Why Delaying Fibroid Surgery Can Be Harmful
There are several myths that can cause a woman to delay fibroid surgery, doing more harm than good. But fear of open surgery or the risks associated with robots and power morcellators can also stall a woman from having a needed procedure. Learning the facts about fibroid surgery, and finding a specialist who can perform minimally invasive procedures without a robot or power morcellator can help many women avoid unnecessary pain, embarrassment and heartache.
Myth 1: Fibroids Will Disappear After Menopause.
As fibroids continue to grow, symptoms like pelvic pain and abnormal bleeding can worsen. First, for any woman to be expected to suffer with pain or cope with embarrassing situations like having to change clothes in the middle of work, or not being able to leave the house for fear of an uncontrolled bleed until menopause is extremely inconvenient. Second, while estrogen diminishes during menopause, it doesn’t disappear, and as fibroids need estrogen to grow, they too will not suddenly vanish.
Myth 2: Fibroids Don’t Affect Fertility
An estimated 6.7 million women in the U.S. experience the heartache of infertility or miscarriage. This is often due to a less than optimal environment in the uterus. Yet, 6 in 10 women dispute (or are unaware) that fibroids affect fertility.
Fibroids can block fallopian tubes, making it difficult for a fertilized egg to make it into the uterus. This can potentially cause an ectopic pregnancy within the tube, a life threatening condition for the mother. Fibroids can make it difficult for an embryo to attach to the uterine wall, or if they are very large, can impede the growth of a fetus. In addition, many women with fibroids end up delivering prematurely, putting the infant at risk.
Myth 3: Removing Fibroids Is Easier To Recover From Than A Hysterectomy
Many fibroids are deep within the muscle, and can be difficult to access. Depending on how many fibroids, or how large they are, there can be painful internal incisions that need to heal.
Three Essential Factors Play a Role in Fibroid Surgery.
The fibroids themselves: How large, how many, and their location all determine the type of surgery.
Fibroids can occur anywhere in the uterus, and are named for their location. Cervical fibroids are rare, whereas most fibroids develop from the muscle or myometrium.
- Serosal fibroids – outside of the uterus, and involve the serosal lining.
- Pedunculated fibroids – on stalks.
- Intramural fibroids – within the muscle.
- Submucosal fibroids – involve the endometrial lining.
The patient’s future plans: Is childbearing still desired? Is retaining your uterus important to you?
The likelihood of recurrence after childbearing is often high for women who have fibroids, so after a point, many women decide that removing the uterus is the appropriate step. However, for many women, retaining their uterus, either to become pregnant or other personal reasons, is important. Doctors will caution women who have fibroid removal surgery, or a myomectomy, that fibroids can and often do return. It is essential for women who are intending to retain their uterus to have the most minimally invasive myomectomy possible, because the probability of these women requiring subsequent fibroid removal surgery is very high.
The surgeon’s skill: Even with a large fibroid or many of them, minimally invasive fibroid removal is possible.
Join any online support group for fibroids and you will discover very strong, supportive, determined women who have experienced every symptom imaginable, struggled emotionally and physically with these tumors, yet whose choices for surgery were almost always limited to open or robotic procedures.
A myomectomy is usually performed for fertility, and it is essential that the uterus be reconstructed so that when it is healed, it is strong enough to sustain a growing baby. The benefit of an open myomectomy is that it can be thorough, and the uterus can be reconstructed. The downside is that it has a very long recovery, at least 2 months, and many women feel it takes them longer. The benefit of a laparoscopic myomectomy is that women have faster recoveries. The downside is that not all fibroids can be removed, since they may not be felt. Robotic surgery is limited in the type and number of fibroids that can be removed, and surgeons often need to use a power morcellator to remove larger fibroids. While rare, this device has been shown to spread a dangerous cancer in the pelvic cavity.
The Center for Innovative GYN Care surgical specialists have taken the best of open and laparoscopic procedures, without the use of a robot or power morcellator. LAAM-Laparoscopic Assisted Abdominal Myomectomy is a technique that uses 1 tiny incision at the belly button for a laparoscope, and a slightly larger incision, about an inch and a half at the bikini line to remove the fibroids. The surgeons are able to feel and remove all of the fibroids, and reconstruct the uterus completely. Patients generally recover in 10 days to 2 weeks.
Read more about LAAM and women who have had large fibroids removed with this groundbreaking fibroid removal surgery with the minimally invasive GYN surgical specialists Dr. Paul J. MacKoul, MD and Dr. Natalya Danilyants, MD.
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