SURGERY FOR FIBROIDS?

 

 

Dr Steven R. Goldstein, an Obgyn in Manhattan, regularly sees patients who come in with fibroids and are very concerned that they are cancerous.

One can hear the word tumor and feel terrified. But a fibroid tumor isn’t cancer. It’s a mass of muscle and connective tissue in the uterus. Fibroids arise in the wall of the uterus. If a fibroid stays within the wall, it’s called intramural. If it grows into the endometrial cavity, it’s called submucosal.

 Fibroids range in size from as small as a pea to the size of an orange and occasionally even to the size of a basketball. But even patients with relatively large benign fibroids do not necessarily need to be operated on.

 Today, transvaginal ultrasound imaging makes it possible to look closely at the ovaries despite the presence of fibroids. In the past, without transvaginal ultrasounds, physicians recommended that large fibroids be removed so they could evaluate the ovaries. Thanks to advances in ultrasound, this is no longer the case, and there is no absolute size at which fibroids must be removed. Dr Goldstein, a Gynecologist in Manhattan, received the Ian Donald Gold Award from the International Society of Ultrasound in Obstetrics in Gynecology for changing the way ultrasound is practiced through research and innovation.

 Women with fibroids often talk about pressure symptoms. Fibroids sometimes lean on the bladder. Still, fibroids are slow growing, and the adjacent organs accommodate very nicely in the overwhelming majority of cases. In addition, if you operate for “symptoms” from fibroids, these symptoms are not relieved. As women get older, they tend to feel the need to urinate more frequently. This is often unrelated to fibroids.

 If your fibroids are not large, not causing extreme bleeding, and not growing rapidly, it may be fine to watch and wait. If you bleed heavily, you will want to include plenty of iron in your diet to ward off the possibility of iron deficiency anaemia.

 The decision to opt for surgery is ultimately yours. After menopause, when estrogen levels are lower, fibroids shrink naturally. However, if you are having painful cramps or heavy menstrual bleeding, you may want to consider surgery. Consider it only if you have been thoroughly evaluated with transvaginal ultrasound and possibly saline infusion Sonohysterography.

 Myomectomy – surgical removal of the fibroid while leaving the uterus in place, is one possibility for women who still want to have children. However, this type of surgery is every bit as complicated from a surgical point of view as a hysterectomy.

 Make sure you check with your gynecologist and evaluate all your options first before deciding on surgery. The above is presented for informational purposes only.

 Dr Goldstein is a Professor of Obstetrics and Gynecology at New York School of Medicine, and a former Director of Gynecologic Ultrasound at New York University Medical Center. If you are suffering from fibroids and  are in the NY area, then a consultation with Dr Steven R. Goldstein, a leading

Obgyn in Manhattan, may be in order.