Alternatives to Hysterectomy
Our office is dedicated to offering alternatives to hysterectomies
and will provide comprehensive evaluation
for women with abnormal uterine bleeding
and/or symptomatic uterine fibroids, which
are non-cancerous conditions that traditionally
often 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.
Treatment options will be discussed.
The state-of-the-art resources available are:
1. 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.
a. 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 mutivitamins with iron can be used when
diet
alone is insufficient.
b. 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.
c. 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. These medications cannot be taken by smokers
over the
age of 35 and by women who have other contraindications to oral contraceptives.
e. 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.
f. 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:
1. Laparoscopic techniques: Fibroids can be removed using narrow telescope-like
instruments inserted through the abdomen, leaving the uterus intact.
2. Hysteroscopy: Fibroids in the uterine cavity can be removed using
a small
telescope-like instrument inserted through the vagina into the uterus.
3. Endometrial ablation: The uterine lining can be removed using a
tube-like medical instrument that incorporates a heated balloon or an
electric
current.
4. 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.
5. Myomectomy: For women with multiple fibroids who are interested
in future
childbearing, fibroids can be removed through abdominal surgery, leaving
the
uterus intact.
6. 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 interested in learning more call Dr. Marcovici at 860-409-1930 for
an appointment!!!
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