K21 -- May 2010 -- Fibroid Treatment Options

Intro: One out of four. That's how many women get fibroids during their childbearing years. The gold standard of treatment has been hysterectomy, which can be a big operation with a long recovery. But now, there are much less invasive options for many women.

"HYSTERECTOMY IS STILL A GOOD OPTION FOR SOME WOMEN."

"BUT FOR WOMEN WHO WANT TO HAVE CHILDREN, OR FOR WOMEN WHO WANT TO KEEP THEIR UTERUS, HYSTERECTOMY IS NOT A GOOD CHOICE."

DR. ELIZABETH STEWART SAYS FOR WOMEN LIKE ELLEN EWALD, NEWER, MINIMALLY INVASIVE OPTIONS FOR TREATMENT OF FIBROIDS MAY BE BETTER OPTIONS.

"I WAS FEARFUL OF AN OPERATION AND I DIDN"T WANT TO LOSE TIME."

ELLEN IS A MARATHON RUNNER, AND A HYSTERECTOMY WOULD HAVE KEPT HER OFF HER FEET FOR AT LEAST SIX WEEKS. BUT ELLEN'S SYMPTOMS WERE SEVERE.

"IT GOT TO THE POINT WHERE MY STOMACH WAS GETTING BIGGER."

FIBROIDS ARE NON CANCEROUS TUMORS OF THE UTERINE WALL. ELLEN HAD ONE THAT WAS LARGE AND PUSHING AGAINST HER BLADDER, MAKING IT HARD TO URINATE. SHE ALSO HAD HEAVY BLEEDING SO ELLEN CONSIDERED THREE MINIMALLY INVASIVE ALTERNATIVES TO HYSTERECTOMY: 1. A LAPAROSCOPIC OR ROBOTIC MYOMECTOMY DURING WHICH DOCTORS REMOVE THE FIBROID WITH MICROSCOPIC TOOLS & A GOOD OPTION IF YOU ONLY HAVE ONE FIBROID 2: UTERINE ARTERY EMBOLIZATION. A PROCEDURE DURING WHICH DOCTORS INSERT SMALL PELLETS INTO THE ARTERY LEADING TO THE UTERUS. THE PELLETS CUT OFF BLOOD SUPPLY TO THE UTERUS, DESTROYING MULTIPLE FIBROIDS. 3: FOCUSED UTRASOUND. THIS PROCEDURE INVOLVES ADMINSTERING SOUND WAVES THAT BREAK UP THE FIBROIDS. THIS IS THE OPTION ELLEN CHOSE.

"I ASKED ALL THE CRUCIAL QUESTIONS. YOU KNOW, WHAT HAPPENS AFTERWARDS, HOW LONG WILL IT TAKE, IF YOU COMPARE THIS TO A HYSTERECTOMY HOW LONG WILL I BE IN THE HOSPITAL. AND SHE SAYS, THERE"S NO DOWN TIME AND YOU"LL GET IMMEDIATE RELIEF. AND I SAID, NO WAY?"

BUT FOR ELLEN, THAT"S EXACTLY WHAT HAPPENED. SHE WAS SYMPTOM-FREE AND ABLE TO RUN JUST DAYS AFTER THE PROCEDURE.

FOR MEDICAL EDGE, I'M VIVIEN WILLIAMS.

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Again, Dr. Stewart says for some women, hysterectomy remains a good option. But for people who don't want to go through a big surgery or want to keep their uterus, a less-invasive procedure may be a good idea. The only real downside to these newer procedures is that new fibroids may form afterwards.

Fibroids can cause different symptoms in different women and not all women respond to treatment the same way. So Dr. Stewart and colleagues are researching these options to find out which ones are best for the different symptoms.

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