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Uterine Fibroid Treatment Options...
Appropriate treatment depends on the size and location
of the fibroids, as well as the severity of symptoms. If you are not experiencing symptoms, Dr. Niedzwiecki will most likely suggest "watchful
waiting" — checking the fibroid at annual gynecologic examinations and monitoring for symptoms.
If symptoms develop, there are a number of treatment options:
Hormone Therapy - drugs that can be used in the treatment of fibroids.
Uterine Artery Embolization - a minimally invasive procedure with short recovery period and almost immediate
improvement. Uterine fibroid embolization is a new non-surgical treatment that causes the fibroid to shrink.
Myolysis
- Destruction of fibroids by needle puncture and electrical current.
Myomectomy - Surgical removal of only the fibroid.
Hysterectomy - Surgical removal of the uterus.
Treatment Option: Hormonal Therapy
Hormonal Therapy
Hormonal Therapy utilizes drugs or shots to change estrogen
levels and/or modify the wall of the uterus. Depending on the size of the fibriod this therapy is usually tried
first. This thearapy might include:
- the use of non-steroidal anti-inflammatory drugs (NSAIDs) such
as ibuprofen (Motrin) or naproxen sodium (Naprosyn),
- birth-control pills, or
- hormone therapy.
Studies show that certain drugs can cause fibroids to shrink.
This may make surgery easier, or it may be used instead of an operation, but the effects are temporary. Some drugs
have been linked to complications which you may wish to discuss with Dr. Niedzwiecki.
In some patients, symptoms are controlled with these treatments
and no other therapy is required. However, some hormone therapies can have risks and side effects (menopausal symptoms,
erratic or no menstruation, bloating, moodiness) when used long-term, and generally are used temporarily.
Uterine Artery Embolization
Fibroid Embolization is a very effective alternative to
hysterectomy to control the symptoms related to fibroids. Uterine Artery Embolization is a new non-surgical
minimally invasive procedure that causes the fibroid to shrink. The procedure is performed under a local anesthetic
in an out-patient facility. X-ray imaging guides a slim catheter incerted through a small incision in the inner
thigh to the specific blood vessels that feed the fibroid. Fibroids are fueled by estrogen enriched blood. This
blood is suplied almost entirely through the uterine arteries. The specific blood vessels feeding the fibroid is
then injected with micro-particles blocking the enriched blood flow. The fibroids no longer receive estrogen enriched
blood, and therefore begin to break down.
Over time the fibroids will shrink and/or be completely reabsorbed
by the body.
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The benefits to Uterine Artery Embolization are:
- No trauma to the uterus - the Uterus is not cut open, removed
or scarred
- No hospital stay or general anesthetic resulting in a short recovery
time
- 94% success rate/1000 patients
- Fibroids do not recur
- Fertility maintained
Myolysis
Myolysis, is done through a laparoscope. A laser fiber (an electrical
device), is placed into the fibroid through the laparoscope, and is used to coagulate the the blood vessels feeding
the fibroid. The dead tissue is then gradually replaced with scar tissue. Recovery is usually rapid.
There are disadvantages to this procedures. There is the possibility
the procedure may cause adhesions, which could cause problems later on.
Surgical Treatments:
Myomectomy
Myomectomy is an operation to remove a fibroid tumor without taking
out the uterus. This means that pregnancy is still possible, although a Cesarean section may be necessary. Fibroids
are removed surgically through an abdominal incision which requires a hospital stay of about 3 to 4 days.
While myomectomy is successful in controlling symptoms about 80
percent of the time, the more fibroids there are in a patient's uterus, the less successful the surgery generally
is. In addition, fibroids grow back several years after myomectomy in 10 percent to 30 percent of cases.
There are risks associated with myomectomy, including infection
and bleeding. The procedure may cause extensive pelvic scarring which may make future surgery difficult and contribute
to future fertility problems. Long-term studies of myomectomy patients who attempted to become pregnant have shown
pregnancy rates between 40 percent and 60 percent.
Surgical Treatments: Hysterectomy
Hysterectomy is usually recommended when the fibroids are causing
symptoms, when they have grown rapidly, or when the fibroids are large (as large as a grapefruit).
Approximately one-third of the more than half-million hysterectomies
performed in the United States each year are due to fibroids.
In a hysterectomy, the uterus is removed either through the vagina,
or in a laparoscopic surgery, or in an open surgical procedure. A procedure is selected based on the size of uterus,
previous surgery, other problems the woman might be having at the same time, and the preference of the woman. In
all cases, the operation is performed while the patient is under general anesthesia. It requires three to four
days of hospitalization and a four- to six-week recovery period. Hysterectomy has a 2 percent risk of post-operative
bleeding and a 15 percent to 38 percent risk of post operative fever.
Hysterectomy is the most common current therapy for women who
have fibroids and is effective in essentially all cases in which bleeding is a problem. It usually resolves the
pain or urinary symptoms that women may have. It is typically performed in women who do not wish to have more children.
Where do I Call for a Consultation?
Please Call
us TODAY at 727-791-7300 if you have any questions.
We're looking forward to helping you .
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