The Vascular and Interventional Centre offers patient-centric and evidence-based uses of medical imaging such as X-rays, magnetic resonance, ultrasound, and other technologies for minimally invasive treatments. Utilizing a multispecialty team of highly skilled doctors and medical professionals, we aim to provide the optimal healthcare outcomes for patients. From detailed prevention methodologies to precise diagnostics, consultation, minimally invasive treatment procedures, and aftercare plans, the team works tirelessly together to orchestrate the most suitable and coherent treatment for patients.
The range of services that we provide includes, but is not limited to, endovascular operations for treating an array of diseases including stroke, orthopedic and oncological embolizations, varicose vein operations, uterine fibroid embolizations, radiofrequency ablations, interventional oncology, and various other procedures. Our multidisciplinary team works closely to select the most suitable, individualized, and patient-centered techniques and technologies to cut down hospitalization periods and enhance patient recovery. We put patient safety and quality service as our priorities by ensuring that a highly trained team operates state-of-the-art equipment. This is to confirm that procedures are carried out with the patients’ safety, comfort, and precision in mind.
Understanding Uterine Fibroids
There are several different locations that fibroids could grow at, and they are classified based on their location. The “subserosal” type of fibroids grow on the outer surface of the uterus and would grow outward, thus not affecting pregnancy, or cause menstrual bleeding and pelvic pain or pressure. The “intramural” type of fibroids grow inside of the uterine wall and are the most common, while the “submucosal” type of fibroids grow inside of the uterine cavity and thus distort the cavity. Lastly, “pedunculated” fibroids are subserosal fibroids that grow on a stalk, and if they grow inside the uterus, they would then be considered interstitial fibroids.
Uterine fibroids are benign (non-cancerous) growths of the uterus, and in Singapore, between 20 to 40% of women are affected by uterine fibroids in their lifetime. While some fibroids may not cause any noticeable symptoms, others can result in heavy and prolonged menstrual bleeding, pelvic pain and pressure, frequent urination, as well as constipation. These symptoms would thus affect women’s lives by causing fatigue and loss of energy. Furthermore, if a woman’s fibroids continue to grow and increase in size, it could lead to a distortion of her pelvis, and this gynecological condition would thus cause a significant distortion in the normal anatomy of the uterus. For uterine cancer Singapore, VIC provides comprehensive care with treatment options and trained medical professionals in Singapore.
Causes and Symptoms
Uterine fibroids, also known as leiomyomas or myomas, are the most common benign tumors of the female genital tract and are the most common indication for perimenopausal women to undergo hysterectomy. Despite their benign nature, they often cause frequent discomfort and complications. In some cases, they can even cause sterility in young women. The incidence of uterine fibroids is highly variable and is influenced by factors such as race, age, family history, and changes in sex steroids in women. Symptoms include menorrhagia, spotting, anemia, dysmenorrhea, prolonged menstrual flow, enlarged uterus, abdominal pressure, difficulty in emptying the bladder, urinary frequency, genital problems (i.e., fibroid expulsion), infertility, recurrent pregnancy loss, subfertility, abnormal uterine bleeding, abdominal distress, and occasionally digestive discomfort, constipation, back pain, and pelvic pain. Vaginal bleeding and anemia are the most common complications, with a symptomatic uterine fibroid being the leading cause of elective hysterectomy.
Traditional vs. Minimally Invasive Treatments for Uterine Fibroids
Uterine fibroids are noncancerous growths in the uterus that can cause symptoms such as heavy menstrual bleeding, pelvic pain, and reproductive issues. There are several treatment options available for patients with fibroid symptoms. Surgical intervention is the traditional management of fibroids and for some patients, hysterectomy or myomectomy may still be the best choice. Both these options offer definitive treatment. A hysterectomy is the most radical option as it involves removal of the uterus. It is, therefore, a very effective treatment but invasive and the significant physiological impact still puts off very young patients. For today’s very young patient antenatal treatment could be a more beneficial option. More conservatively, a myomectomy is preferred as it leaves the uterus intact and means that childbearing is still possible. There are two types of myomectomy available: abdominal myomectomy and hysteroscopic resection. There are no clinical trials that have compared the outcomes of myomectomy with the natural course with conservative treatment, which include the use of hormonal treatments, analgesics and NSAIDs. Care should therefore be taken to individualize the selection of the appropriate surgical procedure, taking into account the patient’s age, the economic, clinical and social circumstances, and her own preference.
Uterine artery embolisation almost always results in the cessation of abnormal vaginal bleeding. The recovery time is far shorter than hysterectomies or myomectomies, which may require an extended period of hospitalization and a long recovery time (two to six weeks). Due to the minimally invasive nature of the technique, the risk of complications associated with surgical procedures, such as anesthesia, hemorrhage, wound infection, and clotting, is lower. The preserved uterine function after uterine artery embolisation may offer psychological benefits, as some patients may feel distressed by their uterus having been removed.
The fibroid embolisation procedure is short, typically taking about 30 to 45 minutes. After the procedure, patients usually stay in the hospital for observation for six to eight hours before being discharged. Most people will be able to be back at work in two to three days. Fibroid embolisation is far less invasive than surgical procedures, which require general anesthesia, a much longer recovery period, and a hospital stay of two to four days. Many women with symptomatic fibroids have been able to conceive and bear children after fibroid embolisation. In many cases, fertility has actually been improved due to the shrinkage of the fibroids after embolisation.
Expertise of Vascular Surgeons
Fibroids Singapore are treated with various medical and surgical options offered by top healthcare providers specializing in women’s health. Vascular surgeons are trained to manage acute vascular injuries, vascular diseases which require or may benefit from intervention, as well as organ-conserving minimally invasive procedures. The management and treatment of a patient with symptomatic uterine fibroids demand the involvement and expertise of a group of gynecologic clinicians and surgeons. In order to provide credible treatment proposals, they must first understand the fundamentals of uterine fibroids and be well-equipped with the knowledge of the currently available treatments.
