3. Surgical management options include:
Uterine artery embolization (UAE). This is a procedure that reduces the blood supply to the uterus and fibroids, causing them to shrink in size. UAE involves making a small incision in the thigh, threading a device to the uterine artery and injecting embolic agents that block blood flow through the uterine artery.
Endometrial ablation. This is an out-patient procedure that cauterizes (burns) the lining of the uterus. It usually takes two minutes or less and can generally be performed in any woman with irregular or heavy periods. While most women who have this procedure stop having periods, patients with fibroids frequently continue to have periods though they are usually much lighter and shorter.
RF fibroid ablation. This is a procedure that uses radiofrequency waves to reduce the size of fibroids. The procedure requires two small incisions and is done as an outpatient. Over time, they will shrink and are eventually resorbed by the body.
Myomectomy. This involves actually removing the fibroids while leaving the uterus behind. Myomectomy is generally reserved for women who want to preserve the uterus for possible future childbearing. The biggest drawback is that new fibroids can grow after the procedure; the risk is 50/50. Myomectomy can be performed either laparoscopically (a minimally invasive camera surgery with a few small incisions) or by laparotomy (a procedure involving a larger incision, usually a bikini cut).
Hysterectomy. This is the most definitive treatment for fibroids. Hysterectomy involves removing the entire uterus along with the fibroids. Depending on age, the ovaries may or may not be removed with the uterus. Regardless of whether or not the ovaries are removed, most doctors are now removing the fallopian tubes since new research indicates that ovarian cancer may actually originate in the fallopian tubes. Hysterectomy may be performed laparoscopically (minimally invasive camera surgery with small incisions) or again by laparotomy (a larger incision, sometimes a bikini cut sometimes an up and down vertical incision).
How Do You Prevent Fibroids?
Because we don’t know what causes fibroids, we cannot definitively tell you how to prevent them. Some things to consider include:
- Exercise: Women who exercise more have been found to have fewer fibroids.
- A diet low in soy since soy mimics estrogen potentially causing fibroids to grow.
- Go organic: Fibroids respond to hormones including the hormones found in foods. Organic foods have fewer and usually no hormones.
- Consume flavonoids: Citrus, berries, legumes and red wine are all high in flavonoids. Flavonoids have been found to reduce over all estrogen levels.
Idries J. Abdur-Rahman, MD, FACOG is a board certified Obstetrician/Gynecologist. He practices alongside his twin brother Dr. Jamil (who is also a board certified Obstetrician/Gynecologist) in the Northwest Suburbs of Chicago. Dr. Idries is a married father of two son’s and three daughters and he is an avid traveler and runner. Learn more at TwinDoctorsTV.com.