Fibroma: the operation

The operation of a fibroid remains a solution often enough proposed, especially when the fibroid is bulky, or it causes pain or bleeding that drugs could not mitigate.

There are several types of operations that can ...

  • remove the fibroids ( myomectomy )
  • remove the uterus ( hysterectomy ): this operation, more radical, is considered in case of large fibroids, if the woman does not want more children or in situations for which it proves impossible to do otherwise).

Laparotomy, that is, open-belly surgery, is the oldest technique. It is less and less practiced, except for large fibroids, or when a vaginal or laparoscopic intervention proves to be complex.

Laparoscopy or endoscopy and a technique that dates back thirty years. It consists in introducing a mini endoscopy camera in the belly, often at the level of the umbilicus, by a small hole of one centimeter; endoscopy tools, pliers, scissors ... are tiny instruments; they are introduced through trocars of a few millimeters in diameter. This technique is reserved for teams trained mainly for large fibroids. It allows a shorter hospital stay.

Many surgical teams remove fibroids that develop inside the uterus naturally (vaginally) when possible. The fibroids must not be too large.

Another technique for treating uterine fibroid is embolization . It is an operation that involves injecting, through a thin catheter introduced at the crease of the groin, microbeads into the arteries of the uterus.

Thus, the small arteries that irrigate the fibroid will be plugged, "asphyxiated", no longer feeding. The fibroids do not disappear, but die and shrink, thus stopping the various symptoms (painful pelvic compressions, bleeding ...). And the womb of the patient is thus preserved.

This intervention is indicated for specific cases, and is only performed in about forty health centers in France. It requires real expertise. This operation is performed by an interventional radiologist. Hospitalization for 24 to 48 hours with prolonged epidural anesthesia may be necessary, as this surgical technique is often painful afterwards.

Should the uterus be removed: hysterectomy or not?

In case of surgery on a uterine fibroid, this question may arise ... When women are menopausal or near the menopause, we can offer them to remove the uterus with the fibroids or fibroids to avoid recurrence: this procedure is called a hysterectomy. If the cervix remains in place, the hysterectomy is sub-total. If the cervix is ​​removed with the uterus, the hysterectomy is total. It is possible to remove also the fallopian tubes and ovaries, the hysterectomy is sub-total or total and enlarged.

Surgeons will do their utmost to preserve the uterus of women who want children. Obviously, since when the uterus is removed, infertility is definitive.

Want to share, share your experience or need advice? See you in our FORUMS Gynecology or A doctor answers you!

Read also :

> Hysterectomy: how is the operation?
> Embolization of the uterine fibroid
> All our articles on women's health

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