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Uterine Fibroid Treatment Video – Brigham and Women’s Hospital

libraries are very common muscle tumors

of the uterus we know that over the

course of a lifetime probably close to

70% of Caucasian women and 80 percent

more than 80 percent of african-american

women will develop thyroid

now the vast majority of women that

develop fibers have no issues they're

found incidentally our up to a quarter

of women will actually have some

symptoms that will bring them in to seek

a physician's evaluation if you haven't

sent some some fibers there will

typically be heavy bleeding or pain or

pressure symptoms sometimes increase

your urinary frequency the options for

managing fibroids include watching and

waiting medical management or

interventional radiology procedures and

surgery Brigham Women's Hospital has all

of these options available most fibers

are usually discovered during a pelvic

exam either in primary care providers

office if the primary care provider does

the pelvic exam or in the animal

gynecologic exam and this often triggers

an ultrasound or some imaging modality

to get a sense of the size and location

of the fibroids alternatively some women

will presume with symptoms that trigger

this evaluation whether it's the heavy

bleeding or the pressure or the pelvic

pain that triggers an imaging that will

lead to diagnosis of fibroids medical

management is typically geared for

abnormal bleeding symptoms most of the

medications in that group affect

bleeding but do nothing for the size and

a bulk type symptoms that patient has

the only medication that is widely used

that effect size and bleeding is a depo

lupron injection overall medical

management of fibroids is not as well

studied as other interventions for

fibroids we know that it's sort of a

band-aid and a lot of patients will

respond to the medical management the

management but their symptoms will

return once they discontinue these 90

days and often they will end up needing

some other intervention in the future

the next set of options for patients are

procedures done by our interventional

radiology physicians

these procedures there are two common

procedures and both of these procedures

are offering and

Hospital the most common procedure year

light artery embolization or uterine

fibroid embolization essentially they

target the blood vessels that feed the

ears and include those vessels basically

to or decrease in blood supply to the

fibroid and overall shrinkage of the

fibroid and the size of yours and the

patient will notice usually a decrease

in bulk and umbria symptoms after these

procedures

the other option performed by our

interventional radiologists is the

magnetic resonance guided focus

ultrasound to qualify for a magnetic

resonance guided focus ultrasound the

fibroids usually have to be of a certain

size usually limited to one fibroid and

usually in the perfect spot meaning that

they can be behind the bladder or it can

be behind the bowel because the energy

of the ultrasound that's use can damage

those important structures if they're

not properly located the options for

surgery include removing the fibroid or

removing the years now removing the

fibroid can be approached in several

different ways

if the fibroid is located completely

inside the cavity of the uterus that can

be removed by an approach called

hysteroscopy where the camera and a put

metal place through the cervix in the

operating room and the fibroid is shaved

down from inside a cavity if the fibroid

is located in the wall of the uterus

this can be approached by either an

abdominal incision similar to an

incision for a c-section side to side in

the skin or up and down in the skin and

the fibroid is typically removed that

way alternative routes to the open

incision include laparoscopy for robotic

surgery both these techniques include

placing small and seeds in the wall of

the abdomen to remove the fibroids the

other surgical option is performing a

hysterectomy hysterectomy can perform

vaginally if the size of fibroid is

small enough with large

give awry with large fibroids oftentimes

the hysterectomy is performed with a big

incision on the abdomen or

laparoscopically or robotically as well

fibroid surgery can be performed by a

general

GYN it can be performed by a minimally

invasive gynecologic surgeon like myself

it can be performed by Reproductive

Endocrinology and infertility specialist

as well as a gynecologic oncologist

depending on the availability of closer

to where you are