Hysterectomy: What Are Your Options?

It’s not uncommon for women to experience heavy bleeding due to fibroids or cysts at various stages in their life, but for older women that are finished having children, gynecologists often recommend hysterectomy. The same holds true for women that are finished having children and may have complications due to cancer, ovarian cysts or tumors.

Endometriosis, fibroids, polyps, and other intrauterine disorders can cause excessive bleeding and pain. Deciding to have a hysterectomy is a big decision for women because once the reproductive organs are removed, hormone replacement therapy is absolutely necessary for overall wellbeing and health.

There are alternative options that many women are unaware exist. Ruben Guzman, M.D., FACOG, OB/GYN with Bayfront Health Medical Group, sheds light on these methods.

“For women that have heavy periods, abnormal uterine bleeding, and irregular bleeding, two procedures that offer an alternative to hysterectomy are Mysosure and Novasure,” says Dr. Guzman. “Novasure is an endometrial ablation procedure that’s done in the office setting and takes approximately two minutes to complete.

“After treatment, there are no more periods; however, this doesn’t affect a woman’s hormone levels. It makes the lining of your uterus unresponsive to growth and shedding. If you want to have more children, this procedure is not for you, as it would make it extremely difficult to get pregnant. Also, this is not a procedure for birth control. 60% to 70% of women have no periods after the ablation while the rest experience much shorter and lighter periods.

“The other alternative method to hysterectomy is Myosure, which treats common causes of abnormal bleeding associated with polyps and fibroids. The Myosure method is noninvasive. Before Myosure, physicians would use an instrument to scrape out the growths and hope they got it all. With Myosure, it’s monitored under ultrasound to precisely and completely remove the polyps or fibroids.”

MYOSURE PROCEDURE
The MyoSure tissue removal procedure removes fibroids, polyps and other intrauterine tissue without having to remove the uterus. Your doctor inserts an instrument into your uterus through the vagina that gently cuts away at the unwanted tissue to take it out of your body. On average, a 3 cm fibroid (about the size of a grape) can be removed in approximately 10 minutes. The MyoSure procedure is designed to allow your doctor to remove any growths in your uterus, while preserving uterine function and form. This is especially important if you want to have children in the future.

The MyoSure procedure is typically an outpatient procedure; you can go home the same day!

How the MyoSure Procedure Works
There are three simple steps to the MyoSure procedure:

STEP 1
Your doctor opens your cervix (the opening to the uterus) slightly by passing through the body’s natural openings (i.e., through the vagina) and inserts a slender cannula with a camera attached through your cervix and into your uterus, allowing him or her to see inside.

STEP 2
Your doctor passes a slender wand through the cannula into your uterus. The side of the wand gently cuts the fibroid or polyp into tiny pieces and suctions the removed tissue through a small open window into the wand and out of your body.

STEP 3
Once the fibroid or polyp has been taken away, the wand is removed from the uterus. Nothing from the MyoSure tissue removal system is left in your body after the procedure.1

NOVASURE PROCEDURE
• QUICK — The actual procedure is done in just fiveminutes or less.
• SIMPLE — There’s no pre-treatment required. And you can have the procedure done any time during your cycle, even if you’re bleeding. It can also be performed right in your doctor’s office.
• SAFE AND EFFECTIVE — Approved by the FDA in 2001 with more than 15 years of clinical experience.

NovaSure endometrial ablation—a one-time, five-minute procedure!
This one-time five-minute procedure is designed to remove just the uterine lining—the endometrium—
which is the part of your body that can cause heavy bleeding. No incisions are required, leaving your uterus intact.

How the NovaSure Procedure Works
Step 1
Your doctor opens your cervix (the opening to your uterus) slightly, inserts a slender wand and extends a triangular-shaped netted device into your uterus.

Step 2
The netting expands, fitting to the size and shape of your uterus.

Step 3
Precisely measured radiofrequency energy is delivered through the netting for no more than 2 minutes.

Step 4
The netted device is pulled back into the wand, and both are removed from your uterus.2

About Dr. Ruben Guzman
Dr. Ruben Guzman is a board-certified obstetrician and gynecologist who offers a wide range of services including medical care through pregnancy and childbirth, as well as well-woman and gynecological care. He is committed to providing care through every stage in life.

Before completing medical school, Dr. Guzman obtained a Bachelor of Science degree in Biology from Wagner College in Staten, New York where he graduated with honors. He received his medical degree from the State University of New York in Buffalo, NY, and completed his residency in Obstetrics and Gynecology at the Maimonides Medical Center in Brooklyn, New York. He then helped develop urogynecologic services, providing care for women with pelvic organ prolapse and urinary incontinence, at St. Luke’s Research Hospital in Manhattan, New York.

Dr. Guzman provides a variety of women’s health care services to include:
• Prenatal care, labor and delivery
• High-risk pregnancies, including those complicated by multiple medical conditions
• Contraceptive counseling and placement of contraceptive devices
• Infertility counseling
• Annual gynecological exams and testing
• Menopausal care, including treating symptoms and hormone replacement therapy
• Urinary incontinence and pelvic organ prolapse
• Abdominal and vaginal hysterectomies
• Robotic-assisted, minimally invasive and laparoscopic procedures
• Endometrial ablation

References:
1. Myosure, “What is Myosure Procedure?”, Hologic 2018, myosure.com
2. Novasure, “What is the Novasure Procedure?”, Hologic 2019, novasure.com