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There is a gentle distance
About every third woman over 30 is affected by it and has fibroids in the uterus. The removal is also gentle with the help of an embolization.
Often without knowing it, because the small plants do not necessarily disturb. However, fibroids can become very large or accumulated and then press adjacent organs. Possible consequences: pain, bleeding, an unpleasant gut feeling, pressure on the bladder. At the latest then a gynecologist should do a closer examination.
Experts complain that too often the entire uterus is taken out in Germany as part of the treatment of fibroids.
Very successful as a therapy proves a gentler procedure that simply starves fibroids and protects the uterus: the embolization .
"In this procedure, we make use of the property that fibroids must be well supplied with blood in order to grow", explains Dr. med. Ingo von Leffern, chief physician of gynecology at Asklepios Klinik Hamburg and expert in the field of uterine fibroids.
"During the operation, we block the vessels that supply the fibroids with blood and oxygen, causing the fibroids to starve, shrink and die." This procedure is minimally invasive, ie without large incisions and under local anesthesia.
"We push a catheter over an artery of the groin to the uterus, " explains Dr. med. from Leffern the procedure. If we reach the right vessel, we inject tiny particles of polyvinyl alcohol or gelatin through the catheter, which cause the blood vessels to close. "This causes the fibroids to shrink by up to half their initial size.
"This process usually lasts up to 3 months, and side effects such as fever are very rare." But not all fibroids can be treated in such a gentle way.
"For ulcers between 10 and 12 cm in size, the limit is reached, " emphasizes von Leffern. "But even if fibroids do not have this size, but the uterus is so enlarged that we can feel it in the pre-examination above the abdomen, we advise against embolization.
"Even fibroids, which are attached to a stalk on the uterus, are not embolized." A trained gynecologist can remove them very easily and scar-free by abdominal or uterine mirroring, "emphasizes von Leffern.
Also excluded from the procedure are all women who may wish to have children. "Even if you have no concerns here in the US or France, we in Germany believe that too few really good studies are available as to whether the treatment could have a negative effect on a possible pregnancy, " von Leffern explains. "We are therefore very careful here."
Even more rare is the myoma treatment with heat. At the Charité in Berlin, a study is currently underway in which fibroids are irradiated with so-called focused ultrasound. This creates extreme heat that "burns" and melts the fibroids. Risk: In the worst case, neighboring organs can be irradiated.
Sometimes, however, a removal of the uterus is inevitable. "If the uterus through the fibroids has grown very much - I have seen cases, as they had twice the size of a football reached - it should be better removed, " says von Leffern. "Because even if the fibroids shrink by half due to embolization, the enlarged uterus will still cause discomfort." The location of the fibroids can also be used for uterine removal (technical term: hysterectomy). "Are these benign tumors very dense in or under the Stored in the lining of the uterus, we advise against embolization and may be in favor of a hysterectomy. " The fibroids so stored would most likely be repelled after embolization, would have to be "taken out bit by bit".
