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.

Types of Hysterectomy Surgeries

ImageThere are several types of hysterectomy surgeries that can be performed and they all have certain benefits as well as challenges/risks.

Abdominal hysterectomy:  As the name suggests, this surgery involves an incision in your abdomen, often 5-7 inches long.  It may be vertical or horizontal depending on a number of factors.  The recovery time for this type of surgery tends to be the longest out of all of the options.

Vaginal hysterectomy:  The surgeon will make a cut in the vagina and remove your uterus that way.

Laparoscopically-assisted vaginal hysterectomy:  The uterus is still removed through a cut in the vagina but the surgeon will use a laparoscope to assist in this process.  It involves 3-4 small abdominal incisions in order to insert the laparoscope.  The recovery time tends to be shorter with this type of surgery.  This is the procedure I had.

Robotic-assisted hysterectomy:  This is also referred to as the DaVinci method.  It utilizes a small robotic machine that works through small incisions similar to laparoscopic surgery.

There are numerous factors that impact which of these surgeries is best for any given patient including weight, recovery time, and the reason for the hysterectomy.  I will post more about the benefits and challenges of some of these surgeries in a future post.

Types of Hysterectomy

This appears to be one of the most misunderstood aspects of hysterectomy.  I was not clear on this either, before I had a hysterectomy.  I found people would hear about my surgery and then would label it with terms that they were familiar with but did not accurately describe my surgery.  Here are the three types of hysterectomy surgeries as found on the Mayo Clinic Site:Image

Supra-cervical hysterectomy (also referred to as a partial or subtotal hysterectomy): This is the removal of the upper part of the uterus only and leaves the cervix in place (first image pictured above).

Total hysterectomy:  This involves the removal of the uterus and cervix and is the procedure I had (bottom left image).  However, if I told people I had a total hysterectomy they assumed that meant the removal of ‘everything’ which is actually a:

Radical hysterectomy: involve removal of the uterus, cervix, fallopian tubes and ovaries (far right image).  This occurs most often when cancer is present.

To add to the confusion, these are types of hysterectomy based on what is removed.  Types of hysterectomy can also be classified based on the type of surgery performed.  More on that in the next post!

The Exquisite Uterus

ImageUntil approximately two years ago, the word uterus rarely, if ever, made it into my vocabulary.  Starting about two years ago though, with the onset of some  crazy menstrual changes, ‘uterus’ crept into my vocabulary a little more often.  However, since my hysterectomy surgery, I have never uttered that word so often.  Seriously, a conversation now doesn’t seem complete without some discussion of it!  I don’t doubt that as memories of my surgery fade, that this word will once again recede in its useage.  Until then however, I will continue blogging about such topics.

Here is an interesting ‘call for proposals’ on that particular subject, called “The Exquisite Uterus”.  Now, I definitely wasn’t feeling that my uterus deserved such a title prior to it’s recent removal, however, the project wants you to reflect on such a topic and the current state of women’s reproductive health issues, especially in the USA.  I don’t want to get too political on this blog, but as a Canadian I have watched in amazement as women’s rights to make decisions about her reproductive system has deterioted greatly in the last several years, south of the border.  If you haven’t thought about these issues lately, perhaps this project just may urge you to do so!

http://www.creativitylessons.com/call-for-proposals.html

48 Hours Post-Bilateral Salpingo Oophorectomy Recovery

A post-operation update from one of the blogs I follow. I love the photo of the heart-shaped dressings! There are also some good pre- and post-op tips. Enjoy!

BRCA2: In This Together

Aug 2: 1pm Surgery, 3pm Recovery Room, 6pm Home.

FRIDAY

I was calm, relaxed and felt totally confident about being in capable hands. I attribute some of that to the Successful Surgery meditation CD I listened to every night before I went to bed for the past 10 days and the first few mornings in addition before the surgery. Jeff was joking around with the nurses, my oncologist checked in and it was an atmosphere of positive energy.

I left the prep room immediately after they administered my first sleeping cocktail of anesthesia. I was out before we hit the hallway, just a couple of feet! My next memory is waking up in recovery groggy and with some discomfort, mainly from the removal of the catheter and the gas bloating from the air they fill your abdomen to see and separate the organs. My legs felt restless and I couldn’t…

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