Sunday, February, 12, 2012

Uterine Fibroids and Hysterectomy - Complications

Table of Contents

In some cases, laparoscopic surgery may be performed as a diagnostic procedure. Laparoscopy involves inserting a scope into a small incision made near the navel. Whereas hysteroscopy allows the doctor to view inside the uterus, laparoscopy provides a view of the outside of the uterus, including the ovaries, fallopian tubes, and general pelvic area.

Other Tests

In certain cases, the doctor may perform an endometrial biopsy to determine if there are abnormal cells in the lining of the uterus that suggest cancer. Endometrial biopsy can be performed in a doctor's office, with or without anesthesia. Dilation & curettage (D&C) is a more invasive procedure that involves scraping the inside lining of the uterus. It can be used to take tissue samples and also as a procedure to help temporarily reduce heavy menstrual bleeding. [For more information on these procedures, see In-Depth Report #100: Menstrual Disorders.]

The doctor may also order a complete blood count (CBC) to check for signs of anemia.

Ruling out Other Conditions that Cause Heavy Bleeding

Almost all women, at some time in their reproductive life, experience heavy bleeding during menstrual periods.

A number of conditions can cause or contribute to the risk:

  • Menstrual disorders
  • Miscarriage
  • Having late periods or approaching menopause
  • Uterine polyps (small benign growths in the uterus)
  • Intrauterine device (IUD)
Intrauterine device
The intrauterine device (IUD) shown uses copper as the active contraceptive; others use progesterone in a plastic device. IUDs are very effective at preventing pregnancy (less than 2% chance per year for the progesterone IUD, less than 1% chance per year for the copper IUD). IUDs come with an increased risk of ectopic pregnancy and perforation of the uterus, and do not protect against sexually transmitted disease. IUDs are prescribed and placed in the uterus by a health care provider.
  • Bleeding disorders that impair blood clotting, Von Willebrand disease
  • Uterine cancer
  • Pelvic infections
  • Adenomyosis. This condition occurs when glands from the uterine lining become embedded in the uterine muscle. Its symptoms are nearly identical to fibroids (heavy bleeding and pain).
  • A number of medical conditions, including thyroid problems and systemic lupus erythematosus
  • Certain drugs, including anticoagulants and anti-inflammatory medications.
  • Often, the cause of heavy bleeding is unknown.

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Review Date: 07/26/2010
Reviewed By: Reviewed by Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)