Importance of alternatives to Hysterectomy

In a pregnant woman, the uterus or womb hosts the growing baby. A hysterectomy is a surgical procedure to remove the uterus. It is a safe procedure. It is performed to treat various pelvic conditions such as:

  • Chronic pelvic pain 

  • Uncontrollable vaginal bleeding

  • Cancer of the uterus, cervix (or ovaries)

  • Fibroids (benign tumours that grow in the uterus)

  • Pelvic inflammatory disease (serious infection of the reproductive organs)

  • Uterine prolapse (a condition in which the uterus slips from its place through the cervix and protrudes out of the vagina)

  • Endometriosis (where the inner lining of the uterus grows outside of the uterine cavity, resulting in pain and bleeding)

  • Adenomyosis (where the inner lining of the uterus grows into the uterine muscles). 

Uterus removal treatment in Delhi is the most effective treatment for women who have completed their family and for uterine or cervical cancer. But it may not be the best option at all times. For instance:

  • For those women, wanting to maintain their fertility - For such women, many conditions are treated by alternate methods instead of going for a hysterectomy. For instance, endometriosis can be treated with hormone therapy, fibroids are treated with other types of uterus sparing surgeries. 

  • In the case of heavy menstrual bleeding - There are a lot of uterine conditions that result in heavy menstrual bleeding. Nearly 30% of all hysterectomies that are performed are done to alleviate the heavy menstrual bleeding. Earlier, the surgical removal of the uterus was considered to be the best option at all times for the management of the condition. Fortunately, modern gynaecology aims at the preservation of the uterus. Nowadays, with advancements in the field, both hormonal and non-hormonal medications are available to treat various conditions related to the uterus. In the present day, the progesterone or progestogen-releasing intrauterine systems (which were initially used as contraceptives) are widely used for treating many uterine conditions and for the reduction in menstrual blood loss.

  • Any other condition/complication where surgery is not recommended, such as breast cancer or liver disease. 

Mirena: A safe alternative to hysterectomy:

An important alternate therapy to the traditional hysterectomy is the usage of Mirena. Mirena is a hormone-releasing intrauterine device (IUD) that provides long-term birth control or contraception. It is a T-shaped device with a plastic (polyethene) frame. It has a steroid reservoir made of a mixture of levonorgestrel and silicone.  

Contraceptive benefits: Mirena prevents pregnancy for 5 years after insertion. These contraception benefits are seen because:

  • It thickens cervical mucus to prevent sperm from reaching or fertilizing with an egg

  • It thins the uterine lining resulting in partial suppression of ovulation.

 The other benefits that Mirena provides are:

  • Eliminating the need to interrupt sex for contraception

  • Does not require the participation of a partner

  • It remains in place for 5 years

  • Removal is possible at any time

  • Quick return to normal fertility

  • Can be used while breast-feeding 

  • No risky side effects like other birth control methods containing estrogen

Non-Contraceptive benefits: 

It is important to note that, apart from the above contraceptive benefits, Mirena is also prescribed for non-contraceptive benefits. It is due to these benefits that sometimes, it is possible to replace or prevent a surgery like a hysterectomy by opting for Mirena. These include:

  • Heavy menstrual bleeding

  • Cramping or pain associated with periods

  • Endometriosis

  • Abnormal growth of the uterine lining or endometrial hyperplasia

  • Adenomyosis

  • Anaemia

  • Fibroids

  • Decreasing the risk of pelvic infection

The procedure of insertion and removal of Mirena:

Mirena is inserted into the vagina by a physician. After sanitizing the vagina and cervix, a special instrument is used to align the cervical canal and uterine cavity and also to measure the depth of the uterine cavity. The horizontal arms are folded and the device is placed inside an applicator tube. The tube is further inserted into the cervical canal and placed in the uterus. The applicator tube is removed.

Mirena is usually left in place for up to 5 years. We have best doctors for uterus removal in Delhi who are experienced in removing Mirena with the help of forceps. The strings of the device are grasped and gently pulled to withdraw from the uterus. Light bleeding and cramping may occur during removal.

Mirena is contraindicated in:

  • Breast/Uterine/cervical cancer

  • Liver disease

  • Fibroids which can interfere with placement or retention of the device

  • Pelvic infection or current pelvic inflammatory disease

  • Unexplained vaginal bleeding

Side effects associated with Mirena include:

  • Headache

  • Acne

  • Breast tenderness

  • Irregular bleeding

  • Cramping or pelvic pain

Hormone releasing devices such as Mirena are widely used by women nowadays to reap the contraceptive and non-contraceptive benefits it offers. Many times, in certain health conditions or when it is necessary to avoid surgery, such non-surgical procedures can prove to be a blessing. To know hysterectomy cost in Delhi and uterus removal cost in Delhi consult the best obstetrics and gynaecology hospital in Delhi.

 

FAQs:

  1. How does Mirena work? 

Mirena is believed to thicken the cervical mucus to stop the sperm from reaching an egg. It also thins the uterine lining, inhibiting ovulation. 

  1. Can tampons be used with Mirena?

Yes. Tampons can be used with Mirena.

  1. What are the different side effects of using Mirena? 

The side effects of Mirena usage are:

  • Pelvic inflammatory disease due to infections

  • Life-threatening infection

  • Mirena can adhere to the wall of the uterus (Embedment)

  • Perforation

  1. Can Mirena offer protection against sexually transmitted diseases?

No, Mirena is a hormonal IUD and offers no protection against sexually transmitted diseases.

 

 

Dr. Yashica Gudesar

HOD And Consultant - Obstetrics & Gynaecology

Manipal Hospitals, Dwarka, Delhi

 

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