Signs and Treatment of Fibroids

In this video, Daren Watts, MD, OBGYN at St. Mark’s Hospital explains the tools and techniques doctors use to diagnose and treat fibroids.

Fibroids are benign smooth muscle tumors. They originate from the uterus,typically from one cell line,and they can increase. They are stimulated by estrogen and progesterone,and so anybody who’s menstruating can have an increase in those fibroids through time. Fibroids is a large problem. About 60 to 80% of women will have fibroids, and so this is not unusual that women anywhere as early as 20,even up to 50 and beyond will have some issues related to uterine fibroids.

Most women will not even know that they have a fibroid, and we don’t really treat those unless they produce symptoms,and those symptoms tend to be heavy vaginal bleeding,increased pelvic pressure or pain,and sometimes if they push on the uterus and bladder they can cause urinary frequency. Then on the size of those, sometimes those fibroids can be intrauterine,and they may require removal either by laparoscopy, sometimes they’re inside the cavity of the uterus, and we can remove those hysteroscopically.

Both of those offer a great minimally invasive option to be able to have a quick return to normal activity,a quick recovery. There are times when the fibroids are big enough that a bigger incision is required in the case of a laparotomy, a bigger incision a longer recovery. But what we offer are options in all areas whether we do them hysteroscopically, that’s with the camera through the uterus, or they’re laparoscopically with small incisions in the abdomen, or with a larger incision. So, I think all options are great options which we offer which can allow, kind of, personalization of the care which needs to be delivered for whatever the issue is.

The Benefits of In-Office Gynecological Procedures

I mean, one of the benefits of doing in office procedures, it allows you to have the procedure done, just like we would do in the hospital, without the hassles of the hospital, the expense of the hospital, you get the same personalized care, but you go into the office,into the procedure room, and then the procedure’s done either with sedation or with a local anesthetic, depending on what the procedure is, but allows you to then be done and to go home without having to go through that whole hospital setting.

We decrease the amount of copay, and most women now require high copays and higher deductibles, and what an office procedural benefits is that we can do it sometimes with anesthesia, sometimes with a local anesthetic, and allow them to have a smaller amount of cost to them,but have the same treatment that would be offered in the hospital. There is a procedure called Essure sterilization, which is a sterilization procedure done by hysteroscopy, so a camera inside the uterus, then we putcoils up in the fallopian tubes.

That’s a procedure we offer in office. We do a NovaSure endometrial ablation. We offer any kind of minor diagnostic procedures hysteroscopically, so if we need to put a camera in the uterus, be able to see anything, and treat polyps, we can do that. We do any other minor procedures like labia plasty, or vestibulectomies, or hymenectomies,any kind of small external vulvular procedures we can offer in office, which allows a lower cost to the patient, and kind of a lower time in and out of the actual procedure.