New Fibroid Surgeries
Various forms of conventional surgery are used to treat women suffering from uterine fibroids. If a woman wants to have children, a myomectomy procedure (in which only the fibroids themselves are removed) will be carried out, if possible. If a woman no longer wishes to have children and her symptoms are severe, she may be advised to undergo a hysterectomy (the removal of the uterus and possibly the other reproductive organs) or endometrial ablation (the removal of the lining of the uterus). All these procedures are "invasive" and would usually require general anaesthetic. Certain new surgical procedures have been developed in recent years. These are designed to be minimally invasive or even non-invasive, and are therefore much less taxing on the body. All the procedures described below have been officially approved for use in the United Kingdom. Because they are new, however, relatively little data is available on long-term results or the risks and benefits of these operations. Furthermore, these procedures may not be available in all U.K. hospitals. If you are considering undergoing one of these procedures, you should discuss the advantages and disadvantages with your doctor and ask him to find out where you might be able to have the procedure carried out.
Uterine Artery Embolisation (UAE)
UAE is a new procedure which works by blocking the blood supply to the fibroids in your uterus and causing them to shrink. It is usually carried out in hospital under sedation and local anaesthetic. You will probably be kept in hospital overnight after the procedure. X-rays are used to guide fine needles which will be inserted into the uterine arteries feeding blood to the fibroids. Then a catheter is inserted into the artery through which small particles of polyvinyl alcohol (PVA) are injected. These particles gradually build up inside the artery and, over the course of several minutes, block it completely. After the procedure, your fibroids will shrink over time and your symptoms will improve. If your fibroids have prevented your reproductive organs from functioning normally, you may find that you will now be able to get pregnant. UAE is normally used to treat large fibroids and has been known to shrink fibroids by up to 60%.
Magnetic-Resonance-Guided Percutaneous Laser Ablation
This procedure is also normally carried out under sedation and with local anaesthetic. A catheter may be inserted in the bladder. First of all, magnetic resonance imaging (an MRI scan) is used to detect the location of your fibroids. Fine needles are then inserted into the fibroids through areas of skin which have been anaesthetised. Fibre optic cables are inserted through the needles and into the fibroids. These cables emit light and heat. The heat shrinks the fibroids. After the procedure, your symptoms should improve and, if infertility has been a problem for you, you may now find it easier to conceive.
Magnetic-Resonance-Guided Focused Ultrasound Surgery
This procedure is usually carried out on an outpatient basis. It is considered non-invasive. You'll be given a mild sedative and pain medication before the procedure begins. When the sedative wears off, after the procedure, you'll be allowed to go home, providing the doctor has checked you out and all is well. Once again, an MRI scan is used to locate your fibroids. Sound waves are then directed at the fibroids. These waves emit pulses of energy which cause the fibroids to shrink. In the months following the procedure, your body gradually removes the treated tissue. Your symptoms should be alleviated and your reproductive system may resume its normal function.
Other Options
Surgery is far from the only course of treatment available for uterine fibroids. In fact, surgery is usually recommended only as a last resort. Check out our article on medication used to treat fibroids for more information.
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