To Each Her Own
By Shelly Reese
Everyone likes to have choices. And with advances in minimally invasive techniques, now doctors can offer an even wider range of treatment options for women suffering from uterine fibroids.
These generally benign growths in the uterus are extremely common, particularly for women in their thirties and beyond. Many women with fibroids never experience any problems and never seek treatment. Others experience symptoms such as back pain, abdominal pressure, urinary symptoms and heavy menstrual bleeding.
Treatment Tailored to Each Woman
While doctors still don’t know what causes fibroids, they have many routes to relief, including medication, surgical removal of fibroids (myomectomy), and minimally invasive techniques including laparoscopic hysterectomy and uterine fibroid embolization (UFE).
“You can’t approach fibroids in a cookbook fashion,” says Wayarne Harlan, MD, of Lifestages Samaritan Centers For Women™, noting the size and location of the fibroids and a woman’s personal wishes must all be taken into consideration. “The same treatment isn’t going to work for everyone. The choice of intervention is a personal one. Consultation with a professional is very helpful.”
Less Invasive Options
For women who want to keep their uterus, doctors can treat fibroids with UFE, a newer nonsurgical technique that generally requires an overnight hospital stay. An interventional radiologist injects tiny acrylic gelatin particles into the small uterine arteries that supply the fibroids with blood. Most women get prompt symptom relief as the fibroids starve, shrink and die. Most patients recover in just a week and their fibroids typically shrink to about half their original size over the course of one to five months, says Robert Tyrrell, MD, an interventional radiologist at Good Samaritan Hospital.
Likewise, minimally invasive options exist for women who opt for removal of their uterus. In a laparoscopic hysterectomy, the surgeon inserts a miniature camera or laparoscope into the abdomen through a small incision.
The surgeon then removes the uterus through a second incision at the top of the vagina or the abdomen, depending on whether or not the cervix – the bottom portion of the uterus – is to be left in place.
These less invasive treatments generally offer shorter hospital stays, lower complication and infection rates and swifter recoveries than open surgical solutions.
A Personal Decision
“When you’re talking to a woman about her uterus, it’s extremely important to recognize her fears and concerns about loss of this organ, should surgery be necessary,” says Dr. Harlan. For many women, their uterus is very important to them. By providing a variety of treatments, doctors are helping ensure each woman can choose the care that meets her unique needs. “I want a patient to feel that she has played an active role in this decision," says Dr. Harlan.