About 33 percent of women have a hysterectomy by the time they are 60. During this operation, all or part of the uterus is removed. Although hysterectomies are common, many women are unaware what the procedure implies. With a standard hysterectomy, the ovaries are preserved – only the uterus is removed. More in this blog from Dr. Natalya Danilyants: Your Hysterectomy Surgery: What About The Ovaries?
Understanding the Uterus and Ovaries
In the female body, the uterus allows the safe and healthy growth of a fetus. However, only the ovaries are involved in the production of eggs and hormones. This means a hysterectomy surgery does not typically impair hormonal health of otherwise-healthy women.
Fibroids can cause long, uncomfortable periods with painful cramps and very heavy bleeding. Some women suffer for years before they get diagnosed and start looking for treatment.
What Are Fibroids?
Fibroids are noncancerous tumors that originate in the muscle of the uterus. Family history, obesity, and early onset of puberty can all make the condition more likely. 80% of all women have fibroids in their womb.
The Benefits Of Minimally Invasive Fibroid Surgery
Sometimes, fibroids can appear without presenting any symptoms. By the time a diagnosis is made, they may have grown, multiplied, and worsened significantly. In the past, women often left fibroids untreated because of the risks involved in fibroid removal surgery. With today’s advancements, women have better options for minimally invasive fibroid removal.
Both these procedures offer significant benefits to the patient:
Women recover faster, with less pain.
Both procedures are outpatient, and patients get to recover in the comfort of their home.
The 2 small incisions are cosmetically appealing and are barely visible once they heal.
Schedule An Evaluation
The sooner you get treatment for fibroids, the more likely you are to make a complete recovery with minimal complications. To get help from experts, call 888 –SURGERY or book a consultation online at the Center for Innovative GYN Care – the recognized provider of life-changing minimally invasive surgery.
Adenomyosis can be difficult to detect. It’s a complex GYN condition and symptoms are often debilitating. Pain can be severe and menstrual bleeding is heavy for some women. It is however one of the conditions that can be difficult to diagnose as it is not well understood by many physicians.
An MRI can often detect adenomyosis. An ultrasound can also be used, but it is less sensitive than an MRI. If the adenomyosis is small and diffuse, it may not appear on any imaging, and can only be diagnosed during surgery. As this is a disease of the uterus, the only definitive cure is hysterectomy.
Women often suffer through the pain thinking it’s normal, which creates barriers to treatment. It’s important to speak with a specialist about these symptoms as they can be relieved.
SYMPTOMS & TREATMENT
Heavy menstrual bleeding from adenomyosis is not only disruptive, it is dangerous as it can cause anemia. The dangers of anemia include life-threatening complications such as congestive heart failure, arrhythmia, and/or heart attack. You can learn more about the risks here.
Adenomyosis is contained within the uterus and the only definitive treatment is hysterectomy. Women who want to preserve fertility can temporarily manage adenomyosis symptoms with medication. Most of the time however these are not very effective, especially when the adenomyosis is extensive.
When it comes to lesser known GYN conditions like adenomyosis, women should seek a specialist for optimal care. A minimally invasive hysterectomy should be performed by a skilled laparoscopic surgeon who is fellowship trained on advanced techniques to prevent damage to the delicate structures in the pelvic cavity. Standard laparoscopic or robotic hysterectomies have a higher risk of damage to ureters, bowel and blood vessels.
SEE A SPECIALIST
To schedule an evaluation with a CIGC specialist, call 888-SURGERY or reach out online. Women travel from around the country and around the world for CIGC’s innovative procedures: learn about our travel program.
Menopause symptoms can be incredibly disruptive and many women are reluctant to undergo a hysterectomy out of fear of menopause. It’s important that women know: menopause symptoms can be managed. A recent study demonstrates estrogen therapy can be safely used post-hysterectomy, as long as it is not combined with progesterone.
Estrogen-only therapy can be safely prescribed to women who’ve had a hysterectomy as it shows no overall increase in breast cancer risk compared with women who had never used HRT. Women using a combination of estrogen and progestogen therapy, had a 2.7 times greater risk than non-users, significantly higher than previously reported.
To schedule an appointment with a CIGC physician Dr. Paul MacKoul MD or Dr. Natalya Danilyants MD and discuss minimally invasive treatment for complex GYN conditions, call 888-SURGERY or contact us online. At The Center for Innovative GYN Care, hysterectomy surgery is performed using the DualPortGYN technique, with two 5 MM incisions and recovery in 7-10 days.
CIGC surgeons developed a safer approach to laparoscopic myomectomy with an advanced surgical technique called LAAM. This innovative approach makes it possible for all women to be candidates for minimally invasive GYN surgery with only 2 small incisions, regardless of the size, location or number of fibroids. Women suffering with fibroids, who no longer wish to preserve fertility, or whose fibroids have created extensive distortion to the uterus, are better candidates for a DualPortGYN hysterectomy.
Uterine fibroid embolization (UFE) is a non-invasive method to treat fibroids that many women consider. It is a procedure performed by radiologists who insert a small catheter into the large vessel in the groin, and then they find and block with plastic particles the vessels that feed the fibroids. Women who want to become pregnant should know: UFE has limitations and may have long-term effects on fertility.
