The treatment of the uterine fibroids depends on the size and the symptoms of the fibroids. Following are some of the most common treatments for the symptomatic fibroids:
- Medications to control the symptoms
Medicines like NSAIDs (no steroidal anti inflammatory drugs) e.g. aspirin, naproxen, can be given to control the menstrual cramps pain. Heavy bleeding may happen because of fibroids leading to anaemia. Iron tablets can be given to increase the haemoglobin. Oral contraceptive can be given to regularise the menses and reduce the heavy flow of the menstruation. Cabergoline is also found to be effective in causing shrinkage of the fibroids.
- Intra uterine devices:
Intrauterine devices containing levonorgestrel (progestin) can also be used for the symptomatic treatment of fibroids. Because of this hormone, the excessive bleeding is controlled. It is also seen to cause the regression of the fibroid tumour size. The fibroid gets shrunken.
- GnRH agonists:
These medications cause regression in the size of the fibroids by stopping the secretion of oestrogen and progesterone putting you in a temporary induced menopausal state. Absence of these hormones results in shrinking of the fibroid.
- MRI guided focused ultrasound surgery:
It is performed when you are inside the MRI machine. The exact location of the fibroid is decided and then high- energy ultrasound waves are targeted into the fibroid. This procedure is also known as sonification. The fibroid hence gets heated and gets broken into multiple tiny pieces. These pieces are then expelled in the menstrual flow.
- Uterine artery embolisation:
Uterine artery Embolisation is a minimally invasive procedure. In this procedure the blood supply to the fibroid is stopped or hampered.
Small particles are introduced in the uterine artery which leads to cutting of the blood supply to the uterus hence leading them to shrink and eventually die.
This is a laparoscopic procedure. An electric current or laser beam is used to destroy the fibroid tissue. It also causes the blood vessels supplying the fibroid to shrink. Another method called as cryomyolysis can also be used. In that procedure, the fibroid is frozen and then is broken into pieces with the laser beam.
- Hysteroscopic myomectomy:
When the fibroid is present in the wall of the uterus, Hysteroscopic myomectomy can be conducted. A resectoscope or endoscope is used. The scope is introduced through the vagina and the cervix in the uterine cavity. High frequency electrical energy is used to cut the fibroid tissue.
- Laparoscopic myomectomy:
In this procedure, the scopes are introduced through ports created in the abdomen. A port is created in the navel to gain access to the abdominal cavity. A laparoscope is used to visualise the area and cut down the fibroid. It gives better results than laparotomic myomectomy.
- Laparotomic/ abdominal/ open myomectomy :
This is most invasive procedure available to treat fibroid. The abdominal cavity is opened by a large incision. The fibroid is removed from the uterus. The healing period is the longest for this treatment. This modality is not favoured now-a-days.
- Endometrial ablation:
Fibroids present in the cavity of the uterus can be removed using this procedure. The fibroids present in the wall and large fibroids cannot be removed by this procedure. The ablation means burning. The inner lining of the uterus is burned using heat, hot water or electric energy hence destroying the fibroid.
Hysterectomy means removal of the uterus. This is the last option of the treatment. Hysterectomy is advised when the fibroids cannot be treated by any other method because either they are too large or cause uncontrolled or heavy bleeding. Women won’t be able to conceive after hysterectomy. It might also lead to an early menopause and deterioration in other health parameters.
Fibroids if symptomatic should be treated as soon as possible in order to avoid painful menses and other complications!! To treat fibroids by the best vascular surgeon in Hyderabad Dr.AbhlilashSandhyala contact us: http://www.interventionsinradiology.com/