Surgical Options For Fibroid Removal

!±8± Surgical Options For Fibroid Removal

The treatment of fibroids depends primarily on the amount of trouble that is caused due to their presence. Many women do not even get to know the presence of fibroids unless they undergo some medical check up.Most women also carry a pregnancy easily though after most surgical options ,it is more difficult to carry a pregnancy.

oIf fibroids are not causing problems and discomfort there is no need for any treatment other than regular medical checkups.

oIf the fibroids cause pain, heavy or lengthy menstrual bleeding, or other pregnancy related problems, a surgery may be required. The two kinds of surgery most commonly performed are hysterectomy and myomectomy.

oIf the fibroids appear just before menopause then medication or simple surgery can be used to shrink them as they shrink naturally during menopause.

There are many treatment options available depending on the particular patients condition and age:

1.Hysterectomy

2.Myomectomy

3.Hysteroscopic resection

4.Embolization

5.Laparoscopic surgery

6.Medication

Hysterectomy

Hysterectomy is a surgical procedure to remove the uterus,usually along with the cervix.This is the most common and permanent cure of fibroids. But a big drawback of this surgery is that a woman cannot ecome pregnant or carry a baby after this surgery. This option is only considered if the fibroids are too large. A hysterectomy is performed by making an incision in the abdomen. Sometimes the ovaries are also removed along with the uterus and cervix. The decision to remove the ovaries depends on how close the woman is to menopause or if the ovaries are diseased.

Vaginal hysterectomy or Laparoscopic vaginal hysterectomy can be performed if fibroids are smaller in size, The uterus can be removed through the vagina instead of the abdomen. The hospital stay for hysterectomy is 2-5 days. The patient fully recovers after 6 week. For six weeks it is advisable to avoid driving,heavy lifting,sexual intercourse and vigorous exercise. Complications after the surgery could be infection,internal bleeding (hemorrhage) needing blood transfusion or injury to other pelvic organs such as the bladder, bowel, or ureters.

Myomectomy

Myomectomy is a method to remove fibroids without removing the uterus. This surgery allows the woman to bear children, but only 50% women can carry a successful pregnancy after a myomectomy. Myomectomy is performed through an incision in the abdomen with the assistance of a laparoscope or
hysteroscope.

Risks after the surgery include:

oHeavy bleeding can occur. A woman is more likely to need a blood transfusion after a myomectomy than after a hysterectomy.

oScarring can occur covering the ovaries or blocking one or both of the fallopian tubes which does not allow the tubes to pick up the eggs after ovulation.

oThe surgery weakens the uterus walls.For delivery of a baby the patient has to go through a cesarean section as labor contraction could tear or rupture the wall.

oInfection

oBlood clots in the legs.

oReoccurrence of fibroids

For removal of small fibroids newer kinds of surgeries are available. The benefits of these options are

oThese options do not require abdominal surgery.

oThey could require an overnight hospital stay but mostly no stay is needed at all.

oThey are cheaper and recovery is quick and less painful.

oThey also show better cosmetic results as barely any stitches are made.

oPatients recover completely within one week or maximum two

Hysteroscopic resection

A thin telescope or hysteroscope is inserted through the cervix. As it allows the surgeon to see inside the uterus, the fibroids can be removed using a laser, electrical knife or wire. It does not require any incision.
The procedure is performed under general or local anesthesia.

Embolization

Under this procedure the fibroids are made to shrink as the blood supply is cut off. Using an X-ray image, a small catheter is threaded through a tiny incision in the groin into the main arteries that supply blood to the uterus. Small particles of plastic are inserted through the catheter to block these blood vessels. Because smaller arteries continue to be connected to the uterus, there is no damage caused. This is all done under local or general anesthesia. The procedure takes an hour.It is necessary to lie flat on the back for 6-7 hours after the surgery to stop the bleeding from the incision. It would take a week to recover completely during which some patients have fever.

