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Surgery to remove uterine fibroids

Uterine fibroids is a tumorwith a benign nature, which develops from the muscular tissue of the female reproductive organ. In some cases it requires surgical intervention because conservative methods do not produce the desired effect.

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Do I need surgery? Indications for surgery

For surgical intervention there are specific indications:

  • The size of the fibroids, or the tumor size higher than the size of uterus at 12 weeks of pregnancy;

  • The tumor threatens to transform into sarcoma;

  • The provision of tumor pressure on the adjacent organs;
  • Rapid growth of education (during the year it grows 4 weeks);
  • The node fibroids omertvenie;

  • The formation of a submucosal node, or it necrosis;

  • Submucosal fibroids, or adenomyosis;

  • The occurrence of metrorrhagia, which becomes a cause of anemia;

  • The inability to carry a pregnancy or to conceive a child;
  • Fibroid has a stalk;
  • The tumor disrupts the process of urination.

As for the method by which you will remove the education, the final decision is taken by the doctor. It depends on several factors: the location of the tumor and its nodes, from the woman's age, her health, etc.


Transaction types

As for the types of operations conducted in this disease, they are divided into two groups: surgery with preservation of the reproductive organ and the removal of the only schools (myomectomy), as well as the operations of removal or fibroids and uterus at the same time (hysterectomy).

As for the hysterectomy, then it is considered a radical surgery that is usually performed on reaching women of 40 years and if it is no longer planning to conceive.In the process of performing surgery can be removed the uterus along with the cervix, and with its preservation. Leaving the cervix is a necessary element in a woman's body, as it gives the normal functioning of the urogenital organs and intestines. Therefore, it is possible, doctors try to save it. However, we must ensure that there are no fibroids or cancerous cells. In addition, deleted, or saved in the operation process can be and appendages.

Hysterectomy

Hysterectomy is performed in several ways:

  • Practiced laparotomia hysterectomy when access on offer through the implementation of cuts in the skin with a scalpel. This method is deprecated and resort to it in rare cases when fibroids gave multiple nodes, and she has grown considerably, and remove it through small incision is not possible.
  • Laparoscopic hysterectomy, when the removal occurs with the use of a special device – a laparoscope. To carry out the operation, the abdominal wall makes several small incisions through which introduced a special tool, and the uterus along with the fibroids is removed. The doctor monitors the progress of the operation on the monitor.

Myomectomy

With regard to myomectomy, this operation allows to save the body, and can also be performed in three ways:

  • Abdominal surgery is performed only in the case when it is not possible to remove the tumor in other ways. Extremely rare modern doctors use this type of intervention. Often resort to it when torsion legs myoma or necrosis of the tumor. In hospital the woman has to spend a few days, the stitches will heal for a long time. The rehabilitation period before a woman can return to his former way of life, to last, on average, two months.
  • Myomectomy with the use of laparoscope. Due to the fact that this method is less traumatic, and seams is very small, the rehabilitation period after surgery lasts just a few days.
  • Myomectomy with the use of a hysteroscope. It is introduced into the vagina and remove the tumor. The implementation of this type of surgery is possible with a single tumor, which is located on the wall of the uterus (anterior or posterior). The operation is usually carried in the condition of clinic and woman, after several hours of observation can go home.

Sizes of uterine fibroids for surgery inmillimeters

To determine the size of tumors, it is necessary to conduct ultrasound studies. Specifies the size, in weeks of pregnancy, and in millimeters.

Myoma size is:

  • Small - up to 2cm (20mm). Corresponds to the period of 4-5 weeks of pregnancy;
  • Average from 2cm (20mm) up to 6cm (60mm) that is mapped to an interval of 4-5 weeks to 10-11 weeks;
  • Large more than 6cm (60mm) or 12 or more weeks.

Be removed by using surgical intervention is necessary the fibroids, which is a large and exceeds 12 weeks of pregnancy or 60 mm.


Complications and consequences

After surgery to remove fibroids may develop certain complications. Although in most cases they can be avoided, as this type of surgical intervention is difficult or dangerous to life and health of a woman. However, in some cases, you may experience the following complications:

  • The tumor may recur;

  • Increases the risk of developing breast cancer;

  • Increases the probability of forming coronary heart disease;

  • There is a risk of infection, as well as during any operation.

However, the risks of developing these and other pathologies significantly increase if, along with the fibroids had hysterectomies. In this case, the period after the operation is divided into early and late.

