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Choosing the Right Treatment for Uterine Fibroids

Choosing the Right Treatment for Uterine Fibroids
Many minimally invasive and non-surgical treatment options are available.

Uterine fibroids are extremely common. About 40 percent of women over 35 have fibroids, although they often don’t know it. In African-American populations, as many as 70 percent of women over 35 have fibroids. While fibroids are almost always non-cancerous, they can cause pain, heavy bleeding, pelvic pressure and problems during pregnancy.

Fibroids were once the leading cause of hysterectomies in the United States, but many alternative treatment options are now available. Gynecologic specialists at the DMC perform the latest minimally invasive and “incisionless” procedures to remove fibroids.

“Every woman is different and there isn’t a single treatment option that will be right for every patient,” said L. Andrea Coleman, M.D., fibroid specialist with DMC Women’s Health Services. “We personalize our approach to care 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it easier for the surgeon to remove the fibroid because there are no tissue pieces left in the uterus that must be withdrawn during the procedure.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.

The bottom line: You have options when it comes to treating fibroids. Make sure your doctor can provide you with the option that is right for you.




Facts about Fibroids
  

  • Fibroids are growths on the smooth muscle of the uterus. They can develop as a single growth or in clusters.
  • Fibroids are almost always benign (non-cancerous), but they can cause significant pain, heavy bleeding, pelvic pressure, problems during pregnancy and frequent urination.
  • About 40 percent of women over 35 have fibroids.
  • About 70 percent of African American women over 35 have fibroids.
  • African-American women are three times more likely to get fibroids than other women. In African-American women, fibroids also seem to occur at a younger age, grow more quickly, and are more likely to cause symptoms.
  • Overweight and obese women are at higher risk of fibroids than other women.
  • Fibroids can be as small as a pea or as large as a pumpkin.
  • Fibroids are the number one cause of hysterectomies in the United States.
  • An estimated 600,000 hysterectomies are performed in the United States annually with about a third of them performed as treatments for fibroids.
  • Researchers are not sure what causes fibroids, but it’s clear that fibroids tend to run in families.
  • Fibroids tend to stop growing or shrink after menopause.

 

 



Andrea Coleman, MD

 

Dr. L. Andrea Coleman is an OB/GYN who specializes in menopause and adolescent gynecology. She is board certified by the American Board of Obstetrics and Gynecology.  Dr. Coleman is a graduate of Meharry Medical College in Nashville, Tennessee.  She completed her residency at Hutzel Hospital here in Detroit, Michigan and is a fellow of the American College of Obstetrics and Gynecology. Currently, Dr. Coleman practices out of  the Northwest Women’s Care located in the professional building on the campus of DMC Sinai-Grace Hospital.

 

 Related DMC Services
DMC Sinai Grace Hospital Women’s Health
DMC Hutzel Women’s Hospital Fibroids 

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