UFE is a good approach to control bleeding, but in younger patients the long-term control of fibroids is very limited. Additional fibroids can grow or the fibroid that was embolized can reestablish blood supply. We highly recommend to women who are told they can get embolized and still want babies, to reconsider the approach because it can affect implantation of the embryo into the lining of the uterus, where the baby grows. With fibroid treatment, it’s important to preserve the blood supply and it’s also important to preserve the lining of the uterus.
According to UpToDate®, the premier evidence-based clinical decision support resource, there is an adverse effect on women who have become pregnant after having UFE: “A systematic review and several case series of pregnancies following UFE or UAE have reported adverse outcomes including miscarriage, preterm delivery, placental problems, and malpresentation.”
Safe fibroid removal, that does not affect fertility, can be achieved with laparoscopic myomectomy using the LAAM technique. This approach was developed by CIGC surgeons Paul MacKoul MD and Natalya Danilyants MD and it takes the best elements of both laparoscopic and open approaches for myomectomy. It is safer than open or robotic procedures, and more effective than UFE at preserving the uterus for fertility. With 2 small incisions, one 5MM incision at the belly button and a 1.5 inch incision at the bikini line, fibroids of any size, number or location can be removed.
If you would like to get a GYN evaluation for your fibroid symptoms, call 888-SURGERY or contact us online. CIGC has offices in Bethesda, MD, Annapolis, MD and Reston, VA. Patients who reside outside the Washington DC area travel to CIGC through our travel program.
When it comes to fibroids, the struggle is real. Symptoms like pain and bleeding can be severe, they can result in tiredness and anemia from blood loss, and can disrupt your whole life. Many are embarrassed to speak up, only to discover when they finally do that other women experience similar symptoms, and struggle to find relief.
LETTING FIBROIDS GROW IS DANGEROUS
Bethenny Frankel of The Real Housewives of New York City recently opened up about her GYN health and how fibroids have affected her life. When she was initially diagnosed a few years back she was told fibroids are common and surgery was not necessary. Years later she got to the point where she had experienced a miscarriage and was suffering from iron deficiency due to very heavy GYN bleeding. It’s important to know fibroids tend to grow and even small fibroids can become very large and can cause severe symptoms. The earlier symptoms are addressed, the less invasive surgery is, and if fertility is desired, the uterus can be better preserved.
Anemia from heavy GYN bleeding due to uterine fibroids can lead to potentially life-threatening complications like congestive heart failure, arrhythmia, and/or heart attack. More on the dangers of anemia here. Large fibroids can also damage other delicate structures in the pelvis, they can affect kidneys and impact circulation. More about the lesser known risks of fibroids here.
FIBROID TREATMENT WITH MINIMALLY INVASIVE APPROACH
When surgical treatment is indicated, fibroids can be removed through hysterectomy, which is definitive treatment as they will not grow back, or myomectomy, which is fibroid removal surgery with preservation of the uterus, for women who still wish to conceive. Fibroids will grow back after a myomectomy and additional surgery may be necessary. Thorough and safe removal is very important with a myomectomy as the uterus needs to be repaired correctly so it can hold a growing baby. Even small fibroids should be removed to allow for a successful pregnancy and longer relief without the need for additional surgery.
Either fibroid removal procedure can be performed with safe, minimally invasive approach to allow the patient to get back to her routine within days rather than weeks. With the advancement of laparoscopic techniques, open GYN surgery, with up to 2 months recovery time, is no longer necessary.
When Bethenny shared her journey dealing with fibroids on ABC’s Good Morning America, she spoke about her inpatient open myomectomy with 3 days in the hospital and a long post-operative recovery of 6 weeks. Women should know, open myomectomy is no longer necessary. Fibroid removal, with preservation of the uterus, can be performed with laparoscopic approach, leading to a much faster recovery. With the LAAM (Laparoscopic Assisted Abdominal Myomectomy) procedure, fibroids of any size and number are removed with 2 small incisions, and recovery is 10-14 days. This is also an inpatient procedure, which due to the minimally invasive technique, does not require any hospital stay.
SURGERY WITH AN OB/GYN VS A GYN SPECIALIST
A woman’s relationship with her OB/GYN is very important. The OB/GYN is an obstetrician, a primary care physician, an office gynecologist, and a part-time fertility specialist, oncologist, and surgeon. While there is no other specialty comparable to that of Obstetrics and Gynecology, the primary focus of OB/GYN is not GYN surgery. When it comes to complex GYN conditions and surgical treatment, it’s best to seek the opinion of a specialist, who performs an increased volume of surgeries and this way maintains and develops surgical skills and expertise, perfecting the approach.
At CIGC, we work closely with our patients’ regular OB/GYNs, who often refer their patients to us for advanced minimally invasive surgical treatment of conditions like fibroids and endometriosis. Valinda Nwadike, MD, an OB/GYN based in Southern Maryland who has been referring patients to us for over a decade, recently decided to undergo herself laparoscopic hysterectomy with the innovative DualPortGYN technique at CIGC. She is now saying:
“I would recommend DualPortGYN to anyone. It is the procedure women deserve. It’s revolutionary. If you laid out all the types of hysterectomy that women can have side by side, why wouldn’t you choose this? I was showing my teeny incisions to my colleagues and they were amazed. They all have the CIGC number now and are making appointments.”