In the early postoperative period a woman may experience:

  • Expressed pain in the abdomen, in the area of the seams. Why doctors prescribe this time taking strong painkillers.
  • To prevent thrombophlebitis the woman is prescribed anticoagulants, to replenish blood volume intravenous fluids, to eliminate the risk of infections antibacterial drugs.
  • The abdomen is painful even for 2 weeks.

  • The scar on the skin can become inflamed or to disperse.

  • Breaks down the process of urination, if corrupted by the mucosa of the canal.
  • There is a risk of development of external and internal bleeding.

  • May be pulmonary embolism, which threatens the development of pulmonary hypertensionpneumonia and even death of the patient.

  • There is a risk of formation of parinita, which in turn can cause sepsis.

  • Often joints occur hematoma.

The later consequences after the removal of the uterus together with the fibroids, include:

  • The inability to conceive a child, as removed fertilized;
  • On the abdominal wall will be visible seam from the surgery;
  • The formation of adhesions in the peritoneum, which could involve pain, increased flatulence, problems with urination;

  • An earlier onset of menopause;

  • Increases the risk of osteoporosis;

  • There is a risk of prolapse of the vagina.

Therefore, doctors try to save the uterus. Especially if the operation is exposed to a young woman or a middle-aged woman.

Popular questions and answers

Naturally, the woman will have surgery, hurts a lot of questions.

The most popular of them:

  • Is it possible to give birth with a myoma? The answer to this question depends on a number of factors. First, the very location of the node may become an obstacle to conceive. Second, if conception does happen, and fibroids were discovered later, the woman will need to be on special control at the doctor, because you do not know how to behave in the tumor with the hormonal changes. Clear indications for medical abortion is: the necrosis of fibroids, torsion or impairment of leg tumor, robbing the fetus of tumor and developmental delay of the child, detection of malignant processes, the presence of submucosal nodes, their location in the region of the cervix, growth of the host. Besides, doctors do not recommend a woman to give birth if its age is over 40 years old, have fibroids and babies.
  • Is it possible to have children after removal uterine fibroids? After the removal of fibroids, there is a high probability of conception, but only if uterus was saved. In addition, after the removal of the tumor from the body, the woman will need to drink-hormonal agents that allow to restore menstrual cycle. After some time it will be possible to plan a pregnancy again.
  • When you can get pregnant again after the surgery? The deadlinewhen again, you will conceive a child are directly proportional to the dependence on how the tumor was removed. If you did a laparoscopic or hysteroscopic myomectomy, doctors recommend to refrain from possible conception during the year. When the abdominal surgery, the recovery time can take up to 3 years. However, all depends on the individual woman and her ability to recover.
  • Spotting after removal uterine fibroids – what is it? Do not worry about the appearance of bleeding from the uterus. They are always seen after such operations. The type of "daub" this process may take two weeks after the intervention. This is due to the natural healing process. However, if their nature changes, the discharge becomes abundant, start accompanied by a putrid odor or change the color resemble the color of meat slops, it is necessary as soon as possible to go to the doctor. This may be a sign of infection or inflammation that threatens serious complications.
  • How long sex after removal uterine fibroids? Sex life under a ban for at least a month. Most often doctors recommend to abstain from sexual relations for two months, as it is the time will heal the scar on the uterus. In addition, there is a risk of infection.
  • How long the hospital after the removal of uterine fibroids? Most often after surgery give hospital for 29 days. Although this period may be shortened or lengthened, depending on how the recovery of women, what are the conditions of her work, what kind of operation was chosen to eliminate fibroids.
  • Is it possible to cure uterine fibroids without surgery? In most cases, education can be treated, without the use of surgery.

On topic: the Treatment of uterine fibroids without surgery – 3 modern methods


Rehabilitation after surgery for removal of uterine fibroids

Rehabilitation is a necessary process after surgery.

Doctors give the following recommendations, observing that the woman can quickly and easily recover:

  • As little as possible to be in direct sunlight.
  • Give up going to the bath, a sauna and a Solarium.
  • to Refrain from sexual activity for 2 months.
  • With such recommendations, as the wearing of a bandage – don't ignore it.
  • Not to lift heavy objects, the weight limit is 3 kg.
  • Exercises using a special device.
  • To abandon the use of tampons, should be used only sanitary pads.
  • To follow a particular diet.
  • Exercise in a remote rehabilitation period.

The implementation of these recommendations will allow the woman to recover faster after the operation, to return to work. In addition, most women claim that their quality of life after surgery improved significantly. Therefore, if you have any symptoms, indicating the presence of the pathological process, must undergo a full medical examination. When you assign the operative intervention should not be to abandon it.