Gynecologic Surgery

Uterine Conditions & Treatment

When a woman faces a medical condition that affects her uterus, the hollow, muscular organ that holds and feeds a fertilized egg, the emotional impact can often be as challenging as the physical. These conditions include, but are not limited to, cervical and uterine cancers such as endometrial cancer, uterine fibroids, uterine prolapse, excessive bleeding and endometriosis.

Treatment options are as varied as the conditions themselves, depending on individual circumstances. A woman’s age, health history, surgical history and diagnosis (benign or cancerous), all factor into the recommended course of action.

Endometriosis, also known as endometrial hyperplasia, is a condition in which the endometrial tissue grows outside the uterus, causing scarring, pain, and heavy bleeding. It can often damage the fallopian tubes and ovaries in the process. A common organic cause of infertility, endometriosis can be treated with medications such as lupron for endometriosis that lowers hormone levels and decreases endometrial growths. While such medications often relieve associated symptoms, a patient should understand the potential side effects before pursuing this treatment regimen.

For endometrial cancer, also known as uterine cancer and more common among women after menopause, standard treatment options include hormone therapy, radiation therapy, chemotherapy and hysterectomy (surgical removal of the uterus). Three of these — radiation therapy, chemotherapy and hysterectomy — are also used to treat cervical cancer.

For benign (non-cancerous) conditions like menorrhagia (heavy menstrual bleeding), non-surgical treatments like hormone therapy or minimally invasive ablative therapies may offer relief.

Hysterectomy

For most uterine conditions, if available non-surgical treatments fail to relieve symptoms, many women choose a more certain result with elective hysterectomy. Each year in the U.S. alone, doctors perform about 600,000 hysterectomies, making it the second most common surgical procedure.¹

While symptoms such as chronic pain and bleeding often point a woman and her doctor toward hysterectomy as the preferred treatment choice, life-threatening conditions such as cancer or uncontrollable bleeding in the uterus often necessitate a hysterectomy and follow-up treatment.

While hysterectomy is relatively safe, always ask your doctor about all treatment options, as well as their risks and benefits, to determine which approach is right for you. And if hysterectomy is recommended or required, you owe it to yourself to learn about robotic surgery, a robot-assisted, minimally invasive surgery that for many women has potential as the safest and most effective treatment available.

Fibroids & Treatment Options

Uterine fibroids* are benign (non-cancerous) tumors occurring in at least one quarter of all women.² They can grow underneath the uterine lining, inside the uterine wall, or outside the uterus.

Many women don’t feel any symptoms with uterine tumors or fibroids. But for others, these fibroids can cause excessive menstrual bleeding (also called menorrhagia), abnormal periods, uterine bleeding, pain, discomfort, frequent urination and infertility.³

Treatments include uterine fibroid embolization – which shrinks the tumor – and surgery. Surgical treatment for uterine tumors most often involves the surgeon removing the entire uterus, via hysterectomy.⁴

While hysterectomy is a proven way to resolve fibroids, it may not be the best surgical treatment for every woman. If, for example, you hope to later become pregnant, you may want to consider alternatives to hysterectomy like myomectomy – a surgical alternative to hysterectomy – may be an option.

Types of Myomectomy

Each year, roughly 65,000 myomectomies are performed in the U.S.⁵ The conventional approach to myomectomy is open surgery, through a large abdominal incision.⁶ After cutting around and removing each uterine fibroid, the surgeon must carefully repair the uterine wall to minimize potential uterine bleeding, infection and scarring. Proper repair is also critical to reducing the risk of uterine rupture during future pregnancies. Menorrhagia is extensive menstrual bleeding.

While myomectomy is also performed laparoscopically, this approach can be challenging for the surgeon, and may compromise results compared to open surgery.⁷ Laparoscopic myomectomies often take longer than open abdominal myomectomies, and up to 28% are converted during surgery to an open abdominal incision.⁸

A new category of minimally invasive myomectomy, robot-assisted myomectomy, combines the best of open and laparoscopic surgery. With the assistance of the robot – the latest evolution in robotics technology – the surgeon may remove uterine fibroids through small incisions with unmatched precision and control.

Learn more

If you would like to explore whether you are a candidate for myomectomy, ask your doctor.