Everything You Need to Know about the Surgical Treatment of Uterine Fibroids

Uterine fibroids, also known as leiomyomas, are benign tumors that develop from the smooth muscle cells in the uterine wall. It is one of the most common gynecological diseases in women of childbearing age. According to statistics, about 20-40% of women of this age experience uterine fibroids. Although benign, fibroids can cause significant discomfort and complications such as pain, bleeding, and reproductive problems. In some cases, surgery is necessary. In this article, we will consider in detail all aspects of the surgical treatment of uterine fibroids.

Types of surgical treatment for uterine fibroids

There are several types of fibroid surgery, each of which has its own indications, advantages, and disadvantages:

Myomectomy

A myomectomy is a surgical procedure that involves removing fibroids while preserving the uterus. This method allows a woman to maintain her reproductive functions, which is extremely important for women who are planning a pregnancy. Myomectomy can be done in a variety of ways, including laparotomy, laparoscopic myomectomy, and hysteroscopic myomectomy.

Indications for myomectomy include symptomatic fibroids causing pain and heavy menstruation, infertility or recurrent pregnancy loss related to fibroids, and rapid growth of fibroids or suspected malignant transformation.

Among the advantages of myomectomy are the preservation of the uterus and reproductive function, as well as a quick recovery with minimally invasive techniques. Disadvantages include the risk of recurrence of fibroids and potential complications such as bleeding, infection, and damage to nearby organs.

Hysterectomy

A hysterectomy is a surgical procedure that involves removing the uterus. This method is used in cases where other treatments are not effective or practical. There are several types of hysterectomy, including partial, total, and radical hysterectomy. Indications for hysterectomy include large or multiple fibroids causing significant symptoms, suspected malignant degeneration of fibroids, and failure or failure of other treatment options.

The benefits of hysterectomy include complete relief of fibroid symptoms and no risk of fibroid recurrence. Disadvantages include the inability to conceive, a long recovery period, and the risk of surgical complications such as infection, bleeding, and damage to nearby organs.

Uterine artery embolization

Uterine artery embolization (UAE) is a minimally invasive procedure designed to reduce blood flow to fibroids, resulting in smaller fibroids and fewer symptoms. The intervention is carried out under X-ray control through a small puncture of the skin.

Among the indications for UAE are symptomatic fibroids in women who are not planning pregnancy, refusal of surgical intervention, as well as the presence of contraindications to other treatment methods.

Advantages of UAE include minimal invasiveness, quick recovery, and preservation of the uterus. Disadvantages include possible side effects such as pain, infection, and amenorrhea, as well as limited data on reproductive effects.

Preparation for surgical treatment

Before surgical treatment of uterine fibroids, a thorough examination is required. This includes clinical examination and history, pelvic ultrasound, magnetic resonance imaging (MRI) if necessary, blood and urine laboratory tests, and consultation with an anesthesiologist.

It is important to discuss all the risks and benefits of your chosen treatment method, as well as other options, with your fibroid doctor. The preparation for the operation also includes abstaining from eating and drinking for a few hours before the operation.

Post-operative period and rehabilitation

The postoperative period depends on the type of procedure performed. Minimally invasive procedures, such as laparoscopic myomectomy or SAE, allow faster recovery and fewer complications. Traditional operations, such as laparotomy, myomectomy, or hysterectomy, require a longer recovery time.

The basic recommendations in the postoperative period include rest and a gradual return to physical activity, a good diet and adequate fluid intake, the use of medications prescribed by a doctor to avoid complications, and regular medical examinations to monitor the healing process and prevent the recurrence of fibroids.

The bottom line

Surgical treatment of uterine fibroids is an important and often necessary step to improve a woman's quality of life. With the right approach and compliance with all recommendations, the treatment is successful and with minimal complications. The success of the treatment depends not only on the correct choice of method but also on careful preparation for the procedure and compliance with the recommendations in the postoperative period.