Fibroid
Uterine fibroids are benign (i.e. non-cancerous) growths arising from the muscle of the uterus. Small fibroids of 1-2 cms generally do not cause any symptoms. A fibroid can cause infertility when it is very large i.e. > 5 cms in diameter, it protrudes in the endometrial canal, or it causes a mechanical obstruction of the fallopian tube or the cervical canal. There are no medicines to cause a permanent cure of fibroid. However, GnRH analogues either in the form of daily or monthly injections for 4-6 months or nasal spray are used in the treatment of fibroids. This treatment can be useful to decrease the size of the fibroids before they can be operated upon. The treatment decreases the size of fibroid by 30-60%. Majority of the cases of fibroid need surgical treatment either laparoscopically or by the traditional cut on the abdomen. Fibroids situated in the cavity of the uterus are best operated upon through the Hysteroscopy.
Depending on the skill of the laparoscopic surgeon, Fibroids of all sizes can be operated laparoscopically. A cut is made on the bulge on the uterus where the fibroid is located. The fibroid is separated or dissected out. The defect on the uterus is sutured or closed laparoscopically. The fibroid is then taken out of the abdomen by cutting it into strips with the help of a morcellator. We have operated on fibroids of 12-15 cms at our setup. The pregnancy rates either natural or with treatment improves after a fibroid surgery.
Hysteroscopy is useful to operate on fibroids that protrude into the cavity of uterus. The fibroid is cut into small strips with the help of energy source passed through resectoscope. The energy source could be either a bipolar or monopolar current. Bipolar current is safer. At our centre, we use a bipolar resectoscope for Hysteroscopic resection of the submucous fibroid.
We at Dr Sudha Tandon’s fertility, IVF, Gynec Endoscopy and Maternity center have all world class facilities for laparoscopic and hysteroscopic