FOR HEAVY MENSTURATION-BLEEDING, OPTIONS OF REMOVAL OF UTERU-HYSTRCTOMY

FOR HEAVY MENSTURATION BLEEDING

OPTIONS OF REMOVAL OF UTERUS- HYSTRECTOMY

DR. TUSHAR N. SHAH

MD DGO

 Normally, the menstruation cycle is of 28-30 days and bleeding for 3-4 days and total loss of blood should be 50-60 ml.in a normal menstruation.

But any women have complaint of

• M.C./period 2-3 times in a month
• Bleeding remains more than 3-5 days
• 10-12 sanitary pads ore more than one pad in night, to be used during period
• Women feels tiredness or passing clots

 Are considering as “heavy period “which resulting in

• Weakness
• Pallor
• Leg cramps
• Breathlessness on exertion
• Decrease immunity

There are many causes for excessive menstruation bleeding like

• Idiopathic means unknown cause
• Fibroid/s
•  Adenomyosis
• Sometime due to Cu”T”
• Polyp, hyper endometriosis growth, endometrial cancer
• Infection, CLD Thyroid etc.

Available treatment Options:

MEDICAL:

• haemostatic drugs
• hormones
• anti-prostaglandin
• antifibrinolyticthese medicines can be use for 3-4 months but again, there will be excessive bleeding then advise for other options like

SURGICAL :

• D&C
• Removal of uterus- AH, VH, LVH

There are other options like ENDOMTIUM ABLATION

 In which inner wall of uterus is ablated through

1.Thermal balloon

2.Hysteroscopic ablation

In thermal balloon therapy

   A special designed balloon catheter is inserted inside of uterus and under control of of computer, hot water is passed through balloon and endometrium ablation is completed through thermos balloon. In this method

1. No cut/ incision on body
2. Procedure of only 30-4- minutes
3. No need of anaesthesia all the times
4. Patient can be discharge same day
5. Patient who is suffering from diabetes, hypertension, hear problem etc and where surgical risk is high, it is very useful and more safe
6. Through the collection of specimens of endometrium during procedure, we can send it for HPE to rule out cancer
7. Less expensive than the surgery

HYSTROSCOPIC ENDOMETRUM ABLATION:

In this method, through the cervix, hysteroscope ablation can be performed with a special instrument without any surgical incisor.

In modern days through mixing of above both methods, patient can get benefit95-98% and patient can be discharge same day.

MIRENA: This is novel hormone pre-loaded CuT, can be inserted in uterus as an OPD procedure and up to five years, it can work on local area and it also works as a contraceptive and after removing it one can get pregnant. It is the best during child bearing age and who wants child in future.

UTERINE ARTERY EMBOLISM:In which with a special technique the blood supply of the uterus can be stopped.