Uterine fibroid dissection: When to have open surgery?

The article was consulted professionally by Master, Dr. Le Nhat Nguyen – Obstetrician and Gynecologist – Share99 DaNang InternationalHealth Hub.

Uterine fibroids are a very common disease in women of child age, especially those with oestrogen intensity, who do not give birth or give birth late. Uterine fibroids are a benign disease, which if detected early will cure very easily. Uterine fibroid surgery is one of the modern treatments to be able to improve the disease quickly, including open surgery.

Uterine fibroids are a benign (non-cancerous) growth mass that develops from the muscle tissue of the uterus, also known as smooth muscle softness or muscle tumors. The size, shape and location of fibroids are varied. They can appear inside, on the outer surface, in the city of the uterus, also when they attach the outside of the uterus to the structure as a trunk. A woman may have only one fibroid or multiple fibroids of different sizes. Fibroid size can be very small for a long time then suddenly increase rapidly or increase slowly for many years.

• Uterine fibroids can be detected at any age but are most common in women aged 30–40 years.
• people. Black women are more likely to have fibroids than women of other racial groups. In addition, black women have fibroids at a younger age, and they are also more likely to have more or greater number of fibroids, more severe symptoms.
• Genetics. If the mother or sister has fibroids, then the sister is at higher risk of developing this disease than other subjects.
• Other factors. Signs of menstruation from an early age; obesity; vitamin D deficiency; have a diet high in red meat and eat less greens, fruits and dairy products; drinking alcohol is likely to increase the risk of developing uterine fibroids.

Many women with fibroids do not have any symptoms. In those who do so, symptoms may be affected by the location, size and number of fibroids.

In women with symptomatic uterine fibroids, the most common signs and symptoms of uterine fibroids include:

• Severe menstrual bleeding
• The menstrual cycle lasts more than a week
• Pelvic or abdominal pain
• Frequent urination
• Difficulty urinating all to empty the bladder
• constipation
• Back pain or leg pain
• Rarely, a fibroid can cause an emergency pain when it exceeds the blood supply and begins to die

Fibroids are usually classified by location:

• Fibroids under the bar
• Fibroids in the muscles of the uterus
• Fibroids under the mucous membranes
• Fibroids can be in the cervical or in extensive ligaments

Although uterine fibroids are usually not dangerous, they can cause discomfort and can lead to complications such as red blood cells (anemia), causing fatigue, severe blood loss.

Fibroids usually do not affect pregnancy. However, it is possible that uterine fibroids – especially lower mucosal fibroids – can cause infertility or miscarriage. Fibroids can also increase the risk of causing a number of pregnancy complications, such as placenta rupture, limiting fetal growth and premature birth.

For uns asym complications only monitor every 3 months. Surgical treatment is considered a thorough treatment, especially in the following cases:

When uterine fibroids are as large as a uterus about 12 weeks pregnant. When there are symptoms of compression of the ureter, causing the kidneys to fluid retention. When there are complications of menopause, hemolysis or prolonged neurotic treatment of internal failure or of fibroids under the mucous membranes. When the tumor is in the wide ligament. When cancer is suspected.

In case surgical treatment is not possible, medical treatment can be applied but only symptomatic treatment, absolutely not atrophy of fibroids.

Mainly progesterone treatment for tumors with complications of menstrual disorders: Menstruation, bleeding that cannot be operated on immediately, indicative to patients who are too young to have children or are having medical conditions that increase the risk of surgery.

When to prescribe open surgery for uterine fibroids?

Currently, the technique of surgery for uterine fibroids by laparoscopy is a popular treatment and is used more by cost savings, patients are less painful, aesthetically high and patients quickly recover faster. Except for cases of large uterine fibroids, there is a possibility of complications such as twisting, rupture of the tumor,… the doctor will proceed to cut the tumor through a large incision in the abdomen. The tumor will be biopsied immediately and if it is benign, the doctor can carry out fibroid dissection.

For this method of surgery, the doctor will make a single long incision in the abdomen, ideally in the bikini line, to access the tumor and process it. Open surgery makes it easy for the surgeon to see the pelvic organs that are difficult to observe in cases where there is a large uterine fibroid or the tumor is in a difficult position to reach. The disadvantages of open surgery are the risk of body anesthesia, blood loss, pain and infection. The recovery time of open surgery is also longer, the patient must be hospitalized for at least 3-4 days and it takes about 4-6 weeks to return to normal activities.

At Share99 General Health Hub, the method of robotic uterine fibroid surgery is considered as the leading method today with uterine fibroids that have been chosen by many patients with advantages such as:

• Visibility is not limited compared to traditional surgical methods and gives images with greater accuracy, more optimal image quality.
• Using a surgical robot will help limit and eliminate unnecessary vibrations because the robot has 4 hands, equivalent to 2 surgeons.
• The robot is capable of operating in difficult positions because it can move freely at 6 angles, threading into the deepest and smallest cavities.
• Robotic surgery is safe and minimizes the risk of complications and surgical infections.
• Compared to the usual method, using a surgical robot will help relieve pain.
• Surgery to dissect uterine fibroids with modern robotic surgery is less blood loss, for quick recovery and reduced hospital stay.
• The aesthetics of this method are higher because the surgical scar is smaller.

Many patients are often worried about how long uterine fibroids are hospitalized. With the advantages of robotic surgery such as less blood loss, less pain but still ensure safety, Share99's Postoperative Recovery (ERAS) program also helps patients quickly recover and reduce hospital stays after surgery. When registering for surgical dissection of uterine fibroids by robotic surgery in combination with Share99's Postoperative Recovery Enhancement (ERAS) program, patients will be cared for 24/24 hours and monitored continuously for at least 2 days after surgery with advanced medical equipment, modern monitoring machines (heart rate monitors, blood pressure, vascular measurements).

In addition, to ensure the earliest recovery and pain relief for patients, a team of anesthesiues, a edithesiious doctor, a nutritionist always accompany the patient. Along with that is a professionally trained nursing team to carry out private care, serving post-surgery surgeries.

Dr. Le Nhat Nguyen more than 20 years of experience in the field of Obstetrics and Gynecology. Dr. Nguyen is a former obstetrician at Gia Dinh People's Health Hub in Ho Chi Minh City. BS has high expertise and strengths in the diagnosis and treatment of obstetric and gynecology diseases such as:

• End of reproduction end of life
• Family planning
• Gynecologic oncology
• Advanced laparoscopic surgery in gynecology

Customers can go directly to Share99 Da Nang for examination or contact hotline 0236 3711 111 for assistance.