Fibroids are typically benign (noncancerous) cellular growths in the uterus that can cause pain or bleeding, or pelvic pressure or heaviness. They are very common and often appear during a woman’s reproductive years.
Dr. Jed Schortz, a gynecological surgeon with Novant Health Gynecologic Surgery & Pelvic Pain - SouthPark in Charlotte who is fellowship-trained and specializes in minimally invasive gynecological surgery (MIGS), lays out the options for treating fibroids.
What are some symptoms of fibroids?
You may suffer from pain, excess menstrual bleeding, vaginal bleeding between cycles, pelvic pressure, backache. Sometimes the bleeding is so severe that it could lead to anemia and the need for a blood transfusion. Some women may have no symptoms at all. Fibroids are very, very common. I want to emphasize that.
How are fibroids diagnosed?
Typically, large fibroids may be felt on routine pelvic exams. The presence of fibroids can be confirmed through an ultrasound.
If you have fibroids but they’re not causing any trouble, do they need to be treated?
If they cause no symptoms, they can be left untreated and instead observed for rapid growth or symptoms.
How do you recommend treating fibroids?
When fibroids are causing symptoms, various treatments are available. It really does vary from patient to patient; we take an individualized approach.
If symptoms are mild, we may offer medication to control the bleeding. If that doesn’t help, surgical and procedural options are available – many of which are minimally invasive. A patient’s current or future desire for fertility is one factor that’s always important to consider.
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Is outpatient surgery an option?
Yes, many of the surgeries and procedures available are outpatient. For example, with minimally invasive surgery, the recovery tends to be much quicker than with traditional open surgery. I often quote to patients that with a minimally invasive surgical approach, they will feel 70% to 80% better in two to four weeks, even for major pelvic surgery such as a hysterectomy.
And if minimally invasive surgery isn’t successful?
As a last resort, we might talk about removing the uterus – a hysterectomy. Again, that’s often done with robot-assisted or laparoscopic – or small-incision camera – surgery. But there are a lot of factors that go into making that decision. Age, for one. Does the woman want to have children or more children?
Also, not all fibroids in the uterus are the same. We look at the size of them, how many and where they’re located, which helps determine the best treatment option. Fibroids don’t always grow. Many shrink with menopause.
You have a reputation for really listening to your patients and taking their symptoms seriously. What advice do you have for women who have talked to their doctors about excess bleeding and abdominal pain – but haven’t had it addressed?
Seek out a doctor who will take the time to really listen to you. Look for a doctor who has been fellowship-trained in minimally invasive surgery, as they perform these surgeries on a regular basis.