Symptoms of fibroids
Fibroids also called leiomyoma which are non-cancerous tumors of muscle layer of the uterus. Uterine fibroids is one of the most common diseases in women of reproductive age, occurring in 20% to 50% during these years.
Depending on the size and location of fibroids they causes symptoms like heavy, prolonged, and intermenstrual bleeding, sometimes infertility, painful cycle. If the fibroids are huge they can cause distension of the abdomen, if they grow on anterior surface can cause pressure effects like frequency of urination, if grown posteriorly can cause constipation.
Management of fibroids
Management depends on the age of the patient, symptoms, size, number and location of fibroids.Size of the fibroids can be temporarily reduced by injection, uterine artery ligation, and ultrasonic waves, which results in temporary relief and helps to postpone for the definitive surgery. Only definitive treatment is surgery either by laparoscopy or hysteroscopy which was previously done with open surgery.
Only fibroids which are causing symptoms like heavy bleeding, pain, pressure symptoms like urinary or constipation and which is causing problems for pregnancy needs removal.
Decision regarding the fibroid or uterus removal taken depending on the age of the patient,she completed her family or not.
When the women is 40 -45 years and above, completed family and when she has symptomatic fibroids we recommend uterus removal otherwise fibroid removal. Laparoscopic fibroid removal is safe and method of option today, even in previous cesarean and huge fibroids.
Laparoscopy is patient friendly where small cuts about a centimeter made on the abdomen through which laparoscope and fine long instruments are inserted. High definition medical grade camera attached to laparoscope. Fibroid removal removal surgery is carried with this small holes, if the fibroids is huge with the same small hole special instrument called morcellator is used to remove from the abdomen in order to prevent spill morcellation can be done in bag.
It is done for small submucosal fibroids, in this method camera is passed in to the uterus through birth passage and fibroid is shaved from the inner lining of the uterus until the base is removed it is called hysteroscopic fibroid resection.
Advantages over open surgery.
High definition camera which increase resolution and increases the precision improves the safety of the surgery.
Small cut less post-operative discomfort, pain blood loss, short stay, fast recovery and no stich removal.
So laparoscopic fibroid removal is patient friendly, outcome is very good with expertise of surgeons, anesthesia team and good quality instruments.