I. About hysterectomy for uterine fibroids
Many patients will have the question, is surgery necessary for fibroids? In fact, there are various treatment modalities for fibroids. The advantages and disadvantages of various treatment modalities are as follows, and today I will focus on hysterectomy first.
Common treatment modalities for fibroids
1. Hysterectomy: surgical removal of the uterus.
Advantages: the uterus is removed and the fibroids will not recur.
Disadvantages: loss of fertility and possible risk of early menopause. Recovery time is 4-6 weeks.
2. Open myomectomy: surgical dissection to remove one or more fibroids
Advantages: the uterus and cervix are preserved, pregnancy is possible, and a pathological diagnosis can be obtained.
Disadvantages: recovery time is usually 2-4 weeks, and the probability of complications is relatively high.
3. Laparoscopic myomectomy: laparoscopic or endoscopic techniques are used to remove one or more fibroids.
Advantages: less invasive, preserves the uterus and cervix, and allows pregnancy. Pathological diagnosis can be obtained
Disadvantages: not suitable for larger, multiple or deep fibroids. Recovery time is 1-4 weeks. Other complications may occur.
4. Uterine artery embolization / UAE: Polyvinyl alcohol is injected into the uterus into the artery with a catheter to prevent blood flow to the myoma, causing ischemic necrosis.
Advantages: minimally invasive, local anesthesia, short hospital stay of 3-5 days, faster recovery, and low complication rate.
Disadvantages: risks include premature amenorrhea, ectopic embolization, post-embolization treatment syndrome such as high fever and pain for 3-5 days after surgery. Pathological diagnosis cannot be obtained.
5.Magnetic resonance-guided focused ultrasound non-invasive treatment: Using magnetic resonance guidance, ultrasound is focused on the leiomyoma to kill the leiomyoma tissue.
Advantages: No hospitalization or only 1 day hospitalization, can resume normal activities quickly, and very low complication rate. The recovery time is minimal and the uterus and cervix are protected.
Disadvantages: pathological diagnosis cannot be obtained.
6.Hormonal drug treatment: GnRHa and other drug treatments lead to myoma contraction
Advantages: conservative treatment method without surgery
Disadvantages: Treatment is only effective for 6-12 months and may lead to menopause.
C. What is hysterectomy?
Hysterectomy is the surgical removal of the uterus, which also includes the removal of the fallopian tubes, ovaries and cervix. After this procedure, a woman no longer has periods, is no longer able to reproduce, and cannot become pregnant.
The uterus is a characteristic of women and is an important organ in the female genitalia, and in general it is best to opt for a procedure that preserves the uterus. Although hysterectomy is a permanent treatment for fibroids, once the uterus is removed, a woman completely loses the right to become pregnant in her later life.
IV. What are the methods of hysterectomy?
The most common method of hysterectomy is to remove the uterus through an incision in the lower abdomen. Each procedure takes 1-2 hours to perform and requires general anesthesia.
For many women, the potential health effects after hysterectomy and recovery from hysterectomy are very important issues. Be sure to consult your surgeon and choose carefully before making a decision about surgery.
V. What are the sequelae of hysterectomy?
1. Easy to combine with mental depression symptoms
The endocrine regulation of the uterus and ovaries forms a feedback system with the central nervous system. After hysterectomy, this feedback link is destroyed, especially when the estrogen level decreases, it will interfere with the normal secretion and metabolism of central neurotransmitters, which may cause different degrees of anxiety and depression symptoms, such as depressed mood, anxiety, lack of interest, insomnia and dreaminess, memory loss, etc., thus reducing the quality of life of women.
2.Increased urinary system symptoms
The female urinary system is homologous with the reproductive system and is an estrogen-dependent organ. The decrease in estrogen level after removal of the uterus can cause thinning of the elastic tissue around the urethra, urinary incontinence, atrophy of the urethral mucosa, decrease in resistance, and easily induce urinary tract infections and a series of urinary tract irritation symptoms such as urinary frequency, urinary urgency, and urinary pain.
3, female sexual function is reduced
Estrogen is the most important regulating hormone of female sexual function, and the ovary is the main secretory organ. After removal of the uterus, the blood flow and function of the ovary are affected by it, and most women may experience different degrees of sexual function changes, such as decreased sexual desire or lack of it, decreased frequency of sexual activity, decreased sexual responsiveness, difficulty in orgasm and decreased sensation of genital organs.
4.Ovarian hypofunction
The endocrine balance between the uterus and the ovaries before menopause is precise and delicate, and hysterectomy is bound to disrupt this balance, which may lead to the decline of ovarian function and the early appearance of menopausal symptoms.
One of the many reasons for performing hysterectomy is uterine fibroids.
VI. Defending the uterus
The uterus is an important feature of women, the controller and regulator of their vital physiological functions, it is also the source of female energy and the guardian of youthful charm. Once the uterus is removed, women completely lose the right to get pregnant later in life.
The uterus also has complex endocrine functions, secreting prostaglandins, sarcosine, macrophage-stimulating factor, leukemia inhibitory factor, etc. Hysterectomy may lead to the early appearance of perimenopausal syndrome, affecting the lipid metabolism, systemic immune function, cerebral blood perfusion, etc. in female patients, causing significant anxiety and depression, decreased quality of sexual life, and even termination of sexual life.
Therefore, please be cautious before choosing hysterectomy.