Fibroids are one of the most common causes of gynecologic complaints in women.  They are also the most common reason for hysterectomy in the United States.  Symptoms include heavy or abnormal bleeding, pain with periods, pain with intercourse and pressure on surrounding organs such as the rectum, and bladder .  Fibroids (leiomyomata) are benign in 99.9% of evaluations.  They come in all sizes and can grow in numerous areas where smooth muscle is associated with the uterus, but most commonly will grow in the lining of the uterus, the wall of the uterus or project off outside surface of the uterus which results in many of the outlined complaints.  Most leiomyomata or fibroids can be treated through minimally invasive procedures(MIS).

Fibroids which grow inside the uterine cavity and cause heavy bleeding can usually be removed through hysteroscopic techniques.  Hysteroscopy is a minimally invasive procedure which requires no incisions and only light anesthesia in the operating room.  By using radiofrequency electrodes, the fibroids can be shaved down or completely removed to restore normal menstrual flow.  In some cases, patients may ask that an ablation procedure be performed at the same time. This can be performed when childbearing is no longer desired to help reduce the continued bleeding postoperatively.

When fibroids are large and grow on the wall or on the outside surfaces of the uterus, they can become more problematic with increased bleeding, cramping, pain or pressure on the surrounding organs.  Traditionally, these were removed either through hysterectomy or abdominal myomectomy.  New technologies in the Minimally Invasively Surgical (MIS) field have allowed these fibroids to be removed through endoscopic procedures.  Dr. Wheeler has been performing myomectomies through the DaVinci robot since 2006 with high success and minimal hospitalization stays.  Most patients are discharged the day of their surgeries or early the next morning with minimal pain.  Recovery is less than one week.

Laparoscopic techniques can be used to remove simpler fibroids which grow on the external surfaces of the uterus; Dr. Wheeler has been performing laparoscopic removal of these fibroids for over 15 years by employing a morcellator to remove the fibroid through small incisions less than 1 inch in diameter.  This allows immediate discharge from the recovery room within one to two hours after surgery with minimal recovery time and pain. 

There are many modalities available for treating patients with fibroids including surgical modalities as well as nonsurgical techniques.  These may involve hormone therapy, embolization procedures and ultrasound ablation of the fibroids. These modalities will be addressed at the time of any consultation to assure that the patient is fully informed of their options and to see if these modalities are appropriate for the individual patient’s needs.