Hysterectomy Alternatives

Our office is dedicated to offering alternatives to hysterectomies. We provide comprehensive evaluation for women with abnormal uterine bleeding and/or symptomatic uterine fibroids, which are non-cancerous conditions that traditionally  lead to hysterectomy. Doctor Marcovici will help women with these challenging problems to make informed decisions that better satisfy their lifestyles, through counseling, a complete spectrum of modern treatment options, and education. Initial evaluation will include a complete physical examination in addition to a careful review of past medical history and prior test results. Further diagnostic tests can be performed in the office as necessary and treatment options will be discussed.

The state-of-the-art resources available are:

• Medical therapy: Some women with abnormal uterine bleeding or fibroids may experience an improvement in symptoms from various hormonal treatments or other prescription medications. The mainstay of medical treatment is to treat symptoms like bleeding or cramping.
• Nutritional therapy - In cases where heavy bleeding leads to anemia, dietary iron can be increased by eating iron-rich foods such as green leafy vegetables and red meat. Iron tablets or multivitamins with iron can be used when diet alone is insufficient.
• Non-steroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen). These medications, taken regularly right before and during the period flow, can decrease the total amount of blood loss. They also can treat menstrual cramps very effectively.
• Birth control pills (oral contraceptives) These pills can decrease the amount of flow, regulate the cycles, and treat cramping. If taken continuously they can eliminate the periods. Smokers, over the age of 35, and women who have other contraindications to oral contraceptives cannot take these medications.
• Injectable progesterone (e.g. Depo-Provera). These shots given every three months eliminate cycles in about 60% of patients and can work for women with fibroids. Side effects include weight gain.
• GnRH analogs (e.g. Lupron). Cause a chemical menopause that is reversible. Usually this is used as a temporary measure to shrink fibroids and stop cycles.

Surgical Options:

• Laparoscopic techniques: Fibroids can be removed using narrow telescope-like instruments inserted through the abdomen, leaving the uterus intact.
• Hysteroscopy: Fibroids in the uterine cavity can be removed using a small telescope-like instrument inserted through the vagina into the uterus.
• Endometrial ablation: The uterine lining can be removed using a tube-like medical instrument that incorporates a heated balloon or an electric current.
• Uterine artery embolization: The size of very large fibroid can be reduced by blocking their blood supply through the use of a small catheter inserted into the groin.
• Myomectomy: For women with multiple fibroids who are interested in future childbearing, fibroids can be removed through abdominal surgery, leaving the uterus intact.
• D & C is, means dilation (opening of the cervix, the entrance into the uterine cavity) and curettage (removal of the lining of the uterine cavity). Either local, regional, or general anesthetic is used for pain control for these outpatient procedures. The lining of the uterus and any other tissue which may be in the uterus, is then sent to the lab for testing.

In conclusion: Sometimes hysterectomy is the best choice for certain conditions. But not always! If your doctor recommends hysterectomy, ask about alternatives or seek a second opinion.

If you're interested in learning more about hysterectomy alternatives call 860-409-1930 to schedule an appointment with Dr. Marcovici!!!