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Fibroids

Dr. Richard Rosenfield is an international expert in treatment of fibroids in Portland. He specializes in minimally invasive surgical techniques for fibroid removal. The information below provides an overview of the most frequently asked question about fibroids.

To find out more about fibroids, choose the specialists at Pearl Women's Center. Ask a question, book online, or call our office in Portland at (503) 771-1883. We serve patients from Oregon, Washington, Idaho, Northern California and Alaska.

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What exactly are fibroids?

Uterine fibroids are noncancerous tumors which develop from the muscle tissue of the uterus (womb). Fibroids vary in size, shape and location and are the most common type of pelvic growth affecting women. Fibroids can cause debilitating symptoms and often require consultation with an expert.

Can any woman get fibroids?

Yes, but fibroids most commonly occur in women 30 to 50 years of age. They are more prevalent in African American women, but any woman can get them. While cause is unclear, research suggests fibroids develop from misplaced cells present in the body before birth. Hormonal drugs like birth control pills may contribute to fibroid growth, and fibroids can grow to massive size.

What are the symptoms?

Fibroids often cause no symptoms. Other women suffer severe symptoms that significantly impact their quality of life. In women who experience symptoms, the most common include prolonged periods, heavy menstrual bleeding, pelvic pressure or pain, frequent urination, difficulty emptying the bladder, constipation, backaches, leg pain and infertility. In rare cases, fibroids may cause acute pain, nausea, fever and swelling of the abdomen.

When should I see a doctor?

You should see Dr. Rosenfield if you experience pelvic pain that doesn't go away, spotting or bleeding between periods, excessively heavy or painful periods, pain with intercourse, difficulty emptying your bladder or moving your bowels. Seek immediate care if you have the sudden onset of sharp pelvic pain or severe vaginal bleeding - saturating a "super" pad or tampon in less than one hour.

What treatment options are available?

There are many treatment options available ranging from monitoring to medications to surgical removal. Dr. Rosenfield can help you determine what is most appropriate for you. Together, you will discuss the severity of symptoms, your plans for pregnancy, how close you are to menopause and your feelings about surgery. The only proven, permanent solution to fibroids is the surgical removal of the uterus more commonly known as a hysterectomy.

Are there different surgical options for fibroid removal?

Yes. There are two main surgical approaches for fibroid removal, myomectomy and hysterectomy. Myomectomy is surgical removal of the fibroid(s) leaving the uterus in place. Dr. Rosenfield frequently recommendeds this approach for women who still want to have children. Myomectomy does not prevent new fibroids from growing and more surgery may be necessary in the event of a recurrence. The second surgical approach is hysterectomy, the only proven permanent solution to fibroids. The vast majority of women are able to retain the ovaries, responsible for hormone production.

What's the least invasive surgical treatment?

Modern gynecologic surgery offers minimally invasive options for virtually all major surgeries. We are definitely living in a new surgical landscape. Historically, surgeons performed most operations with large incisions across the abdomen, resulting in trauma to the body, pain and a long healing process. Not so today.

Advances in technology have revolutionized the surgical world, opening up new opportunities to replace large incisions with tiny ones. This is the basic concept of minimally invasive surgery or MIS. Small incisions minimize pain, cause much less trauma and allow for speedy recoveries. The new gold standard for removal of fibroids is via MIS, yet less than 40% of women in the US are aware of this option, and the majority of surgery continues to be performed with large incisions due to lack of advanced surgical training and expertise.

MIS procedures incorporate the use of endoscopic equipment such as a laparoscope to view the internal organs of a patient on a video monitor. At our center, the procedures are entirely outpatient, performed in our onsite Medicare Certified, AAAHC approved SurgiCenter. Patients go home the same day and are back to work in days, not weeks.

While robotic surgery has received a fair amount of attention lately, its role in gynecologic surgery remains controversial. Recent studies have revealed greater cost, longer surgeries, and more pain with robotic surgery as compared to laparoscopy. As an expert surgeon and educator in both techniques, Dr. Rosenfield recommends the more patient friendly and cost effective laparoscopic approach for fibroids and robotic surgery for more complex cases involving cancer.

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