| Fibroids are the most common non cancerous tumors arising
from the uterus. Also known as myomas, and fibromyomas. Up to
70% of the general population but more common in African American
women (up to 80%), two to five times more common. Average uterus
has six to eight fibroids and fibroids cause symptoms in 20-50%
of women.
Fibroids are extremely common, non-cancerous growths or tumors
and they rise from the muscular walls of the uterus. They
are composed of muscle tissue and can range in size from less
than an inch in length to up to eight inches or more, the
size of a melon. Fibroids start from a small microscopic origin
at the time of puberty and gradually increase in size. They
are fed by the hormones produced by the ovaries and nourished
by the blood flow that irrigates the uterus and the ovaries.
Fibroids are generally benign with less than 1% chance of
malignancy. It is thought that three out of four women in
Los Angeles and across the country have fibroids and one out
of three women has fibroids that require treatment.
If you consider the uterus as a room then fibroids can be
classified by their location in this room (location of the
fibroids are extremely important in the type of problems that
they cause):
Subserosal, like a chimney
Intramural, in the wall
Submucosal, like a wall fixture
Intacavitary, like a chandlier
More that 200,000 hysterectomies are performed each year to
relieve symptoms of fibroids. The majority of these women
can avoid a hysterectomy in our centers. We proudly have the
lowest hysterectomy rates for treatment of fibroid tumors.
Every day we offer women that have been told they need hysterectomy
minimally invasive options to spare their organs.
If you suspect that you have fibroids or have been told that
you have them and would like to explore your options please
call us for a consultation. We look forward to helping you
with your problem.
Diagnosis
Diagnosing and identifying the location of each fibroid is
easily done in our offices. We use simple non-invasive or
minimally invasive techniques such as ultrasonography, hysterosonography
or office hysteroscopy to evaluate the size and location of
these fibroid tumors. Ultrasonography and hysterosonography
utilize sound waves (non x-ray) to obtain a clear image of
the uterus. We use 3-D ultrasound to determine the location
and volume of each fibroid tumor.
Office hysteroscopy allows direct visualization of the endometrial
cavity and sampling of suspicious lesions. Both the physician
and patient can visualize the fibroid tumor on the monitor
as it is being performed.
Fibroids Cause
Heavy or painful periods or irregular bleeding
Pressure and fullness in the lower abdomen
Urinary frequency (enlarged fibroids put pressure on the
bladder)
Pain with sex
Back pain
Difficulty getting pregnant (Fibroids may distort the uterine
lining where the fetus implants and grows)
Constipation of bloating
Treatment
Medication can offer relief from the symptoms of fibroids
and even slow or stop their growth. But, once you stop taking
the medicine, the fibroids often grow back. Lupron, progestational
agents, and birth control pills help alleviate some of the
symptoms of the fibroids. Fibroids symptoms usually return
when medical treatment stops.
Surgical Options Include
Uterine artery
embolization (UAE), a minimally invasive technique, is
accomplished through a small needle opening in the groin.
This procedure works by cutting the blood supply to the fibroids,
blocking their source of nutrition. Subsequently this allows
for the patients body to absorb the fibroid tumors over time.
85% of women report resolution of their symptoms three months
after the procedure. General anesthesia is not required and
it is best performed under local anesthesia with conscious
sedation. It is an outpatient procedure with the usual one
week recovery time.
Myomectomy
removes fibroids and repairs the uterus. Can be done through
and incision in the abdomen, laparoscopically, or hysteroscopically.
18,000 myomectomies are performed every year. Not a cure and
the fibroids may return. 50% of women who had a myomectomy
had evidence by ultrasound of recurrence of their fibroids
within one year.
Hysterectomy
is the only complete cure that involves removing the entire
uterus or the womb.
In our center we offer the full range of diagnostic and treatment
options. Including surgical and non-surgical treatment and
minimally invasive options such as laparoscopic and Hysteroscopic
surgeries and uterine artery embolization. Not all procedures
are ideal for all therefore contact us for a personal evaluation
and treatment plan.
We recognize fibroids as a complicated and debilitating medical
problem in women. Our goal is to offer each patient personalized,
advanced, and least invasive option, without unnecessarily
removing an organ in the treatment of fibroid tumors.
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