Laparoscopic surgery

Under this form of surgery a pencil-thin surgical telescope called laparoscope is inserted through one or more tiny incisions in the abdomen to remove the fibroids.

o Laparoscopic myomectomy is used for small and easy to reach fibroids and an incision in the uterus is made to remove them.

oLaparoscopic myolysis is a procedure used for bigger or difficult to reach fibroids. A laser or electric needle is used to destroy or shrink them.

Medication

1. Certain drugs called Gonadotropin releasing hormone agonists (GnRH agonists) can also be used to treat fibroids.They indirectly block production of estrogen which shrinks the fibroids. Once the size of the
fibroids is reduced to one thirds,it is easier to remove them through vaginal hysterectomy or laparoscopic surgery ,rather than abdominal surgery which is more complicated. It can also be used for women close to menopause as fibroids shrink naturally after menopause. It is available as Lupron (leuprolide),Synarel (nafarelin) and Zoladex (goserelin)

Disadvantages and side effects of these drugs are:-

oIf these drugs are consumed for more than 6 months, it causes bone loss leading to osteoporosis or joint pain.

oOnce the drug consumption stops, the fibroids grow back.

oMost women stop having menstrual periods during the period of drug consumption.

oThis drug has a similar effect as menopause, hence causes all problems that are seen during menopause such as Hot flashes,vaginal dryness ,irregular vaginal bleeding ,mood swings and low sex drive

2.To reduce heavy bleeding due to fibroids, Progestogen or Androgens are also given as synthetic hormones. But they do not shrink the fibroids. Sometimes GnRH agonist is prescribed in combination with a low dose of estrogen or progestogen, which reduces the side effects of GnRH agonists.

Surgical Options For Fibroid Removal

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Folic Acid in the Prevention of Birth Defects

!±8± Folic Acid in the Prevention of Birth Defects

Twenty years of rigorous research shows that adequate consumption of folic acid before and during the first trimester of pregnancy can prevent up to 50% - 70% of neural tube defects (NTDs), a condition that can result in anencephaly and spina bifida. This session of Public Health Grand Rounds reviews global strategies to reduce the burden of NTDs worldwide through mandatory fortification of staple foods with folic acid. Comments on this video are allowed in accordance with our comment policy: www.cdc.gov This video can also be viewed at www.cdc.gov

Folic Acid in the Prevention of Birth Defects

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Omega-3 Supplements Boost Fertility

!±8± Omega-3 Supplements Boost Fertility

Diet and nutrition can contribute to a person's chances of conceiving, and studies show that omega-3 from fish oil pills can boost fertility in both men and women. Omega-3 supplements have been found to regulate hormone levels and create an ideal environment for a healthy pregnancy. Omega-3 fatty acids also have a positive effect on specific problems with male and female infertility.

Omega-3 for Female Fertility

The first condition required for female fertility is a healthy and regular menstrual cycle with minimal cramps and pre-menstrual syndrome. If a woman's menstrual cycle is too irregular, it will be difficult for her to predict her most fertile days and schedule intercourse around it. Women with irregular menstrual cycles are also likely to experience anovulation, a condition where the ovaries fail to release a mature egg. Women who take daily doses of omega-3 fatty acids have observed decreased menstrual clamps, less clots in their menstrual blood, and fewer PMS symptoms like depressions.

Aside from these benefits, research shows that omega-3 fatty acids can treat polycystic ovary syndrome (PCOS), a form of infertility closely related to high insulin levels. Simply reducing insulin levels won't treat PCOS; studies show that an imbalance in eicosanoids also triggers this condition. Clinical studies on women with PCOS show that consuming omega-3 supplement with long-chain EPA increased their chances of getting pregnant and reduced the risk of miscarriage. They also had lower rates of premature births, which can cause a number of developmental problems in childhood.

