Text on screen Fertility Authority. Your Most Trusted Source Ask the Experts How are fibroids diagnosed and treated Dr. Jenna McCarthy, South Florida Institute for Reproductive Medicine Most of the time, fibroids are initially diagnosed on ultrasound. And then they can be definitively diagnosed from a fertility standpoint by either a saline infusion sonogram, or an HSG. If the fibroid is well away from the cavity, and it's not changing the shape of the cavity at all, and it's not causing you any other symptoms, there's no reason you need to have it taken out.
So, doctors typically will recommend that you have the fibroid taken out if it's changing the shape of the cavity, or if it's causing some of the other symptoms. Fibroids are typically removed one of two ways. You can either have them removed by having a surgery, either laparoscopically or an open surgery where they make an incision in the belly, and have the fibroids removed. Alternatively, fibroids that are completely within the cavity can sometimes be removed vaginally. It depends on where the fibroid is. So, let's start with a large fibroid that's large enough that it's changing the shape of the cavity.
That type of fibroid might be removed laparoscopically, which is a couple of small incisions on the belly, nothing big. The procedure is usually performed as an outpatient procedure, which means that you can go home the same day, sleep in your own bed, take your pain medicines yourself, instead of having to be in the hospital. The healing time from that is typically two to six weeks, depending on the woman and how active she is. And then we usually ask you to wait three months before trying to get pregnant.
Some doctors will err on the side of caution and say as much as six months before trying to get pregnant. And then, typically, if the fibroid that was removed was large enough that we actually went all the way through the wall of the uterus to take it out, we'll recommend a csection for delivery, to help prevent the chance that the scar that's left in its place doesn't pop open during labor. The other way to remove fibroids is hysteroscopically, or vaginally. Those are fibroids that are completely within the cavity.
So, basically, they can put a little camera inside the uterus and look around you can see the whole fibroid. Those, the recovery time is even faster. The surgery itself, again, is outpatient. You go home the same day. The pain is much, much less associated with it. Most women are back to work within a week to two weeks. Some women don't even need that much time. And we usually don't ask you to wait more than one normal period before you try and get pregnant. And neither of the two surgeries make it so that you can or cannot have fertility treatments.
Some gynecologists are extremely skilled at removing fibroids. Other gynecologists prefer to refer those patients to either a reproductive endocrinologist or a minimally invasive surgeon. The advantage to doing that is most REs and minimally invasive surgeons are trained in doing laparoscopic myomectomies. The difference between a laparoscopic myomectomy and an abdominal myomectomy is the recovery time. With a laparoscopic, most women, really, are up and around and doing for themselves in about two weeks. It may be six weeks before they feel 100 percent, but they're usually at 80 percent or better by two weeks.
Patient Story Robotic Uterine Fibroid Embolization with Magellan
Ivana I love to walk. It really feels great. I'm a teacher. Sometimes I work with the preschoolers or first grade, and you want to kind of be on their level, when you're sitting down. So I wasn't able to sit down a lot of times. And I noticed a lot of bloating. My body just wasn't functioning the way that it normally was. Last year the doctor noticed that I had fibroids that were the size of lemons. I was in pain a lot. I couldn't wear anything that buttoned. It literally looked like I was nine months pregnant. I was embarrassed. I sought.
Medical advice from my OBGYN about other options other than a hysterectomy. And he referred me to Dr. Bagla. Dr. Bagla Ivana, when she sought us out to have uterine fibroid embolization and it was performed robotically, she was ecstatic and knew that she was undergoing a procedure that would offer her a chance to really change her life. With traditional surgery, such as hysterectomy or myomectomy, there is an open incision, and most women are not ecstatic about having a large incision in the lower part of their abdomen, the scar, the potential.
For bleeding, or infections. With fibroid embolization as a whole, that procedure can be performed minimally invasively on an outpatient basis sometimes, and just through a simple needle hole. What's unique about the Magellan System is its ability to get to both right and left uterine artery, which is critical for the procedure. It offers support for our microcatheter to then deliver the embolic material right into the correct place within the uterus. Ivana The puncture that he made with the Magellan Robotics System, literally it was a little bandaid. And I remember, I had trouble finding where the incision was. Now I'm breathing.
Endometriosis, Uterine Fibroids, and Estrogen Dominance
Now, when we have a stage called estrogen dominance estrogen proliferates tissue when it's dominant. Estrogen within itself is very good. I helps us with our brain tissue, our memory. It helps us to think clearly, prevents foggy brain and all this other stuff. Estrogen in itself is very goodit's not bad. But when you have an estrogen dominance situation where the estrogen is very dominant over the progesterone, you're going to have all these symptoms and you're going to have a proliferation of tissue. For instance, if a woman comes in with cysts on her ovaries or cysts in her breasts.
Or she has fibroids on the inner uterine lining, or she has endometriosis these are all tissues that are being proliferated. They are increasing because she's got too much estrogen in her. Thus, we have a lot of increase in the amounts of hysterectomies because women are getting large fibroids and they're bleeding heavy, heavy, heavy, so they have anemia. I went through this myself, personally, in my forties. I had a lot of estrogen dominance but back then we didn't know exactly what to do. And so, I ended up having a hysterectomy because every time.
Embosphere Microspheres from Merit Medical the most clinically studied spherical embolic available. Made from a proprietary formulation of an acrylic copolymer crosslinked with gelatin and indicated for the embolization of symptomatic uterine fibroids, AVMs, and hypervascular tumors. No other spherical embolic has as much clinical evidence supporting its effectiveness. Embosphere Microspheres predictably occlude the vasculature according to the size of the embolic. This allows the interventional radiologists to embolize accurately at the desired level of occlusion. The results from the fibroid registry, published in obstetrics and gynecology, demonstrate high physician confidence in.
Embosphere Microspheres with interventional radiologist choosing Embosphere Microspheres in 73 percent of cases. Independent physician studies published in peerreviewed journals repeatedly demonstrate the superior performance of Embosphere Microspheres for uterine fibroids over other spherical embolics. A landmark randomized controlled trial of Embosphere Microspheres versus spherical PVA reported that 92.3 percent of patients had 100 percent infarction of all of their fibroids. Embosphere Microspheres from Merit Medical. No other embolic has as much clinical data supporting excellent clinical outcomes. Please contact your local Merit sales representative to arrange for trial, or call Merit customer service for more information.
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