Delaying Fibroids & Endometriosis Treatment Can Be Dangerous

Uterine fibroids can be unpredictable. They can continue to grow, and in some cases grow very large, very fast. Removing them when they are smaller can help preserve a woman’s fertility, but will also result in a faster recovery for the patient. The larger the fibroid, the more damage to the uterus.WTOP-January-FB-image.png

With endometriosis, the condition can cause a lot of damage to the reproductive system, if left untreated. We’ve seen countless patients who’ve been told for years, that their pain is in their head. We all need to think more about what the patient is experiencing with these conditions, and the risks they face with surgery when their condition is allowed to go unchecked.

Read more in this recent CIGC article, shared by WTOP:
The silence & stigma of period pain: fibroids, endometriosis can destroy a woman’s life.

To get in touch with an advanced CIGC surgical specialist Dr. Natalya Danilyants or Dr. Paul MacKoul, call 888-SURGERY, or reach out online. Women residing outside the Washington DC area, who consider traveling for advanced GYN surgery, can look into CIGC’s travel program.


UFE Is A Risk For Women With Large Fibroids

Women who struggle with fibroid symptoms often look for non-invasive treatment methods, it is however important to know the risks associated with every procedure.

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Embolization, when used on large fibroids, is less efficient, and can even be dangerous. It can result in die-off and expulsion of the fibroid tumor, which can lead to an infection. Also, fibroids shrink only about 30-46% following uterine fibroid embolizatin (UFE), which may not be enough for large fibroids to alleviate symptoms. In several studies, response to embolization was not as effective in patients with fibroids greater than 8 cm, and additional therapy was needed. Women are still at risk for having a hysterectomy following UFE treatment for large fibroids.

Additional information is available in this recent article provided by The Center for Innovative GYN Care and shared by WTOP:
Hysterectomy may still be required after an embolization procedure.

Alternatively, myomectomy and hysterectomy procedures remove fibroids entirely, offering fewer post-operative complications. CIGC founders Dr. Natalya Danilyants and Dr. Paul MacKoul have developed the advanced LAAM myomectomy surgery to thoroughly remove even large fibroids with only 2 small incisions. The advanced DualPortGYN hysterectomy, also developed by CIGC physicians, is definitive fibroid treatment with two 5 mm incisions. Most women recover in less than 2 weeks following LAAM, and in 1 week following DualPortGYN surgery.

Myomectomy and hysterectomy patient reviews are available on the CIGC blog in the patient spotlight section, as well as on doctor review sites: Dr. Natalya Danilyants reviews | Dr. Paul MacKoul reviews.

To schedule an appointment with a CIGC surgical specialist, call 888-SURGERY or reach out online. Women residing outside the Washington DC area can look into our travel program.


Akena’s Journey: Fibroids & Hysterectomy Surgery

Fibroids often run in families, and they have been shown to affect African American women more severely. CIGC patient Akena shared her journey dealing with fibroid symptoms, and looking to find relief.


“In 2002/2003 my periods became really heavy and the cramping was unbearable. The fibroids actually became palpable to me. I could feel them. Fast forward 3-4 years later, in 2007 my fibroids had gotten so large that I had to have a myomectomy. I wanted the opportunity to have kids. It was an open procedure because my fibroids were so large. My gynecologist at the time told me I wasn’t a candidate for a laparoscopic procedure because they wouldn’t be able to get all of them.” said Akena.

“I think I was told that fibroids could come back, and pretty quickly. In 2010 the fibroids returned. The cramps got heavier, the bleeding got heavier. I knew they were going to be a problem and they are only going to get bigger.”

“I really wanted kids. Sometime last year, I started looking into my fertility. I went back to the same OB/GYN. He checked my ovarian reserve, which was really low. I went to a specialist. Over time, my ovarian reserve got worse. At this point. I hear the radio ad. I was so disappointed in my OB/GYN and discouraged by my fertility specialist. I needed to try something else. That’s when I reached out to The Center for Innovative GYN Care.”


By the time Akena reached out to CIGC, her fibroids had severely grown and her symptoms had worsened. She went through a fertility screening again, to test her ovarian reserve.

“The results of my test were not what I wanted to hear. My uterus was essentially non-existent. The fibroids were pressing on my bladder and would engulf it if I didn’t take care of this. Dr. MacKoul was honest, saying the likelihood that you are going to be able to get pregnant on your own is very, very low. Finally, I’m coming to terms with the fact that he is right.”

“I had surgery at the end of summer. I got up the evening after my surgery, moving slowly, of course, but I was able to move around without assistance. I could concur with a lot of the stories that have already been told by other CIGC patients.”