Even if you don't have PCOS, consuming fish oil supplements is essential for pre-natal care. 60% of the human brain structure is made up of omega-3 fatty acids, and the mother's omega-3 stores are critical for the baby's brain development. The baby's need for long-chain DHA is greatest during the third trimester as this is when neurons and nerve cells are formed at a prodigious rate. Without an adequate supply of omega-3 fatty acids, the baby's brain cannot keep up with the need for DHA, and he or she could be at risk for learning disorders and other developmental problems.

Omega-3 for Male Fertility

Omega-3 essential fatty acids are critical for a healthy prostate gland and sperm production. The anti-inflammatory capabilities of omega-3 fatty acids prevent a condition called prostatitis, or the swelling of the prostate. Daily doses of fish oil lower blood pressure and moderate the amount of blood that travels to the genitals and prostate. This lowers the risk of erectile dysfunction and promotes a healthy prostate. However, male fertility involves more than just healthy sperm production. For an egg to be fertilized, sperm needs to be strong, plentiful, mobile, and healthy.

Omega-3 fatty acids DHA and EPA make up part of the structure of all cell membranes in the body, including sperm cells. Research shows that men with low sperm viability and poor sperm motility have low levels of DHA in their sperm cells when compared to fertile men. Often, low DHA levels in sperm are related to unhealthy eating habits of infertile men. When the body has more cholesterol than omega-3 fatty acids, cholesterol makes up part of the sperm membrane's structure, preventing it from maturing properly. Not only are immature sperm cells unable to penetrate the egg, but they also create free radicals that cause the oxidation of healthier sperm cells. Fortunately, this situation can be reversed with daily consumption of omega-3 supplements.

Omega-3 fatty acids are critical to forming and sustaining life, and every fertility diet should make room for this importance substance. Make fish oil supplements a part of your pre-natal care and fertility plan.

Omega-3 Supplements Boost Fertility

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Medication Schedules For Vitamins and Dieting

!±8± Medication Schedules For Vitamins and Dieting

If you're on medication, you know how important it is to take your medications on time. You probably either have a written schedule, and online service that sends reminders to your phone or e-mail, or a pill case separated into the days of the week. Maybe you don't have to take multiple medications, and if this is the case, you can still use a medication schedule.

If you're dieting, you can use a medication schedule to remind you to take certain dietary supplements or vitamins. Sometimes vitamins like Vitamin C and Iron can upset your stomach if you haven't eaten anything, so it's important to take these and other vitamins with food. If you have a dietary supplement you take, it might be more beneficial to your weight loss and healthy eating to take it at the same time every day.

Perhaps you've recently found out you're pregnant. A medication schedule can help you to remember to take all the important prenatal vitamins essential to make your baby as healthy as possible. Then, if you're prescribed medicine before or after the birth, you can incorporate it into the schedule, and you'll already know how to use the medication schedule.

Maybe you've been recently diagnosed with a disease, such as diabetes. It may not be necessary to take medication right away if you agree to change your lifestyle and diet. If you take certain herbal supplements and vitamins that can help you maintain your sugars, you'll want to take them at times of the day where they will counteract your blood sugar.

Vitamins can also be taken as part of a beauty and skin health regimen. If you have bad skin, you might have a certain regimen for washing your face every morning and evening. You might be taking a hair, skin, and nail supplement to help your skin. Using an online medication schedule can help you organize this information.

A medication schedule can also help you to remember to take your birth control every day. Many people set an alarm on their cell phone to remind them to take their birth control at the same time everyday, however, this will not help you know when it's time to refill your prescription. A medication schedule can send text reminders to your phone and also reminders for when to refill the medicine.

Keeping track of the dietary and vitamin supplements you are taking can also help you to find a schedule that works for you. Perhaps you've tried a new dietary supplement. You can track its progress using your medication schedule. If you haven't lost any weight with the schedule you've made for a couple of weeks, you might choose to take a different supplement.

Medication schedules are important to remember to take the medicine, vitamins, and herbal supplements on a daily basis. Life can be busy and fast paced. If you don't remember to take a medication or your birth control, you might run into some problems in the future.

Medication Schedules For Vitamins and Dieting

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