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Uterine Fibroids Uterine Fibroids Treatment
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Symptoms of myoma and indications for surgery
Myoma is a benign tumor, and usually 50 of the cases it is asymptomatic, or it does not result in symptoms but in the rest, 50 result in some symptoms which may cause a woman to come to the hospital seeking gynecological solutions for care. So some of the symptoms which are common and for which surgery or treatments are indicated are menhorrhaga or excessive uterine bleeding persistent pelvic pain presence of infertility, even though infertility is related to only 3 of cases of myoma sometimes it might be indicated for.
And other compression symptoms like pressure on the bladder or the rectum or also as are common symptoms or other complications. Not all myomas should be treated All myomas are not to be managed only if they cause symptoms or complications for which a woman comes for gynecological care Generally surgical treatments are indicated for symptomatic myomas asymptomatic myomas should be managed expectantly unless they are very large so the general indications for myomectomy are myomasses abnormal uterine bleeding usually menorhhaga with persistent pelvic pain ZXOS which are associated with infertility and big myomas which are bigger than 14 weeks are also indications for surgery.
Histotripsy, a noninvasive cancer treatment MconneX MichEpedia
What we've done in our laboratory here which we call the histotripsy laboratory is to develop a new surgical modality which is uh. noninvasive and it has real time image guidance in the form of ultrasound. uh. imaging. The modality itself is a knifeless surgical approach which the idea here is to generate some very energetic microbubbles ultrasonically. The generation of these bubbles is called cavitation. And these bubbles oscillate very rapidly and create a lot of mechanical stress on all the tissues and cells around it. And essentially mechanically fractionate these.
Cells, so that at the end of the treatment if you look even under electron microscope microscope you don't see any recognizable tissue fragments. So basically what we do is generate what you might call micro or nano blenders. We can generate these in a very confined, precise volume. That ultrasonic focus acts like essentially a scalpel. The range of application for this technology is anyplace where we want to remove tissue at a tissuefluid interface. We can actually either remove the tissue or drill a very precise hole through the tissue.
One of the applications that we've been developing is to treat newborn infants who don't have a left ventricle. These infants only survive if you can create a flow channel in the septum between the lefthand and uh. right atrium. The way that people do that now is to thread a very small catheter up into the heart and essentially punch a hole in this atrial septum and this is a very dangerous procedure with about fifty percent mortality. And so we've developed an approach where these uh. newborn infants, we actually generator a hole in the atrial septum.
We've done over a hundred dogs, innumerable piglets and so we're now in the development of this technology where we want to take it into the clinic so that the pediatric surgeons can employ it. Another application where we've founded a company called Histosonics is the treatment of uh. enlarged prostate. BPH And in this application we actually go in and homogenize the tissue around the urethra and this homogenized tissue is actually urinated out by the patient. The whole thing is noninvasive. The alternative technology is called TURP where a.
Dr. Savitha Krishnan Hysteroscopic Sterilization
If you finish child bearing and you're sure you want a permanent procedure, these patients I offer hysteroscopic procedures which blocks the Fallopian tubes. This procedure is a procedure where we're putting a small camera into the cavity of the uterus, we visualize both Fallopian tubes, and we block the Fallopian tubes. So it's permanent, and there are no hormones involved. There are no incisions on the abdomen, you can go home within an hour of this office procedure and it takes about 10 min in the office. This method of contraception, if you look at an IUD,.
Which is our most reliable form of contraception that's reversible, A copper IUD is 97 effective. A Mirena IUD, which is a progesterone releasing five year IUD, or intrauterine device, is 98 effective. Now you look at Adiana as well as Essure, which are the permanent methods of birth control or hysteroscopic sterilization, they're both higher than the IUD effectiveness. The reason the Adiana and the Essure procedures is permanent is that the Adiana matrix occludes the Fallopian tube, and the Essure matrix also causes inflammation and causes the Fallopian tube to become blocked.
Unless you have a surgical procedure to reverse this blockage, this is a permanent occlusion of the Fallopian tube. Most of my patients are telling all of their office mates and their friends about this procedure because patients are not very aware of this great option for them that can be offered in the office. So most patients actually come in stating to me that they had wished they had known about this procedure much earlier because they would have proceeded with this as opposed to a hormonal method of contraception.
All patients thank me for actually offering this in the office for them as opposed to the operating room. Because I think the operating room for them generates a lot of apprehension, because we're putting a patient to sleep, it's a different environment. For this procedure the patient's awake the entire time, they're with their familiar gynecologist, they have their spouse in the room with them holding their hand if they want, and everyone is involved in the procedure. So most patients are very very thankful for having this procedure done in the office.
Dr. Savitha Krishnan
My goal for my practice has always been to offer women the least invasive most successful procedures for their symptoms. And with having hysteroscopic sterilization for contraception and having endometerial ablation for heavy menstrual cycles offered in the office, provides this goal for my patients as well as myself. So it gives me a huge satisfaction to see that the quality of life of my patients is so much better with a simple office procedure as opposed to submitting them to general anesthesia in a major procedure in the operating room.
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Patient Webinar NonSurgical Treatment Options For Uterine Fibroids
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