Endometrial Ablation and fibroids

blog pic 19Endometrial ablation was definitely a term I was unfamiliar with until all hell broke lose in my uterus!  It was presented to me as one of the options to try to deal with my ‘issues’ (other options presented included an IUD, changing my birth control, and as a last resort, a hysterectomy).  Even now, I find it challenging to find much information online about what it is exactly.  This article presents this option quite positively though I was told it is not without its risks and drawbacks (one being that it may only be a temporary solution).  Of course, it was a decision I never had to make due to my emergency hysterectomy surgery but for those of you looking into your options, perhaps this will help:

Endometrial ablation is one of the many minimally-invasive methods used to treat heavy menstrual bleeding due to fibroids or other causes.  It  is very effective in treating the bleeding that can accompany uterine fibroids in 40-60% of those treated, causing endometrial ablation to gain popularity, among other options, for the treatment of fibroids.

How It Works

Ablation procedures remove (destroy) the lining of the uterus, thereby eliminating heavy menstrual bleeding, in some cases, or simply decreasing the bleeding in others.  Abnormal bleeding is typically a result of bleeding from the uterine lining , destruction of this lining can lead to decreased bleeding or no menses without having a hysterectomy.  Because the uterus is preserved, this is also called a  uterine -sparing procedure.

There are no incisions and this procedure can be done in as little as five or 10 minutes in the office or in a hospital out-patient setting.   No recovery time is necessary, and,therefore, no time off from work is required except for the day of the procedure.

The amount of anesthesia needed is minimal, and it can even be performed using local numbing medicine placed in the cervix (a small local pain killer similar to what is done in the dentist’s office).

Things To Consider

As the inside lining or nest is essentially destroyed, the procedure should not be considered if there is even a remote chance that you may want children.

Not only will the nest or cavity of the uterus be unable to properly receive the embryo, if a pregnancy successfully attaches to the nest/ lining, the pregnancy could be frought  with potentially life-threatening difficulties such as placenta acreta, a condition where the placenta or afterbirth does not separate/detach after a delivery as it should.  This can lead to extreme bleeding and possibly an emergency hysterectomy under some circumstances.

There are numerous types of endometrial ablation methods. A consultation with your doctor to discuss your family planning wishes, while providing you with options for treatment will be a good time to address these concerns.

Originally retrieved from here.

Hysterectomy – The Basics

Here is a great summary of the general information that is helpful when considering a hysterectomy.  Over the next several weeks, I hope to break down this information in even more detail. For example, what are the reasons for a hysterectomy and what are the main risk factors.  Check in during this time to get more information on the topics mentioned here.Image

Hysterectomy

Description

During a hysterectomy, the surgeon may remove the entire uterus or just part of it. The fallopian tubes and ovaries may also be removed.

Types of hysterectomy:

  • Partial (supracervical) hysterectomy: The upper part of the uterus is removed. The cervix is left in place.
  • Total hysterectomy: The entire uterus and cervix are removed.
  • Radical hysterectomy: The uterus, cervix upper part of the vagina, and tissue on both sides of the cervix are removed. This is most often done if you have cancer.

Your doctor will help you decide which type of hysterectomy is best for you. The choice often depends on your medical history and reason for the surgery.

Why the Procedure is Performed

There are many reasons a woman may need a hysterectomy. The procedure may be recommended if you have:

Hysterectomy is a major surgery. It is possible that your condition may be treated without this major surgery. Talk with your doctor or nurse about all your treatment options. Less invasive procedures include:

Risks

Risks of any surgery are:

Risks of a hysterectomy are:

  • Injury to the bladder or ureters
  • Pain during sexual intercourse
  • Early menopause if the ovaries are removed
  • Decreased interest in sex
  • Increased risk of heart disease if the ovaries are removed before menopause

Ask your doctor if taking estrogen can help lower the risk of heart disease and help menopause symptoms.

Before the Procedure

Before deciding to have a hysterectomy, ask your doctor or nurse what to expect after the procedure. Many women who have had a hysterectomy notice changes in their body and in how they feel about themselves. Talk with your doctor, nurse, family, and friends about these possible changes before you have surgery.

Tell your health care team about all the medicines you are taking. These include herbs, supplements, and other medicines you bought without a prescription.

During the days before the surgery:

  • You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), warfarin (Coumadin), and any other drugs like these.
  • Ask your doctor which drugs you should still take on the day of your surgery.
  • If you smoke, try to stop. Ask your doctor or nurse for help quitting.

On the day of your surgery:

  • You will usually be asked not to drink or eat anything for 8 hours before the surgery.
  • Take any medicines your doctor told you to take with a small sip of water.
  • Arrive at the hospital on time.

After the Procedure

After surgery, you will be given pain medicines to relieve any discomfort.

You may also have a tube, called a catheter, inserted into your bladder to pass urine. The catheter will likely be removed before you go home.

You will be asked to get up and move around as soon as possible after surgery. This helps prevent blood clots from forming in your legs and speeds recovery.

You will be asked to get up to use the bathroom as soon as you are able. You may return to a normal diet as soon as you can without causing nausea or vomiting.

How long you stay in the hospital depends on the type of hysterectomy.

  • You can likely go home the next day when surgery is done through the vagina using a laparoscope or after robotic surgery.
  • When a larger surgical cut (incision) in the abdomen is made, you may need to stay in the hospital 1 to 2 days. You may need to stay longer if the hysterectomy is done because of cancer.

Outlook (Prognosis)

How long it takes you to recover depends on the type of hysterectomy. Average recovery times are:

  • Abdominal hysterectomy: 4 to 6 weeks
  • Vaginal hysterectomy: 3 to 4 weeks
  • Robot-assisted or total laparoscopic hysterectomy: 2 to 4 weeks

A hysterectomy will cause menopause if you also have your ovaries removed. Removal of the ovaries can also lead to a decreased sex drive. Your doctor may recommend estrogen replacement therapy. Discuss with your doctor the risks and benefits of this therapy.

If the hysterectomy was done for cancer, you may need further treatment.

Retrieved from: http://www.nlm.nih.gov/medlineplus/ency/article/002915.htm

Under Pressure – Myomectomy

A blog post about someone who had a myomectomy (removal of a fibroid).

Organic girl's Blog

Mid April – (slightly TMI)

It all began with one night after going out with some friends, I had a drink so when I got home I decided to drink a lot of water before I went to bed. Little did I know I would be up all night having to pee. After a sleepless night I asked my mom what she thought it might be, she suspected a UTI, then another friend of mine scared me into going to Urgent Care to make sure it wasn’t in my kidneys. So to Urgent Care, we went to get it checked out, I gave a urine sample and waited. The doctor came in and stated that I did have a UTI (which I later that night found out that I did not have) but wanted to do a CT scan of my abdomen because it was very distended. So distended that…

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Alternatives to Hysterectomy

blog pic 19Hysterectomy is only one option for a number of issues, and usually the ‘last option’ to consider.  Here is a video that discusses some of the issues where a hysterectomy may be considered but it reviews some of your other choices to consider instead of a hysterectomy.  I was considering some of these options but of course, ended up with emergency surgery, so I didn’t have a lot of options at that moment.  That being said, I’m happy that’s how things ended up for me.  When I was faced with all of the alternatives, it was a bit overwhelming.  I felt that there was a ‘best choice’ and somehow I had to figure out which option that was.  When the choice was taken away from me to some extent, it was a bit of a relief.  I was then able to just focus on the next steps in my recovery.  However, for those of you who are exploring your options, hopefully this video will provide you some good information.