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.

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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.”

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


GET A GYN EVALUATION

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.


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Rashetta’s Story: Minimally Invasive Removal of Large Fibroids is Possible

RashettaCIGC patient Rashetta from Washington DC first found out she had fibroids in college. A cyst on her ovary ruptured and she had to go to the hospital. On a follow-up ultrasound, Rashetta found out that she also had fibroids.

About 70-80% of women will get fibroids by age 50. Fibroids affect African American women 2 to 3 times more frequently than white and Hispanic women. Also, African American women are more likely to develop problems with fibroids at an earlier age, with the fibroids growing faster, becoming larger, and causing more bleeding and anemia than in women of other races.

THE WATCH AND WAIT METHOD FOR LARGE FIBROIDS DOESN’T WORK

“For years I saw the same doctor, waiting and watching my fibroids grow, and for a while, the pain wasn’t altering my daily activities. But then, the pain got progressively worse. I found myself in bed, crying in pain.”

Many doctors advise their patients to delay surgery if fibroids aren’t bothering them. The problem with fibroids, especially large fibroids is that they will continue to grow and frequently cause serious damage to the uterus. For women who wish to maintain fertility, avoiding to remove the fibroid when it is first discovered can lead to far worse symptoms down the line.

MINIMALLY INVASIVE MYOMECTOMY FOR LARGE FIBROIDS

A friend of Rashetta’s had a procedure with Paul MacKoul MD and told her that a minimally invasive myomectomy for a large fibroid is possible with this surgeon.

“I was hesitant to change, because my doctor knew my history, but I figured it couldn’t have hurt to have a conversation with him,” said Rashetta. “Even from my first consultation, the feeling that you get when you first meet someone and feel comfortable, that’s how I felt. When I first met him and he walked me through the procedure, he was so thorough. He drew out what was going on with my fibroids, and I realized in talking to him that I shouldn’t have done the watch and wait approach.”


The LAAM technique developed by minimally invasive GYN surgeons of The Center for Innovative GYN Care uses only 2 small incisions to safely remove fibroids of any size. LAAM is an important development, as it allows the surgeons to feel all of the fibroids. Patients return to themselves post surgery within 2 weeks.

 “I planned to be off for 2 weeks, and I can work from home, so while I stayed home for 3 weeks, I was back working after 2. That was a far cry from the 2-3 months the other doctor told me. The first couple of days after a myomectomy are painful. And I needed someone to be at home with me for that.”

RAISING AWARENESS OF FIBROIDS & MINIMALLY INVASIVE FIBROID REMOVAL

Rashetta’s journey has brought The White Dress Project in Washington DC and she now heads the DC chapter, raising awareness of fibroids and minimally invasive fibroid surgery.

 “I really feel like I was meant to work with this organization. It’s an issue that not a lot of people want to talk about and there isn’t a lot of awareness. I have a friend that is just now scheduling the surgery. She knows that I’m involved with The White Dress project, and I’m going to sit down with her and give her as much support as I can. But, if any woman has questions (about fibroids or minimally invasive surgery) don’t be afraid to ask Dr. MacKoul.”

BOOK A CONSULT

Call 888-SURGERY or visit us online to schedule a consult with a fibroid specialist of CIGC. Out-of-town patients can benefit from innovative GYN procedures at CIGC through our travel program.

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