Uterine fibroids are growths that occur in the walls of the uterus. Pedunculated fibroids are connected to the walls of the uterus via a thin stalk of tissue. These fibroids can become twisted, leading to severe pain and heavy bleeding. There are a number of different surgical treatments that can be used to treat this condition.
Uterine Fibroid Embolization
One way in which pedunculated fibroids can be treated is via a process known as uterine artery embolization. This treatment, RadiologyInfo explains, utilizes a fluoroscope, a special kind of camera that provides medical imaging with the assistance of x-rays. The fluoroscope is used to guide the injection of small particles into the arteries, which supply the fibroid's blood supply. These particles then form small clots, known as emboli, which then block off the arteries. These emboli may be made up of polyvinyl alcohol, which is a type of plastic that is similar to sand, gelatin sponge molecules, or small particles called microspheres. This disrupts blood flow to the fibroid, causing it to shrivel and shrink. This procedure is effective for women who do not want to become pregnant, because its effects on fertility are not known.
Myomectomy
Myomectomy is surgical procedure that can also be done to treat pedunculated fibroids, the Mayo Clinic notes. With this procedure, the fibroid is surgically removed from the uterus. The surgeon then attempts to repair the tissue around the surgical site to help the uterus heal. In many cases, this kind of procedure keeps the uterus functional, which allows the patient to remain fertile. Because large fibroids can impair fertility, patients who have a myomectomy may find that their chances of having a baby increase after the procedure. Sometimes patients who have pedunculated fibroids removed in this manner experience a recurrence of the fibroids, which may require additional surgery.
Hysterectomy
A hysterectomy is the only treatment for a pedunculated fibroid that is guaranteed to correct the problems. This procedure, Healthsquare explains, involves the total removal of the uterus, which eliminates the possibility of having future fibroids, but also prevents the woman from becoming pregnant. Patients who have pedunculated fibroids that are causing a lot of bleeding, or who have experienced multiple recurrences of the fibroids, may need to have a hysterectomy. This procedure may also be necessary if, after a myomectomy, the surgeon is unable to stitch the uterus back together.
