Pelvic and Reproductive Surgery
For some patients and couples, reproductive surgery is an important step in the treatment of infertility. At the UC Center for Reproductive Health, our highly trained physicians use the most innovative technology and surgical techniques to correct anatomical disorders of the uterus, fallopian tubes and ovaries to help restore reproductive function.
Most reproductive surgery is minimally invasive — resulting in no or small incisions — and can be performed through an endoscope on an outpatient basis. An endoscope involves the use of either a laparoscope (a small telescope inserted into the abdominal wall) or a hysteroscope (a small telescope inserted within the uterine cavity) to see inside the patient’s body. Minimally invasive surgery is often associated with decreased pain compared with that of traditional surgery and allows patients to return home the same day.
For some minimally invasive procedures, a robot (Robotic Assisted Laparoscopy) can be used to enhance surgical precision and increase maneuverability of surgical instruments. Robotic surgery also gives physicians a three-dimensional view and superior picture quality, allowing for greater accuracy and precision.
Because each of our patients and couples are unique, not all corrective surgeries can be performed using minimally invasive techniques and the use of robotic technology. Some conditions are more complicated and may require a laparotomy (an incision on the abdomen) and hospitalization for recovery time. Our physicians will consult with you regarding your options and the best method(s) of treatment for your particular case.
A tuboplasty corrects the blockage or scarring of the fallopian tube(s). Fallopian tube blockage can hinder the sperm and egg from reaching one another in order for fertilization to occur. This is often referred to as tubal infertility. Blockage or scarring may occur as a result of a previous pelvic infection, inflammation including endometriosis and previous pelvic surgery.
A tubal reversal is the re-opening or re-connecting of “tied” fallopian tubes from a previous tubal ligation or “having your tubes tied.” A number of factors including the patient’s age and how the tubes were “tied” determines if one is a candidate for this procedure. Unfortunately, not every tubal reversal is successful but the vast majority, as many as 75 percent of couples, achieve pregnancy.
Uterine malformation is the result of abnormal development of the uterus, fallopian tubes, cervix and/or vagina during fetal development. These abnormalities can result in symptoms including no menstrual cycles (amenorrhea), infertility, recurrent pregnancy loss and chronic pelvic pain. Whether surgery is needed depends on the extent of the individual’s problem.
It is estimated that endometriosis occurs in roughly 5 to 10 percent of women. Endometriosis is a condition where tissue that normally lines the uterus develops outside the uterine cavity in abnormal locations such as the ovaries, fallopian tubes and abdominal cavity. Symptoms may depend on the location of the excess tissue development and can cause pelvic pain (often worsening during the menstrual cycle), painful intercourse and infertility. Treatment, such a hormone therapy, surgery or both, may help relieve the pain associated with endometriosis and restore one’s fertility.
Some women who have had previous pelvic surgery, pelvic infections or suffer from endometriosis may have a buildup or excess of scar tissue. Surgical procedures can be preformed to remove scar tissue because scar tissue can restrict the egg from reaching the fallopian tube. With endometriosis, the growth and bleeding cycle of endometrial implants causes irritation, inflammation and a release of toxins that produce scar tissue around the ovary. In this case, the entire ovary or fallopian tube can become encased in scar tissue and in more severe cases can stick to nearby structures such as the bowel.
Approximately 30 to 50 percent of women have fibroid tumors, which are typically benign, non-cancerous growths of muscle in the wall of the uterus. While most fibroid tumors go unnoticed, some can grow during the reproductive years, and depending on their size and location can cause infertility, recurrent miscarriages, excessive uterine bleeding, pain and pressure or severe anemia. Depending on their size and location, fibroid tumors can be removed either hysteroscopically or laparoscopically to restore normal fertility and menstrual function.
Ovarian cysts are fluid filled sacs within the ovary. While most are benign, non-cancerous and resolve on their own, some ovarian cysts cause infertility and pain and may require surgical removal.
Abnormal uterine bleeding is heavy or irregular bleeding between periods that happens for different reasons including polyps, fibroids or cancer. This bleeding can also occur without any apparent cause and is also referred to as Dysfunctional Uterine Bleeding (DUB). Treatments include hormone therapy, hysteroscopy surgery or endometrial ablation. Endometrial ablation is a procedure that destroys (ablates) the uterine lining (endometrium) using radiofrequency, freezing, heated fluid or balloon or electrosurgery.