What are the Alternatives to Hysterectomy?

Uterine artery embolization, myomectomy, and hormone therapy are alternatives to hysterectomy. A hysterectomy is a womb-removal procedure generally performed to eliminate cancerous tumors, fibroids, and other growths in or outside the uterus. By using alternatives to hysterectomy, women are able to maintain functioning uteruses, experience future pregnancies, and face a lower risk of death and hemorrhaging during tumor removal or fibroid removal. While conception is still possible, cesarean section (C-section) delivery might be advised after the use of these alternatives.

Many women select myomectomy as one of the leading ways to avoid having a hysterectomy. A myomectomy is a surgical procedure during which individual growths or fibroids are excised from the uterus. Three main types of myomectomies exist. During an abdominal myomectomy, a surgery beneficial in removing large and deeply-embedded growths, doctors enter the uterus by cutting into the lower abdomen. Afterward, the uterine walls are stitched to lose any openings.

A laparoscopic myomectomy is used for small and easily accessible growths. Surgeons fill the uterine cavity with gaseous carbon dioxide as a telescope and long cutting tools are used to locate and remove fibroids and tumors. A hysteroscopic myomectomy, solely for growths attached to the outside of the uterus, allows a surgeon to use special shaving instruments and a telescope to shear tumors and fibroids off the outer uterine wall.

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Bloodless myomectomy is a fourth style of myomectomy that is not yet mainstream. For women with very large tumors and fibroids, a bloodless myomectomy is one the safest alternatives to having a hysterectomy. Large growths can bleed so excessively during a regular myomectomy that blood transfusions might be needed and death is a possibility. In a bloodless myomectomy, however, surgeons clamp vessels during tissue removal so that little patient blood is lost and the death risk is minimized.

During embolization, surgeons insert sand-like synthetic particles into specific arteries that supply blood to the uterine tumors or fibroids. By strategically blocking and reducing pelvic area blood flow with the particles, embolization can starve the growths, causing them to die and shrink over several months. The procedure can be completed in roughly 15 to 20 minutes. Cramping and abdominal pain might result in the weeks after embolization.

For women who do not desire invasive surgery, drug and hormone therapy are among the possible alternatives to having a hysterectomy. There is no drug that will completely remove uterine growths. Oral contraceptives and drugs that mimic gonadotropin-releasing hormones (GnRH) can relieve pain and deliver partial shrinking. An intrauterine device (IUD) which delivers the hormone progestin to the uterus may also ease pain and growth of fibroids and tumors. Some women who are wary of hysterectomies sometimes elect to forgo any treatment, deciding to simply monitor the uterine growths with regular medical check-ups.

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