist singly or they may be in multiples and they can be present in different layers/sites of the
uterus. Fibroids may or may not be symptomatic.
Their cause is largely unknown; however statistically
there are certain common factors that are seen in women with fibroids, which mean that these women
have a predisposition towards fibroids.
The definitive treatment for fibroids is surgery,
although there are some treatment options for women reluctant to undergo fibroid surgery for one
reason or the other. Surgery is recommended for women
with heavy bleeding per vagina leading to Anemia, intractable pain, menstrual irregularities,
and/or difficulty in conceiving.
There are two options for fibroid surgery. They are
Hysterectomy which is removal of the uterus in total or Myomectomy which means removal of the
fibroid(s) only, preserving the uterus.
Myomectomy is an option offered to or preferred by
those women who are in the child -bearing period, or those women who have not completed their
family and are desirous of having more children.
Hysterectomy on the other hand is the more commonly
performed operation for fibroids. It is done on women who have
deep seated tumors, multiple tumors, tumors which are difficult to remove from the uterus and for
those women who have crossed the child bearing age or have completed their family.
Surgery is usually performed under General Anesthesia but may be done
under Spinal anesthesia as well.
The various types of surgical procedures being done
-Uterine artery occlusion
Hysterectomy and myomectomy both are major surgeries
with their concomitant risks and complications. After
myomectomy there is a chance that the fibroids may reoccur. Prior to surgery, the patient needs to undergo certain tests which include blood
tests and an EKG (especially in older patients).
As with any other major surgery the risks in case of
fibroid surgery are,
Quite a few women undergo fibroid surgery as they have excessive vaginal bleeding
leading to Anemia and are therefore anemic before surgery. In such cases their Hemoglobin level
needs to be corrected before surgery and adequate arrangements for blood transfusions should be
ready before starting the operation.
Strict precaution should be undertaken to ensure that the
instruments, etc. used are well and thoroughly sterilized. This will minimize chances of
infection. Also a good antibiotic cover should be given pre as
well as post-operatively.
There are several medicines which give good protection from pain; however some
degree of pain postoperatively is almost inevitable.
- Injury to surrounding
The surgeon has to be very careful that surrounding structures are
not damaged. The bladder is catheterized prior to starting
surgery to keep it empty and the intestines are packed away with sterile surgical towels to keep
them away from the site of fibroid surgery.
- Thromboembolism, which means traveling of a blood clot and its
getting lodged in some major blood vessel.
In addition the cost factors for fibroid surgery need
to be considered.
So although surgery remains a popular method for its
treatment, with the new developments more and morepeople are looking for alternatives. They are
searching for other methods to avoid the risks and costs involved in surgical