Uterine Fibroids Specialists & Treatment in Delhi

Indications

Surgical intervention for uterine fibroids is considered in the following situations:

• Symptoms: Persistent symptoms such as heavy menstrual bleeding, pelvic pain or pressure, frequent urination, or difficulty emptying the bladder.
• Infertility: Fibroids that interfere with fertility or cause recurrent miscarriages.
• Rapid Growth: Fibroids that grow rapidly or cause complications such as compression of nearby organs.
• Failed Conservative Management: Fibroids that do not respond to medical treatments or minimally invasive procedures.

Types of Surgical Procedures for Uterine Fibroids

1. Myomectomy
   • Procedure: Myomectomy involves surgical removal of fibroids while preserving the uterus. This procedure is suitable for women who wish to maintain their fertility.
   • Techniques: Myomectomy can be performed through different approaches including:
     • Abdominal Myomectomy: Through a large incision in the abdomen, suitable for larger or multiple fibroids.
     • Laparoscopic Myomectomy: Minimally invasive surgery using small incisions and a camera (laparoscope) to guide the removal of fibroids.
     • Hysteroscopic Myomectomy: Removal of fibroids that protrude into the uterine cavity using a hysteroscope inserted through the vagina and cervix.
2. Hysterectomy
   • Procedure: Hysterectomy involves the surgical removal of the uterus and may also include removal of the cervix and ovaries depending on the specific case.
   • Indications: Recommended for women who have completed childbearing, have severe symptoms, large or numerous fibroids, or for those who prefer definitive treatment.
   • Types: Hysterectomy can be performed through various approaches including:
     • Abdominal Hysterectomy: Traditional open surgery through an abdominal incision.
     • Vaginal Hysterectomy: Surgery performed through the vagina, suitable for some cases depending on the size and position of the uterus.
     • Laparoscopic or Robotic-Assisted Hysterectomy: Minimally invasive procedures using small incisions and specialized instruments guided by a camera.

Procedure Steps

1. Preoperative Preparation
   • Evaluation: Comprehensive medical evaluation, imaging studies (e.g., ultrasound, MRI) to assess fibroid size and location.
   • Discussion: Detailed discussion with the surgeon regarding surgical options, risks, benefits, and expected outcomes.
   • Anesthesia: General anesthesia is typically used for abdominal or laparoscopic surgeries. Regional anesthesia may be an option for vaginal surgeries.
2. Surgical Procedure
   • Incision: Depending on the type of surgery, an incision is made either in the abdomen (abdominal or laparoscopic) or the vagina (vaginal hysterectomy).
   • Fibroid Removal: Fibroids are carefully removed while preserving the uterus (myomectomy) or the entire uterus is removed (hysterectomy).
   • Closure: Incisions are closed with sutures or staples, and dressings are applied as needed.
3. Postoperative Care
   • Pain Management: Pain relief medications are administered as needed.
   • Hospital Stay: The length of hospitalization varies depending on the type of surgery and individual recovery.
   • Recovery: Instructions on wound care, activity restrictions, and follow-up appointments are provided.
   • Monitoring: Regular follow-up visits to monitor healing, manage any complications, and assess symptoms.

Risks and Complications

• Infection: Risk of infection at the surgical site.
• Bleeding: Postoperative bleeding or hematoma formation.
• Adverse Anesthesia Reactions: Potential reactions to anesthesia medications.
• Damage to Nearby Organs: Rare risk of injury to nearby organs or structures.
• Blood Clots: Risk of deep vein thrombosis (DVT) or pulmonary embolism (PE), especially after abdominal surgeries.

Recovery and Outlook

• Immediate Recovery: Patients typically experience some discomfort and may need pain relief medications. Recovery time varies depending on the type of surgery performed.
• Long-Term Outlook: Most women experience relief from symptoms after surgery. Fertility preservation may be possible with myomectomy, but this depends on individual circumstances.

Conclusion

Surgical treatment for uterine fibroids is tailored to individual patient needs, considering factors such as symptom severity, desire for fertility, and overall health. It is important for patients to discuss their options thoroughly with a healthcare provider to make informed decisions about their treatment plan. Advances in surgical techniques, including minimally invasive approaches, have improved recovery times and outcomes for many women undergoing surgery for uterine fibroids. Regular follow-up care is essential to monitor healing and ensure optimal postoperative recovery.