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Ask The Expert Archive

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Uterine Fibroid Archive Questions

Below are Dr. Richard’s answers to Uterine Fibroid questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.

Now displaying records 1 to 12 of 12.


Q : 1

I have two uterine fibroids. I am interested in the uterine fibroid embolization procedure. I am post menopausal(possibly). My thyroid stimulating hormone was at 5.5 but I decreased to 3.75. I periodically have uterine bleeding.

If you have not had any menstrual bleeding for a year, then you would be considered post menopausal. However, if you have "periodic bleeding", after entering menopause, then you would be considered to have "post menopausal bleeding". This demands the attention of a gynecologist. The standard evaluation of post menopausal bleeding includes an endometrial sampling (biopsy). Now, after this evaluation is completed, there are some women who have fibroid related episodic bleeding. Then you might be a candidate for a uterine fibroid embolization. I would not expect you thyroid to be responsible for the bleeding as your lab test is no normal.

Q : 2

I had a myomectomy in 12/2011 and all fibroids (and more) have grown back-the largest is 4cm (subserosal and intramural). 80% of the women on my mom's side have had to have hysterectomies. My largest fibroids are on the left and seem to be the culprit. I'm also anemic and my cycle comes every 18 days. I meet with my OB/GYN next week to discuss but would UAE and hysterectomy be my best and only options?

It sounds like you would be a candidate for either a uterine fibroid embolization or a hysterectomy. Do you have any specific questions about uterine fibroid embolization? If you would like to consult with me or one of my partners, please call Nicki Wallace at 410-328-0000 to make an appointment.

Q : 3

I am in my 40's with fibroids about 2.3 cm but have been having heavy bleeding with small/large blood clots every month. I did D&C Hysteroscopy in June 2013 and that didn't help and my OBGYN suggested Novasure Ablation which I don't want to do so he suggested UFE that ia done by radiologist. Does this procedure really work? Is there another procedure that will get rid of fibroids completely? Also, do you do the surgery and is it only done in Baltimore?

I am hearing three questions. Does uterine fibroid embolization work for fibroid related menstrual bleeding, are there alternative procedures to treat fibroid related menstrual bleeding and where is the procedure performed? Uterine fibroid embolization has a 90 % clinical success rate for treating fibroid related heavy menstrual bleeding. Alternatives include removal of the uterus and fibroids(hysterectomy) removal of the fibroids only (myomectomy) and uterine fibroid embolization. These are the approved methods. experimental options include High Intensity Focused Ultrasound (HIFU) and percutaneous thermal ablation. Experimental options are often not covered by insurance. I perform uterine fibroid embolization at the University of Maryland Hospital and at Good Samaritan Hospital, both are located in Baltimore.

Q : 4

How many UFE(UAE)procedures would you say you have done in the course of your career?

I have been doing the procedure for 12 years. So with the conservative estimate of one procedure per week, approximately 600.

Q : 5

My wife is pregnant, but has fibroids. Can she receive surgery for the fibroids while pregnant?

Fibroids are very common. Most of the time, there is no need to operate on the fibroids during pregnancy. Most women can deliver with the fibroids in place without any problems. You should talk with your obstetrician about your concerns.

Q : 6

My wife has a 6.45 cm uterine fibroid and her doctor is recommending the removal of the uterus. My wife and I still want to have children. Are there alternative treatment options?

Fibroid tumors may or may not cause problems with fertility. A 6-7 cm fibroid is not especially large and should be easily managed with a fibroid embolization or myomectomy (a surgery where the fibroid tumor is removed, and the uterus is repaired and remains in the woman). Your wife should be evaluated by a gynecologist who specializes in one of these procedures.

Q : 7

Is there something over the counter I can buy to shrink my fibroid or is there a special diet I can follow to prevent future fibroids?

I do not know of any over the counter medications or herbal remedies that I can recommend for shrinking fibroids. I am not aware of any scientifically proven dietary associations with fibroids.

Q : 8

Is UFE typically covered by insurance? Do I need a referral from my current GYN or primary care doctor?

UFE is usually covered by insurance. The need for a referral is based on your insurance policy. If you do not have a requirement that you see you primary care doctor for a referral, then you do not need a referral to have a consultation with an interventional radiologist to discuss this treatment option.

Q : 9

I'm considering UAE for my fibroid. If this treatment makes a fibroid shrink by degenerating it, isn't that dangerous? Is it the same as a fibroid degenerating on it's own? Is it okay to let a fibroid degenerate on it's own when it outgrowns it's blood supply? I'm confused and hope you can explain.

The natural process by which the body takes a fibroid apart after menopause is called hyaline degeneration. This is the same process by which the body uses to take apart the fibroid after the fibroid embolization. As this is a natural process, it is not dangerous.

Q : 10

How can fibroids be treated without surgery?

Fibroid treatment options are 1) non-steroidal anti-inflammatory medications such as Ibuprofen. 2) hormone medications such as birth control pills. 3) uterine fibroid embolization. 4)Partial hysterectomy or myomectomy and 5) hysterectomy.

Q : 11

What is the best way to treat a fibroids? I want to have a baby and I found out that I have fibroids.

The presence of fibroids may not have any thing to do with having a baby. As up to 80% of women have fibroids, and less than 10% of women have infertility, most fibriods do not cause infertility. So most fibroids do not need to be treated. Fibroids can be discovered on your annual pelvic examination for you annual pap smear. If your doctor thinks that your uterus is enlarged, then an ultrasound or MRI examination can more clearly see if there are any fibroids.

Q : 12

Do fibroids pose a life risk? My mother is having fibroid surgery soon. How risky is the operation?

Uterine fibroids are benign, or not life-threatening tumors. There are various ways of treating uterine fibroids, and the differnt forms of treatment have different amounts of risk.


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