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Dedication
To the millions of women
who received an unnecessary
hysterectomy for fibroids
May their daughters and granddaughters realize that there are
options to hysterectomy for
fibroids, and may their physicians
explain those options completely,
and without bias.
Introduction
Many women suffering with uterine fibroids will be told that
they need a hysterectomy.
Hysterectomy is an option for women with symptomatic
fibroids, however it is completely unnecessary!
This guide is designed for those women who do not want to
lose their uterus, a precious organ of their bodies.
Understanding Fibroids
Fibroids are benign, non-cancerous tumors that involve the
uterus. They are the most common pelvic tumor in women.
One of every three adult women in the United States have
fibroids and up to 80% of adult African-American women have
these tumors.
Most women who have fibroids have no symptoms. These
women do not require any treatment, but it is our belief at
the Atlanta Interventional Institute that people need to be
more proactive with their own health. This often requires a
commitment to a healthier lifestyle. This approach is taking
immediate preventive measures rather than waiting for
something to break and try to fix it at that point.
This proactive, preventive approach is not only good for your
fibroid health, it is also beneficial for your overall health.
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Submucosal fibroids reside just underneath the lining of the uterus and are
responsible for the often heavy periods women with fibroids have.
Women will often report having to change pads (typically > 8/day) less than
every couple of hours and report episodes of blood gushing or flooding
out with the passage of clots (sometimes as big as her fist !).
Subserosal fibroids are located just beneath the outer surface of the uterus
and are responsible for the bulk-related symptoms that a fibroid sufferer
may experience. These fibroids grow away from the uterus and will press
on adjacent structures in the pelvis to cause these symptoms.
For example those fibroids located in the front of the uterus will compress
the bladder to cause increased urinary frequency and nocturia (waking up
at night to urinate; often multiple times each night). Those are located
more laterally will press on pelvic nerves to cause pelvic pain which can be
felt all across the pelvis, in to her lower back, hips, buttocks, and even
down her legs. Subserosal fibroids in other locations can cause dyspareunia
(painful intercourse), constipation, or hydronephrosis (blockage of the
kidney).
Intramural fibroids are found in the muscular wall of the uterus. These
tumors can grow in either direction (toward the lining or toward the outer
surface or both) and therefore have the potential to cause heavy bleeding
(like the submucosal fibroids) or bulk-related symptoms (like the subserosal
fibroids) or both.
Avoiding Hysterectomy Copyright 2015 Atlanta
Interventional Institute
Transvaginal: A gel containing condom is placed over the thin probe. Gel is
placed on the end of the condom and scanning is performed inside the
patients vagina.
Pelvic MRI scanning is another imaging tool that is used to evaluate
fibroids. This exam is performed by the patient laying flat on the MRI table.
A picture of the womans pelvic area is created by the use of magnetic and
radiofrequency waves.
Unlike a CT scanner (which looks similar to a MRI machine), the MRI images
are created without the use of x-rays. The MRI pictures are much higher in
resolution than ultrasound and are often used to better evaluate the
complete extent of the fibroids in the uterus and for the presence of other
conditions that have similar symptoms to fibroids (example: adenomyosis).
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Average time waited to seek treatment 3.6 years with 25% over 5
years.
When asked why they waited so long, over 50% did not want
hysterectomy and 75% wanted a treatment option that avoided
surgery altogether (but werent given one).
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Questions the patient should consider asking during the consult include:
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http://www.sirweb.org/patients/uterine-fibroids/
National Uterine Fibroid Foundation
http://nuff.org/
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