Center for Fibroid Care

 

 

About Us

 

The Center for Fibroid Care provides a holistic, multidisciplinary approach to manage and treat fibroid tumors. This is done through a variety of treatment methods. We offer lifestyle changes and medication as well as invasive and non-invasive surgery. We also treat many of the problems caused by fibroids including heavy bleeding, anemia, chronic pain, and infertility. 

 

Our team strives to improve your quality of life and ensure that your long-term goals for treatment are achieved.  In addition, the Center will strive to understand more about the nature of the disease and add insight through research about those most at risk for aggressive disease.

 

What are Fibroids?

 

Fibroids are benign (not cancer) growths on the muscle of the uterus (womb). These growths are made up of muscle and fibrous tissue and vary in size. They can develop in all people with a uterus. About 80 percent of people with fibroids are under the age of 50, and 70 percent are Black. There is a 50 percent chance that fibroids will cause symptoms. Symptoms may include heavy menstrual periods, reproductive issues, pain, urinary problems, bleeding, and anemia. Symptoms may vary depending on how many fibroids you have and where they are located. 

 

Our Team

 

We have an experienced multidisciplinary team that works to manage and treat fibroid tumors. The team includes surgeons, interventional radiologists, obstetricians, reproductive endocrinologists, nurses, and nutritionists. Together, we guide patients through a wide range of options to avoid having to remove the uterus. We offer minimally invasive approaches along with options to help you get the most out of treatment.

 

As we create your treatment plan, we will discuss relevant minimally invasive tools such as laparoscopic or robotic myomectomy and hysterectomy, ultrasound and uterine artery embolization (UAE) as well as medications that minimize fibroids and holistic alternatives. In addition, we are the first institution to offer an active surveillance program, where we will simply monitor the fibroids with you without any treatment. These options can help you make the most out of your health and wellness now and going forward.

 

Our team prioritizes longitudinal care and focuses on research to better understand the nature of fibroid disease and its long-term outcomes.

 

 

What can I expect?

With your help, our team will develop an individualized treatment plan, one that supports your goals for symptom management and long-term care. Before your first visit, we will send you 2 surveys: The Quality of Life (QOL) survey and a life goals survey. These 2 surveys will help us understand how your fibroid(s) is/are affecting your life and what your goals for treatment are.

 

If pregnancy is a goal of fibroid treatment, we will also help you schedule appointments with Reproductive Endocrinologist and Infertility (REI) specialists or an obstetrician (OB doctor), if needed. 

 

Focusing Research on Prevention: The LIFE Study

 

At the Center for Fibroid Care, we aim to better understand the nature of fibroid disease and conduct research to better optimize patient care and treatment options. The goal of the LIFE study (Lifestyle Intervention in Fibroid Elimination) is to study a holistic program that reduces the chance of fibroid recurrence (growing back). We enroll patients in this study after their procedure or surgery. We monitor recurrence through the use of ultrasound and through assessing symptoms.

 

Treatment Options

1. Medications

We may recommend certain medications for patients whose fibroids cause mild-to-moderate symptoms. These symptoms may include pelvic discomfort and heavy menstrual bleeding, and the goal of taking the medication(s) is to relieve pain and reduce menstrual blood flow. Please note that medications alone cannot reduce or remove fibroids. When we do recommend them, it is usually to ease symptoms in patients with small, contained fibroids.

 

Oral Contraceptives

Oral contraceptives (birth control pills) may help reduce heavy menstrual bleeding that may be caused by fibroids. These are not recommended for patients who wish to become pregnant in the near future.

 

Gonadotropin-Releasing Hormone (GnRH) Agonists and Antagonists

Gonadotropin-releasing hormone (GnRH) agonists and antagonists are medications that decrease estrogen and progesterone levels in the body. The goal of taking these medications is to shrink or reduce the number of fibroids and reduce uterine bleeding. This medication also keeps you from ovulating and stops menstrual periods. For this reason, it is not recommended for patients who wish to become pregnant.

 

Progestins

Progestin is a synthetic version of the hormone progesterone. This medication is used to thin the lining of the uterus, which helps reduce heavy menstrual bleeding caused by fibroids. Potential side effects of taking progestins include breast pain or dizziness. These symptoms usually go away after taking the medication for a few weeks.

 

Iron Supplements

Since fibroids can cause heavy menstrual bleeding and anemia, we may recommend taking iron supplements. Iron supplements work by replenishing the body’s supply of red blood cells. Side effects may include constipation. However, time-released iron supplements can reduce this side effect. Your doctor will recommend a dose that may be right for you.

 

Pain Medications

Your doctor may recommend an OTC (over the counter) nonsteroidal anti-inflammatory drug (NSAID) to help relieve mild pain. NSAIDs (such as ibuprofen or naproxen) can also reduce heavy menstrual bleeding caused by fibroids. The most common side effect of taking NSAIDs is abdominal pain. In rare cases, patients who have taken this medication for 90 days in a row or longer have developed stomach ulcers. Your doctor will develop a plan for you that recommends how often and when to take this medication.

