Surgical removal of submucosal fibroids

30 Jul Surgical removal of submucosal fibroids

Fibroids are the commonest benign (non-cancerous) tumours of the uterus (womb), affecting up to half of all women. They are mostly incidental and do not cause symptoms unless they are large, leading to heavy periods, pressure and reduced fertility. The types of fibroids are classified according to their location within the uterus. The location and size of a fibroid affects how likely it will lead to symptoms and how it is treated.

What is submucosal fibroid?

Submucosal fibroids arise close to the internal lining of the uterus (endometrium), often causing an indentation of the cavity of the uterus. The endometrial lining and cavity is where menstrual bleeding occurs. It is also where an embryo attaches itself to in conception. A submucosal fibroid affecting the endometrial lining and cavity is, therefore, much more likely to lead to heavy periods and reduced fertility. The more indentation of the cavity, the more symptomatic the fibroid becomes.

How is a submucosal fibroid treated?

A submucosal fibroid a type of fibroid that is more readily removed surgically through hysteroscopy. Hysteroscopy is a procedure where a thin telescope (hysteroscope) is passed through the cervix from the vagina and into the uterus. It is fitted with a light source and video camera to allow the surgeon to examine the internal lining of the uterus through a video monitor. Photographs may be taken. This is a minimally invasive procedure with no abdominal incisions. The submucosal fibroid can then be resected (cut and removed) under vision at the same time. The majority of submucosal fibroids can be resected in a single procedure. A repeat (staged) procedure may be required if the fibroid is large. It is important to completely remove the fibroid to improve symptoms and reduce the chance of recurrence. Hysteroscopy is usually done under general anaesthetic in a hospital as a day procedure.

Who should be performing my hysteroscopy?

A specialist gynaecologist with extensive training and experience in the surgical management of fibroids is the best person to perform this procedure. For those searching for the specialist most likely to offer them a successful treatment plan, navigating the large number of practicing gynaecologists can be overwhelming and confusing.

A gynaecologist in Australia is any specialist who received their qualification from The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Some gynaecologists are true subspecialists in gynaecology. That is, they do not practice obstetrics and solely practice gynaecology. As such, they have a high volume of experience in treating particular gynaecology conditions – such as endometriosis, fibroids, heavy periods and ovarian cysts. Some have further subspecialised in fertility treatment, cancer treatment, and treatment of urinary symptoms in women.

Other gynaecologists are first and foremost obstetricians, experts in looking after women throughout pregnancy and childbirth. Gynaecology may not form a large part of their practice. While many are competent in managing gynaecological conditions in the office, not all are up to date with latest advancements in medical and in particular, surgical treatments – including advancements in minimally invasive surgery such as complex hysteroscopic, laparoscopic and robotic surgery.

While all surgery carries associated risks, it is recognised that gynaecologists performing high volume surgery have been shown to have lower complication rates. With this in mind, do not hesitate to ask your gynaecologist how much of their work is gynaecology rather than obstetrics, what areas of gynaecology form their main bulk and focus of work, how frequently they perform a particular type of surgery, and what type of complications have they previously encountered.

Is Dr Kuswanto the right gynaecologist for you?

Dr Kent Kuswanto is a gynaecologist specialising in complex gynaecological pelvic surgery and minimally invasive gynaecology surgery. This includes hysteroscopic, laparoscopic and robotic surgery. Kent does not practice obstetrics (pregnancy and childbirth) any longer in order to focus his entire practice solely on minimally invasive gynaecology surgery. Kent has extensive experience in treating women with a full range of gynaecological problems including abnormal heavy or irregular periods, ovarian cysts, fibroids, uterine polyps, endometriosis and adenomyosis.