Uterine fibroids: Uterine fibroids affect almost 20% of the women between the age of 30 to 50 years. Overweight or obese women have higher chances of having fibroids with its sizes ranging from a pea to a lemon. Treatment options are many and can be confusing; but thankfully, with medical tourism in the picture, it is easier for the patients to choose the right procedure for uterine fibroids treatment in India at world-class facilities for one third the cost of same surgery in western countries.The uterine fibroid surgery in India is done with most advanced methods including modern laparoscopic and hysteroscopic techniques. Besides, the cost of laparoscopic/hysteroscopic uterine fibroid surgery in India is very affordable, which makes getting uterine fibroids treatment in India very lucrative for medical tourists.
- Medical Management - GnRH agonists, Progestin, oral contraceptive pills, androgenic agents and anti-estrogens.
- Surgical Management -
- Myomectomy: This procedure is for removal of fibroids but conserves the uterus. There are different techniques of performing myomectomy like Hysteroscopic, laparoscopic and open myomectomy.
- Uterine Artery Embolization/Uterine Fibroid Embolization (UAE/UFE):The blood flow to the uterus and/or fibroid is blocked, leading to necrosis and a gradual shrinkage of the fibroid.
- Hysterectomy: It is one of the options which involves complete or partial removal of uterus and the fibroid. It can be done the conventional way or minimally invasive way.
Varicocele: Varicocele is the enlargement of the veins in the scrotum, the bag where testicles are held. It is very similar to the varicose veins in the legs, which are formed when valves in the veins prevent proper blood flow. The backup causes the veins to dilate and can cause the testicles to shrink in size or even damage the testicles because of poor blood flow, resulting in infertility.Varicocele causes no signs or symptoms (it rarely causes pain) and thus goes unnoticed until you get yourself examined for infertility treatment or get a routine physical check-up. However, if you feel pain or swelling in the scrotum, or find a mass on your scrotum; you should see a doctor immediately. Varicocele can be diagnosed by physical examination or through an ultrasound.
Treatment Option -
- Surgery- Also known as Varicocelectomy, it can be done as open or laparoscopic surgery. Usually done on an outpatient basis under local or general anaesthesia, the urologist will go in through your abdomen or groin and clamp the abnormal veins. Blood can then flow around the abnormal veins to the normal ones.
- Varicocele Embolization- Varicocele embolization is a less invasive procedure. A small catheter is inserted into a groin. A coil is then placed into the catheter and into the varicocele. This blocks blood from getting into the abnormal veins.
Embolization: Embolization refers to the passage of an embolus within the bloodstream. Embolus is defined as any moving mass inside the blood vessel. It can be in any form- solid, liquid or gas. The embolus moves with blood circulation and can block blood capillaries resulting in blockage of blood flow beyond it. Embolization can be pathological, which can be because of any complication of surgery or disease or can be therapeutic, which is for treatment purpose. Embolization can be used to treat bleeding or to treat tumours or few forms of cancer by deliberately blocking the blood vessels.
Treatment Option- Two most popular Embolization treatments are-
- Uterine artery Embolization- Uterine Artery Embolization (UAE) also known as uterine fibroid embolization (UFE) is the minimally invasive surgical procedure for treating fibroids in the uterus.UAE/ UFE is the minimally invasive procedure usually performed under local anaesthesia in a fluoroscopy room by an interventional radiologist. The surgeon begins by making a small incision in skin near the groin to access the femoral artery. The catheter is then inserted in the artery and advanced towards the uterine artery following which contrast fluid containing iodine is injected which flows through the uterine artery and its branches helping to map the fibroids which appear on the fluoroscope monitor.After gaining proper access of the uterine artery that is supplying blood to the fibroids, the surgeon injects small particles into the blood vessels which are made of plastic or gelatine. After several minutes the arteries are blocked and again the arteriogram (injections with contrast material) is done to make sure that blood flow to the fibroids is blocked. Then the same procedure is repeated for the other uterine artery.The procedure usually takes about 1 or 1 and half hour to complete.
- Varicocele embolization- Varicocele Embolization is performed under local anaesthesia during which a small incision or a puncture is made in skin of the groin area. A catheter is then inserted in the underlying vein and advanced towards the testicular vein.The dye is then injected for mapping the area of problem to determine the site that needs to be blocked or embolized. The blood flow to the vein is then blocked using coils or balloons and the blood flow is redirected to other normal pathways. The procedure usually takes 2 hours to complete.
Kidney Stone or Lithotripsy: Lithotripsy is the medical procedure which involves destruction of hardened masses like renal or kidney stones and gall bladder stones. Lithotripsy involves sending shock waves to break kidney stones into tiny pieces which can pass through the urinary track on their own.The kidney stones that are small can pass out through urine but sometimes it is not a possible form of elimination and can cause problems. Some of the causes for performing lithotripsy are:
- The kidney stone is too large to pass out of the system on its own
- The stones are causing persistent pain and bleeding
- The kidney stone is causing obstruction in urine flow
- The kidney stone is causing kidney damage,It may be increasing in size
- The kidney stone may lead to urinary tract infection.
Treatment Option- The treatment for kidney stone depends on the type of kidney stone. There are various treatment strategies, though the most common one is ESWL or Electric Shock Wave Lithotripsy. The options are as follows:
- Lithotripsy- It is done by fragmenting the larger kidney stones with sound waves of high frequency so that they pass out of the body through the urine.
- Percutaneous Nephrolithotomy(PCNL)/ Tunnel Surgery- It is done by making incisions on the back to remove stones that are obstructing, infecting and damaging the kidney as they are too big and causing pain.
- Ureterorenoscopy/ Uretroscopy- It is also called retrograde intra-renal surgery. It is done by removing the kidney stone with an uretero-scope which has a small camera and a device to remove the stone for further analysis.
- Medications-The continuous pain needs to be addressed with pain medication along with antibiotics for infection.