 

 

2. Surgical Treatment Options

If your fibroid symptoms do not improve with medication, or if we suspect fibroids may be causing infertility, we may recommend surgery to remove them. At the Center for Fibroid Care, our team of surgeons perform 4 types of surgery to manage and treat fibroids. Factors to consider when choosing a procedure include your lifestyle, severity of symptoms, and any future pregnancy plans.

 

Myomectomy

Myomectomy refers to the surgical removal of fibroids. It is used to treat bleeding, infertility, pain, and pressure caused by fibroids. Myomectomy preserves the uterus. For this reason, it may be a better option for patients who wish to become pregnant. There is a chance of new fibroids growing after surgery, however, especially in patients who have multiple fibroids.

 

Our fibroid surgeons can use 1-4 procedures to remove fibroids, depending on their size, number and location. This surgery can be done laparoscopically, robotically, or through a laparotomy incision. The laparoscopic and robotic approaches are minimally invasive. Therefore, the recovery time is shortened to about 2 weeks. The laparotomy is an open surgery, so the recovery time can be up to 4 weeks.

 

Hysteroscopy

During a hysteroscopy, the surgeon inserts a thin, lighted scope through the vagina into the uterus. This allows them to diagnose and remove fibroids on the inner wall of the uterus. A hysteroscopy can be done using local or general anesthesia. A hysteroscopy is an outpatient procedure which means you do not stay overnight in the hospital. Recovery time takes anywhere from 1–3 days, depending on the number, size, and location of the fibroids.

 

Laparotomy Incision Surgery

A laparotomy is done using general anesthesia. This surgery is recommended for patients with large fibroids, multiple fibroids, or fibroids that have grown into the wall of the uterus. During a laparotomy, the surgeon will make an abdominal incision (cut) that is several inches long to remove fibroids. This procedure requires a stay of 1–2 nights in the hospital. Recovery time is approximately 4-6 weeks.

 

Hysterectomy

Hysterectomy is the removal of the uterus with surgery. It is the only treatment that prevents fibroids from coming back. We usually recommended it for patients whose fibroids are causing pain and menstrual bleeding that interfere with daily life and/or for patients who do not want to become pregnant.

Hysterectomy can be performed in several ways, depending on the size, number, and location of the fibroid or fibroids. There are 4 different types:

1. Laparoscopy (open surgery) in which a lighted scope and other instruments are inserted through small abdominal incisions

2. Robotic, laparoscopy (minimally invasive)

3. Vaginal surgery in which the uterus is removed through the vagina.

4.Laparotomy (open surgery) through an incision reserved for fibroid uteri that are very large

 

A hysterectomy may require a 1–2 night stay in the hospital, depending on which type of hysterectomy is performed. Recovery time is usually up to 2 weeks for minimally invasive surgery and up to 4 weeks for open surgery.

 

3. Non-Surgical Treatment Options

Endometrial Ablation

Endometrial ablation is a procedure which eliminates the lining of the uterus, which is needed for fertility. For this reason, it is not recommended for patients who wish to become pregnant. Endometrial ablation may be recommended for patients who have heavy menstrual bleeding.

 

Endometrial ablation is done as an outpatient procedure using local or spinal anesthesia. Side effects from the procedure include cramping, nausea, or a watery or slightly bloody discharge. Recovery may take anywhere from 2 days to 2 weeks. This depends on the number, size, and location of the fibroids. 

 

Transcervical Radiofrequency Ablation (Sonata)

Transcervical radiofrequency ablation (Sonata) is an incision-free procedure. It uses an ultrasound to guide a laser into each fibroid. The Sonata Treatment device delivers radiofrequency energy. This type of energy shrinks fibroids and reduces related symptoms. Multiple fibroids can be treated during the procedure. The fibroids are treated from inside the uterus, so there are no incisions. No tissue needs to be cut or removed with surgery. The best candidates for this procedure have a few fibroids with each one measuring less than 6 cm.

 

Focusing Research on Prevention

 

The LIFE Study

At the Center for Fibroid Care, we aim to better understand the nature of fibroid disease and conduct research to better optimize patient care and treatment options. The goal of the LIFE study (Lifestyle Intervention in Fibroid Elimination) is to study a holistic program that reduces the chance of fibroid recurrence (growing back). We enroll patients in this study after their procedure or surgery. We monitor recurrence through the use of ultrasound and through assessing symptoms.

 

Contact Information 

For more information about the Center for Fibroid Care, please call 646-754-3106 or visit www.nyulangone.org/centerforfibroidcare

 

 

 

©2022 NYU Langone Health. All rights reserved. Reviewed for health literacy. This information is not intended as a substitute for professional medical care. Always follow your health care provider's instructions.