Fibroids are very common. They occur in 2 or 3 out of every 10 women over the age of 35. They occur most often in women between the ages of 30 and 50, although some women in their 20s sometimes have them. Fibroids can cause pain, abnormal bleeding, infertility, and other symptoms such as frequent urination, pressure, abdominal bloating and constipation. Although most women with fibroids can be treated with minimally invasive surgery, some women with a very large uterus or with multiple fibroids may require open surgery. The treatment that is best for any individual woman will depend on a variety of factors that our doctors will discuss with you during an office consultation.
Symptomatic patients may experience heavy bleeding, irregular bleeding, painful periods, as well as pelvic pressure and urinary frequency from an enlarged uterus. Usually premenopausal women are the patients who seek out treatment. This is because when menopause occurs and estrogen production declines, fibroids usually shrink and abnormal bleeding significantly improves.
Fibroid tumors are a common female health problem. They consist of muscular tumors that grow in the wall of the uterus and are almost always benign (not cancerous), with rare cases (less than 1 in 1,000) resulting in cancer. Fibroid tumors can grow as a single tumor, or there can be many of them in the uterus. They can be as small as an apple seed or as big as a grapefruit. About 20 percent to 80 percent of women develop fibroids by the time they reach age 50.
Your doctor may find that you have fibroids during a regular pelvic exam to check your uterus, ovaries, and vagina. The doctor can feel the fibroid with her or his fingers during an ordinary pelvic exam, as a (usually painless) lump or mass on the uterus. To analyze the inside of your abdomen and uterus, your doctor will most likely order an ultrasound, MRI, X-ray or a CT scan.
Most women with fibroids do not have any symptoms. For women who do have symptoms, there are treatments that can help. Talk with your doctor about the best way to treat your fibroids. She or he will consider many things before helping you choose a treatment.
Some factors to consider when choosing a treatment plan:
- Whether or not you are having symptoms from the fibroids
- If you might want to become pregnant in the future
- The size of the fibroids
- The location of the fibroids
- Your age and how close to menopause you might be
If you have fibroids with moderate or severe symptoms, a Myomectomy is a surgery to remove fibroid tumors without taking out the healthy tissue of the uterus. This is best for women who wish to have children after treatment for their fibroids or who wish to keep their uterus for other reasons. However, if your fibroids were embedded deeply in the uterus, you might need a cesarean section to deliver. Myomectomy can be performed in many ways. It can be major surgery (involving cutting into the abdomen) or performed with laparoscopy. The type of surgery that can be done depends on the type, size, and location of the fibroid tumors. After myomectomy new fibroids can grow and cause trouble later. All of the possible risks of surgery are present and depend on how extensive the surgery is. However, it is advantageous to perform surgery in the least invasive way possible while still getting optimal results.
A hysterectomy is the surgical removal of the uterus. Hysterectomy is the second most commonly performed surgery in the United States. The vast majority are performed to treat cervical or ovarian cancer, endometriosis or tumors (fibroids) which may cause excessive and disabling menstrual periods. A hysterectomy can be performed with minimally invasive Laparoscopic procedure. This allows greater precision, smaller incisions, less pain and scarring and a dramatically shorter recovery period.
A hysterectomy involves removal of part or all of the uterus and may involve removal of the ovaries, cervix and fallopian tubes. This results in sterility and menopause, if the ovaries are removed. The surgery usually requires just an overnight hospital stay.
A total hysterectomy removes all of the uterus, including the cervix. The ovaries and the fallopian tubes may or may not be removed. This is the most common type of hysterectomy. A partial hysterectomy removes just the upper part of the uterus.
Uterine Artery Embolization
This procedure is done by an Interventional Radiologist. Uterine artery embolization represents a fundamentally new approach to the treatment of fibroids. Embolization is a minimally invasive procedure that blocks the arteries that supply blood to the fibroids. It is a procedure that uses angiographic techniques (similar to those used in heart catheterization) to place a catheter into the uterine arteries. Small particles are injected into the arteries, which results in their blockage. The blockage of the blood supply cause shrinkage of the fibroids resulting in resolution of their symptoms. This has led to the use of this technique as a stand-alone treatment for symptomatic fibroids.
Women can get treatment for heavy periods with an endometrial ablation procedure. Many women begin to experience heavy and / or irregular bleeding in their 30s and 40s, as they begin to get closer to menopause. Heavy periods can take a physical, social, and emotional toll as well.
Endometrial ablation is an effective treatment for heavy periods. This procedure is an effective way to reduce or stop heavy bleeding for women who have not reached menopause or do not plan to have children. Endometrial ablation is done by removing most, if not all of the lining in the uterus. This is quick outpatient procedure where heat is applied to treat the endometrium. It requires no incisions and is performed at our doctor’s office. You can go home later that day and return to normal activities the next day. This procedure will allow you to get back to living your life!