“I realized having a hysterectomy was the best option for my particular situation. I had to shelve the fact that I’m not going to have a kid that comes from my own body. The fibroids were so large and affecting other things on the inside that he also had to remove an ovary.”


“My recovery has been amazing. The incisions are small, and it was nothing like having an open procedure. I’m very lucky to have a partner now who is supportive and who wants to get through this together. And he allowed me the space to get through this on my terms. I would wish and hope that any woman has the same support system I do, and to have such a supportive team throughout the surgical process.”


CIGC advanced laparoscopic specialists Dr. Paul MacKoul and Dr. Natalya Danilyants, and CIGC-trained physician Dr. Rupen Baxi have provided minimally invasive surgical treatment for thousands of fibroid patients.

LAAM myomectomy is a uterus sparing procedure, performed on patients who are able to retain fertility. CIGC surgeons use 2 small incisions to remove fibroids any number and size. Women recover faster, with less pain, and are usually back to work in less than 2 weeks.

DualPortGYN hysterectomy is definitive fibroid treatment. CIGC specialists use two 5 mm incisions to remove the uterus, and women recover in 1 week.


To schedule an appointment with Natalya Danilyants MD, Paul MacKoul MD or Rupen Baxi MD, call 888-SURGERY or submit this form online. Women have traveled to CIGC for advanced GYN surgery from 46 states and 30 countries. Learn about our travel program. For patient feedback, visit the patient spotlight section on our website, or doctor review sites: Dr. Natalya Danilyants Reviews | Dr. Paul MacKoul Reviews | Dr. Rupen Baxi Reviews.

The Benefits of Minimally Invasive Fibroid Removal at CIGC

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.

Girl suffering menstrual pains on the bed

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.

CIGC founders Natalya Danilyants MD and Paul MacKoul MD have perfected groundbreaking, minimally invasive approaches to fibroid removal. The innovative LAAM approach for minimally invasive myomectomy is performed using only 2 small incisions, and women recover in less than 2 weeks. Minimally invasive hysterectomy as definitive fibroid treatment is performed with the advanced DualPortGYN technique, and most women recover in 1 week.

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.

Women travel from across the country and around the world for CIGC’s innovative procedures. Learn about our travel program. For patient CIGC testimonials, visit our patient spotlight section or online doctor review sites: Dr. Rupen Baxi Reviews | Dr. Natalya Danilyants Reviews | Dr. Paul MacKoul Reviews.

LAAM: A Better Minimally Invasive Myomectomy

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.

Read testimonials from CIGC patients after minimally invasive fibroid removal with LAAM:

Rashetta’s Story: Minimally Invasive Removal of Large Fibroids is Possible
Sherri’s Story: Traveling For Minimally Invasive Fibroid Surgery
Azundai’s Journey: Finding The Best Fibroid Removal Surgery

To speak with a CIGC minimally invasive GYN surgeon Paul MacKoul MD or Natalya Danilyants MD about your fibroid removal surgery, call 888-SURGERY or contact us online. More patient feedback is available on doctor review sites: Dr. Paul MacKoul Reviews | Dr. Natalya Danilyants Reviews.




Think Twice Before Getting UFE To Treat Fibroids

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.

Learn more about the risks of UFE and safer treatment for fibroids in this WTOP News article:

Women With Fibroids Should Think Twice Before Getting UFE


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.


The Center For Innovative GYN Care: Who We Are
Dr. Paul MacKoul Reviews | Dr. Natalya Danilyants Reviews
Paul MacKoul MD on Facebook | Natalya Danilyants MD on Facebook
Paul MacKoul MD on Twitter | Natalya Danilyants MD on Twitter
Paul MacKoul MD on LinkedIn | Natalya Danilyants MD on LinkedIn


Fibroids: What Is The Right Approach For Treatment?

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.

Smiling young girl drinking tea and writing


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.


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.


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.”

You can read her full story here: OBGYN Chooses CIGC For Laparoscopic Hysterectomy


Women looking to get evaluated by CIGC’s advanced surgical specialists Dr. Paul J. MacKoul MD and Dr. Natalya Danilyants MD can call 888-SURGERY or book an appointment online. Out-of-town patients travel to the Washington DC area for minimally invasive GYN surgery through our travel program. CIGC has offices in Bethesda, MD, Annapolis, MD and Reston, VA.


The Center For Innovative GYN Care: Who We Are
Dr. Paul MacKoul Reviews | Dr. Natalya Danilyants Reviews
Paul MacKoul MD on Facebook | Natalya Danilyants MD on Facebook
Paul MacKoul MD on Twitter | Natalya Danilyants MD on Twitter
Paul MacKoul MD on LinkedIn | Natalya Danilyants MD on LinkedIn