Treatment options for abnormal uterine bleeding and fibroids

>>Susie As-sanie: My name is Susie
As-Sanie and I’m the Director of the Minimally Invasive Gynecologic Surgery
Program at the University of Michigan. Today I’d like to talk a little bit about
treatment options for abnormal uterine bleeding. Abnormal uterine bleeding is a common condition
that affects many women and it’s very important to see your doctor to determine
the cause of bleeding. Once the cause of bleeding
is identified you can discuss with your physician what treatment options
might be best suited for your particular needs. One of the most common treatment options
for abnormal bleeding is hormonal therapy, which is a very safe and
effective therapy for many women. There are many different methods of using
hormonal therapy and some can be as simple as taking a pill every day, using a patch
once a week, there are various different types of injections, as well as local treatments
within the vagina and or the uterus. If a hormonal treatment option is
not considered appropriate for you, or if that treatment option does
not seem to be working for you, there are many different surgical
options that might be best. There are three surgical approaches to
the treatment of abnormal uterine bleeding and these include endometrial
ablation, myomectomy, which is removal of uterine fibroids, as well
as hysterectomy which is removal of the uterus. Endometrial ablation is a simple
outpatient surgical technique that essentially destroys
the lining of the uterus. There are many different methods of performing
a endometrial ablation and you should talk to your physician about which
method might be best for you. Endometrial ablation can be done in the office or in an outpatient surgical
center with very light anesthesia. Most patients go home the same day and can
go back to work within two to three days. The risks of this procedure are generally
minimal and its best used to treat patients with regular but heavy menstrual bleeding. Some patients might also find that
their uterine cramping associated with their heavy bleeding might
also improve after this procedure. A second surgical approach to abnormal uterine
bleeding is myomectomy which is surgical removal of uterine fibroids when they are
considered the source of abnormal bleeding. There are many different approaches to
myomectomy and this primary depends on the size and location of uterine fibroids. Uterine fibroids can be directly
in the lining of the uterus and these can often be removed vaginally through
a procedure called hysteroscopic myomectomy. If this treatment option is
thought to be appropriate for you, this is an outpatient surgery option in which
the patient can often go home the same day and back to work within two to three days. When uterine fibroids are more deeply
infiltrating into the muscle of the uterus or the surface of the uterus, hysteroscopic
myomectomy may not be an option, but patients might still be a candidate
for a minimally invasive approach through a laparoscopic myomectomy. At the University of Michigan, we perform
many robotic myomectomy’s for the patients with abnormal uterine bleeding and or
infertility related to uterine fibroids. This procedure is an excellent
treatment option for many patients because it is a minimally invasive approach,
in which patients can go home the same day, and usually back to work
within ten to fourteen days. Small incisions are made on the abdomen,
and the uterine fibroids are removed, and the uterus is repaired to
restore its normal anatomy. Again, many patients go home the same day and
are back to work within ten to fourteen days. This option is an excellent option for
women who wish to preserve their fertility as pregnancy can still be a choice
after this surgical approach. The final surgical approach for abnormal
uterine bleeding is hysterectomy. Hysterectomy is a surgical removal
of the uterus and possibly the cervix and does not necessarily mean
that the ovaries will be removed. As long as the ovaries are retained,
a patient would not be in menopause and may continue to produce her own hormones. If a patient chooses to undergo hysterectomy
for the treatment of abnormal uterine bleeding, most women are actually candidates
for a minimally invasive approach. Minimally invasive options
include vaginal hysterectomy, laparoscopic hysterectomy,
and robotic hysterectomy. If a patient undergoes a minimally
invasive approach to hysterectomy, she’s usually in the hospital
for less than twenty four hours and goes home for a four to six week recovery. Many patients can go back to all of their
usual activities within that time period and have minimal pain, minimal
bleeding and a low risk of infection and quick healing after this procedure. In most women undergoing hysterectomy, removal of the ovaries is not
required, nor is it recommended. As long as a woman retains one or
both ovaries, she’s not menopausal, which means that she continues to
ovulate and make her own hormones. What that means is that you would not need
to be on hormonal therapy after this surgery. When choosing a physician for the treatment
of abnormal bleeding, it’s very important that you find a doctor that listens to
you, listens to your specific concerns, and needs and is able to offer you a wide range of treatment options that
are appropriate for you. At the University of Michigan Division of
Minimally Invasive Gynecologic Surgery, we take pride in giving each of our patients
a very specific treatment plan option that focuses on their individual needs. We have expertise in the medical as well
as surgical options for the treatment of abnormal uterine bleeding,
and have particular expertise in minimally invasive surgery options, such
as microscopic myomectomy and hysterectomy, particularly with the use of
the robotic assistive devices. For more information, we encourage you
to visit our website or to call us. We look forward to working with you to find the
best treatment option for your particular needs.

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