Treating Fibroids

There are alternatives to hysterectomy.

Fibroids are benign tumors that grow from the walls of the uterus. They may cause symptoms such as painful periods and excessive bleeding, as well as abdominal swelling, pressure on the bladder or bowel, and back pain.

Whether or not fibroids require treatment depends on their location, size and growth rate, and whether they are causing symptoms, according to Robert Inzer, M.D., an obstetrician/gynecologist on the medical staff at Baylor University Medical Center at Dallas. The good news is there are a variety of treatment options available, such as:

Surgery. Hysterectomy (removal of the uterus) is the most common treatment for fibroids, since it’s considered a cure. Today, even large fibroids can be removed with minimally invasive techniques. Laparoscopic supracervical hysterectomy (LASH) removes the uterus and fibroids, but spares the cervix and ovaries. For women who want to preserve childbearing, hysteroscopic or laparoscopic myomectomy may remove only the fibroids, keeping the uterus intact.

Radiology. Interventional radiologists on the medical staff at Baylor Dallas offer uterine fibroid embolization (UFE), a nonsurgical procedure in which tiny plastic spheres are injected through a catheter to block the blood supply of individual fibroids, causing them to shrink. “This may be an effective treatment option for many women,” Dr. Inzer says.

Medication. Since estrogen fuels fibroid growth, lowering estrogen will shrink fibroids. “Medication buys time for women nearing menopause until their estrogen decreases naturally, and shrinking very large fibroids with medication opens up additional surgical options,” Dr. Inzer says.

Women should consult with their gynecologist and be prepared to answer the following questions:

• What are my symptoms?
• Do I want a surgical or nonsurgical procedure?
• Have I completed my childbearing?
• Can I wait until menopause?
• How much time can I take off work?
• Do I want to take daily medication?

No matter how it’s accomplished, “removing or shrinking fibroids often brings significant relief of symptoms,” Dr. Inzer says.

By Deborah Paddison

For a referral to a gynecologist on the medical staff at Baylor Dallas, call 1-800-4BAYLOR or use our on-line physician directory. Learn more about fibroids.