Fibroids And Future Pregnancies

Which Fibroids Are The Most Troublesome?

Fibroid tumors are common. Many women develop them late into their 30s and 40s and often do not experience any significant problems. However, depending upon the size and placement of the tumors, a woman may have some very serious repercussions resulting from fibroids. The type that seems to cause the most significant issues is the submucous fibroid which grows into the uterine cavity. Even small tumors that grow into the cavity of the uterus can create heavy or prolonged bleeding which may go on long past the time of the menstrual period, causing anemia and pain. They have also been implicated as a cause of infertility, recurring miscarriage and premature delivery.

There Is A Surgery That Can Help With Infertility

Today there are some very effective ways to deal with fibroids, both medicinally and surgically. When a woman with fibroids wants to ensure her ability to conceive and carry a baby, specific treatments are necessary. Myomectomy, the surgical removal of fibroids, is one way in which a woman can be rid of the problem and still have a healthy pregnancy.

In the hands of an expert, myomectomy can be accomplished safely and with minimal blood loss. If the surgeon is experienced in this type of surgery, the need to convert to an unplanned hysterectomy during the surgery due to uncontrollable bleeding is virtually eliminated. A successful myomectomy should conclude with the symptoms related to fibroids being resolved, the uterus intact, normal and capable of withstanding a pregnancy.

The Use Of Imaging In Surgery

Depending upon where the fibroids are located, different methods of performing the myomectomy are used. The hysteroscopic (telescopic) technique requires the insertion of a telescope into the uterus via the vagina and is used to address submucous fibroids-those found inside the uterus. An abdominal myomectomy is performed through a bikini incision and is used to remove mural fibroids, which grow on the outside wall of the uterus, and subserosal fibroids which are bulging out of the uterus. Laparoscopic surgery, done through the navel, is sometimes used. However, when a woman wants to have a baby, this is not the best method since it is not possible to fully reconstruct the uterus after surgery using this method.

Proper Reconstruction Ensures Safe Pregnancy

The most important part of the myomectomy is the proper and optimal reconstruction of the uterus after the surgery. The repair work to the walls of the uterus is critical to prevent bleeding and/or infection. If the uterus is not repaired well post surgery, the potential for rupture during pregnancy or delivery is high. The use of imaging, such as MRI, x-ray and sonohysterography (ultrasound) are all very useful aids to help the surgeon detect, find and determine the type of operation necessary to remove the fibroids.

Not all surgeries are advisable for a woman who is infertile and is hoping to conceive. Some surgeries will render her infertile completely, so proper consultation with a specialist and careful selection of a surgeon is imperative when it comes to surgically removing fibroid tumors.


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