What are uterine fibroids?
How common are they? Who is more at risk and at what point in their lives?
What are the range of symptoms one might suffer?
What are the various treatment options for uterine fibroids?
Uterine fibroids are noncancerous tumors that develop on the smooth muscle of the uterus and often appear during childbearing years.
The condition is fairly common – some 50-70 percent of women have fibroids but many are unaware as they often have no symptoms. In African American women, the prevalence of fibroids is higher. They’ve also been found to occur at a younger age, grow more quickly, and are more likely to cause symptoms. Overweight and obese women are also at higher risk of fibroids than other women.
The symptoms vary, but some women do suffer frequent urination, pelvic pressure, severe discomfort, pain and heavy bleeding, as well as problems during pregnancy. A physician may discover fibroids during a pelvic exam or prenatal ultrasound.
In general, uterine fibroids seldom require treatment. Medical therapy and surgical procedures can shrink or remove fibroids if the patient suffers discomfort or troublesome symptoms. Rarely, fibroids can require emergency treatment if they cause sudden, sharp pelvic pain or profuse menstrual bleeding.
Fibroids are the leading cause for hysterectomy procedures worldwide. An estimated 600,000 hysterectomies are performed in the United States annually with about a third of them performed as treatments for fibroids.
Many alternative treatment options are now available.
Gynecologic specialists at the DMC perform the latest minimally invasive procedures. The approach to care is personalized, based on the patient’s medical needs as well as her social and lifestyle needs.
At the DMC, your fibroid treatment options may include:
- Hysteroscopic Myomectomy — A hysteroscope is a flexible fiber-optic scope that a physician inserts into the uterus through the vagina and cervix. Using this incisionless approach, physicians can use several new techniques to remove fibroids. This is called a myomectomy. Unfortunately, about 30 percent of the time, the fibroids grow back after all types of myomectomy. The following hysterocopic myomectomy techniques are available:
- MyoSure™ Fibroid Removal — This insicionless procedure safely and effectively removes submucosal fibroids. MyoSure is an excellent option for women seeking to reduce heavy bleeding symptoms and preserve uterine form and function. MyoSure is an outpatient procedure and requires no incision. On average, a 3 cm fibroid (about the size of a grape), can be removed in approximately 10 minutes. Some women will experience mild cramping after the procedure. Your doctor may recommend an over-the counter pain reliever if cramping persists. You should be able to resume your normal activity within two days.
- Versapoint™ Electrosurgery — This procedure vaporizes fibroids instead of shaving or cutting them. The Versapoint System makes it easier for the surgeon to remove the fibroid because there are no tissue pieces left in the uterus that must be withdrawn during the procedure. The procedure is performed during an outpatient visit and offers the patient a choice of local instead of general anesthesia. A hospital stay is usually not required and patients usually return to normal activity within a few days.
- Uterine Ablation — Several types of minimally invasive ablation procedure are available and can be very effective in controlling heavy menstrual bleeding from benign causes. By destroying the endometrial lining of the uterus, bleeding can be stopped while leaving the uterus in place. The physician uses a hysteroscope inserted through the vagina to destroy the endometrial lining with extreme heat, extreme cold or a special cutting device.
- Uterine Artery Embolization — Also known as uterine fibroid embolization, this minimally invasive procedure blocks the arteries that supply blood to uterine fibroids. Using a catheter, small particles are injected into the uterine arteries. The particles block the arteries that feed the fibroids and cause the fibroids to shrink.
Minimally Invasive Hysterectomy
When a hysterectomy is medically necessary, DMC specialists can perform a minimally invasive laparoscopic procedure to remove the uterus with just three tiny incisions. This is called a minimally invasive hysterectomy. With a traditional hysterectomy, women have a large incision from the belly button all the way down to the pubic bone. But with minimally invasive laparoscopic procedures, physicians can remove the uterus with a quarter-inch incision at the belly button and two half-inch incisions in the lower abdomen. Compared to open surgery, patients who have laparoscopic surgery generally:
- Spend less time in the hospital
- Have a faster recovery and less internal scarring
- Have less pain
- Have a lower risk of complications.
Several different types of minimally invasive hysterectomy are available, including a procedure called Supracervical Hysterectomy. This highly specialized procedure leaves the cervix intact and may result in better bowel and bladder function and better sexual function compared to a traditional hysterectomy. But supracervical laparoscopic hysterectomy is not an option for every woman. Since the procedure leaves the woman’s cervix intact, it is only offered to women who have no history of cervical cancer or cervical dysplasia.
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