Uterine fibroids aka fibroid tumors are benign (non-cancerous) growths that occur within the smooth muscle of the uterus called the myometrium. Typically, uterine fibroids are slow growing and are most commonly found in women during the ages of 25-50. The malignant or cancerous form of a fibroid tumor is called a leiomyosarcoma; this type of tumor is rare.

Uterine fibroids are the most common cause of hysterectomy (uterus removal) in the United States. However, most women do not need their uterus removed and instead can have alternative treatments such as a myomectomy, which means removing the tumor from the uterus.

While it is true that 70 percent to 80 percent of women have uterine fibroids, not all are symptomatic or require treatment. Uterine Fibroid symptoms include heavy vaginal bleeding, irregular menstrual cycles, anemia (low blood count), pelvic pain, pelvic or vaginal pressure, abdominal cramping, and abdominal distention.

Causes of Uterine Fibroids
While the specific cause of uterine fibroids is unknown, we do know that they respond to hormones such as estrogen and progesterone and grow during the reproductive years. Pregnancy and childbirth seem to decrease the risk. Once a woman goes into menopause (average age of 51) the fibroids typically shrink and women will often stop having symptoms. It is thought that estrogen increases the growth of fibroids; therefore, if a woman utilizes post-menopausal hormone replacement with estrogen, the fibroids may not shrink as much as they would otherwise. African-American women have a higher risks of fibroids compared to Caucasian women and women that have mothers or sisters with fibroids have a higher risk of having them as well.

Types of Uterine Fibroids

  • Submucosal Fibroids: are fibroids that grow inside the cavity of the uterus. This type of fibroids is typically treated with hysteroscopic (a camera inside the uterus itself) resection or removal.
  • Intramural Fibroids: are fibroids located in the muscle layer of the uterus itself. These fibroids are most commonly treated laparoscopically.
  • Subserosal Fibroids: are fibroids located on the outside of the uterus (i.e. toward the abdominal side of the uterus). These are the ones that are typically treated through laparoscopy.

Diagnosis of Fibroids
Ultimately, an ultrasound or MRI of the uterus is the best way to diagnose the location, number, and type of fibroids as well as the overall size of the uterus.

Uterine Fibroids Treatment
Various treatment options are available for uterine fibroids, and most do not require a hysterectomy or removal of the uterus. Treatment options include:

  • Hysterectomy (uterus removal)– is the most common treatment in the USA today. It is typically NOT necessary.to remove the uterus to treat symptoms of fibroids.
  • Myomectomy– removing the individual fibroid tumor while preserving the uterus
  • Laparoscopic Myomectomy– removal of uterine fibroid tumors using a miniature incision approach through the abdomen.
  • Robotic Myomectomy(Robot assisted laparoscopic surgery, typically robot not necessary and much more expensive)
  • Uterine Artery Embolization(Radiologic treatment to cut blood supply off to the fibroids)
  • ExAblate(MRI focused Ultrasound, Ablation of Uterine Fibroids)

Doctors Miklos and Moore are considered worldwide experts in laparoscopic approach to advanced gynecologic surgery, including Laparoscopic Myomectomy. They’ve been performing this procedure for over 20 years.

Benefits of the Laparoscopic Approach to Uterine Fibroid Removal
This procedure is completed by inserting a small camera through a tiny incision in the belly button and working off High-Definition Video monitors to surgically remove the fibroids. Once the fibroids or myoma’s are visualized and injected with a vasoconstrictive agent such as Pitressin solution. This decreases the blood flow to the fibroid and allows the removal of the fibroid(s) from the uterus with minimal bleeding. Once laparoscopic fibroid removal is completed the defect in the uterus must be closed. This step is rate limiting for many surgeons, as suturing laparoscopically is one of the most difficult skills to master. Laparoscopic surgery for uterine fibroids can be complex in nature and does require a high-level of surgical expertise for a successful outcome. Drs. Moore and Miklos can complete a laparoscopic fibroid removal with precision and minimal bleeding. With this procedure, there is less pain, small scars, smaller incisions than robotic surgery, faster recovery, and no hysterectomy.

Uterine fibroids are certainly painful and troublesome to plenty of women worldwide. With Doctor Miklos and Doctor Moore, you can put this delicate, important procedure into the hands of true professionals.