Uterine Fibroids

When uterine fibroids become too large, too numerous or start pressing against another organ, patients may experience pelvic pain or pressure and changes with menstruation. Additional symptoms include:

• Constipation
• Difficulty emptying bladder
• Enlargement of the lower abdomen
• Fatigue due to heavy periods and bleeding
• Frequent urination
• Heavy, painful menstrual bleeding
• Infertility or difficulty getting pregnant
• Lower back pain or leg pain
• Miscarriage(s)
• Pain during sexual intercourse

• Hormonal and medication therapies: Pain relievers may work to reduce the pain of menstrual cramps; birth control pills and other hormonal methods can control heavy periods. An intrauterine device that releases progestogen hormone may be prescribed to reduce heavy bleeding. Medications called gonadotropin-releasing hormone (GnRH) agonists will reduce the size of uterine fibroids and stop menstrual bleeding. Because of side effects, GnRH agonists are typically used for up to six months, and fibroids will usually return to their previous size after the drug is stopped.
• Endometrial Ablation: In this procedure a thin inner layer of the uterus is destroyed, reducing menstrual bleeding. It is only recommended for patients that competed their family and do not desire future fertility. It has limitations in patient with large fibroids distorting the cavity.
• Radiofrequency ablation: often referred to as “Acessa®” procedure is a same-day, outpatient minimally invasive procedure that uses radiofrequency and heat to destroy individual fibroids one by one and turns their consistency from a hard baseball to a marshmallow and gradually reduces their size. By shrinking the fibroids and changing the consistency, patients enjoy less severe symptoms including pelvic pain and bleeding.
• Uterine Fibroid Embolization (UFE): This procedure is used to alleviate severe symptoms such as anemia, cramps or incontinence. Small particles are injected into the bloodstream around the uterine vessels to block the flow to fibroids resulting in the fibroids shrinking.
• Hysteroscopy Myomectomy: is a quick outpatient procedure to remove the intra cavity fibroid vaginally with no incision.
• Minimally invasive surgery or robotic surgery: A minimally invasive outpatient, same-day procedure called a myomectomy, is an option for those who wish to keep the option to become pregnant following the procedure.
• Hysterectomy: In rare cases, the surgical removal of the uterus (hysterectomy) may be the best option for treating a patient’s uterine fibroid.