New Treatments Mean Fibroids Don’t Have To Weigh You Down
 
Arlene Vollin, a 46-year-old deputy sheriff in Alexandria, Va., underwent laparoscopic surgery this past fall to have uterine fibroids removed. Her fibroids were so large that she appeared 35 weeks pregnant. For 11 years, fibroids affected how much Arlene could eat at one sitting, caused sleep loss because she couldn’t sleep on her stomach or side, and she was urinating four to five times each night.

"Before I visited GW Hospital, a doctor told me my fibroids were so large it was impossible to have them removed laparoscopically,” Vollin says. “So I was extremely surprised and pleased to find Dr. Paul MacKoul and learn that he could perform such an advanced laparoscopic procedure. He was able to remove the fibroids through three very small incisions. As a result of the procedure, I have regained my normal eating and sleeping patterns, and I am free of the constant discomfort. I have my life back!”

The GW Hospital Advantage
 
“Our approach is unique to the DC region,” says Damian Alagia, MD, Program Director for Minimally Invasive Gynecological Surgery and Clinical Associate Professor of Obstetrics and Gynecology. “We have combined resources so that each patient has a team of surgeons committed to offering a spectrum of procedures that best meet that patient’s needs.”

Until recently, treatment for heavy uterine bleeding and uterine fibroids often involved a hysterectomy, an operation to remove a woman’s uterus. Today, this is just one of many options to solve these problems.

“We now can offer women a wide range of treatments to help improve their quality of life,” says James K. Robinson, MD, Assistant Professor of Obstetrics and Gynecology who is fellowship-trained in laparoscopic surgery. “When performed by an experienced practitioner, the advanced surgical techniques offered at GW Hospital can be very beneficial.”

In the past, laparoscopic removal of larger fibroids was difficult: doctors would start the procedure intending to use a small incision, but often find it necessary to make a much larger incision. Paul J. MacKoul, MD, FACOG, Director of Gynecological Oncology and Clinical Associate Professor of Obstetrics and Gynecology, has pioneered a procedure to remove even the largest of fibroids through three quarter inch incisions.

“New techniques developed at GW Hospital now allow us to remove fibroids of any size,” says Dr. MacKoul. “These techniques allow for excellent control of blood flow to the fibroids. The fibroids then are removed in pieces through the smallest incisions possible. Minimal blood loss with tiny incisions results in a very fast recovery with minimal pain. As a result, most of our patients are able to leave the hospital the same day of the surgery and are back to work within two weeks.”
 
The spectrum of treatment options for fibroids includes:

• Minimally invasive removal of fibroids or the uterus as well as ablative techniques for management of heavy periods or abnormal uterine bleeding.
  
  
• Medicines that block the production of estrogen, causing the fibroids to shrink temporarily
  
  
• Uterine artery embolization, a procedure that blocks blood flow to the fibroid, causing it to die.

To learn more about fibroid treatment options available at GW Hospital, please call 1-888-4GW-DOCS or visit www.gwhospital.com.
 
About Uterine Fibroids
 
Uterine fibroids, benign tumors found in the uterus, occur in as many as 80 percent of women annually, and they are more common in African-American women. Most fibroids are asymptomatic, but one in four women complain of aggravating symptoms, such as:

• Heavy bleeding
• Pain
• Abdominal distension
• Frequent urination
• Constipation

During the one- to two-hour procedure, an interventional radiologist inserts a catheter into the groin area through a small incision and threads it to the arteries on both sides of the uterus. The physician then injects tiny particles that will block blood flow to the fibroid, causing it to shrink or even disappear.

A one-night hospital stay is routine. Most women experience relief from symptoms and are back to normal activities soon.

“Most patients find that UAE reduces or completely relieves their symptoms,” says Anthony Venbrux, MD, Director of Interventional Radiology; Professor of Radiology and Surgery at GW Hospital. “In fact, studies have shown it to be at least 85 percent effective in providing symptom relief.”

UAE is an option for most fibroid patients; however, it typically is reserved for women who no longer wish to have children since there are no long-term studies on its effects on fertility. It may not be ideal for massive fibroids as patients may not have desired shrinkage of benign tumors. Talk with your doctor to determine if you are a candidate for UAE.

---

As seen in The George Washington University Hospital Health NewsWinter 2007.