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Uterine fibroids (AKA myoma(s), leiomyoma(s), leiomyomata) are the most common tumors in women of childbearing age. The fibroids are made of swirling muscle cells that grow within and around the wall of the uterus. Depending on where they grow (in the uterine cavity, within the muscle, on the outer portion of the uterus) the fibroids can cause different symptoms. These symptoms include heavy or painful periods, bleeding between menstrual periods, the feeling of pressure in the lower abdomen or pelvis, frequent urinating or the urge to urinate, painful sex and low back pain. Fibroids have been associated with infertility, miscarriage and pre-term labor and
delivery.

African American woman are at three- to five-times greater risk for fibroids, as are over-weight and obese women. Pregnancy and hormonal birth control tend to decrease the risk of fibroids. Fibroids are estrogen dependent; therefore they do not grow significantly after menopause, but can still cause symptoms in the menopausal state.

Fibroids can lose blood supply in pregnancy (infarction) and become very painful or lead to contractions. Some women with fibroids may not be able to get pregnant naturally. Advances in non-invasive and minimally invasive surgical treatments for infertility may help some of these women get pregnant.

Women who have pain, heavy bleeding, cramping and other symptoms might benefit from treatment. Medications can offer relief from the symptoms of fibroids and even slow or stop their growth. But, once you stop taking the medicine, the fibroids often grow back.

There are several types of fibroid surgery:

Myomectomy(s) remove only the fibroid(s) and leaves the muscle of the uterus in place. This surgery is best for women who wish to maintain fertility options, as this surgery increases the risk of blood loss and blood transfusions and may require caesarean sections for future deliveries.

Hysterectomy, a procedure that removes the uterus (not including tubes and ovaries) is the only sure way to cure fibroids. If the cervix (the part of the uterus that extends into the vagina) is left behind it is called a supracervical hysterectomy. If the cervix is removed it is called a total hysterectomy. Again, the tubes and ovaries have nothing to do with a hysterectomy.

Myomectomy and hysterectomy can be performed through small incisions (called minimally invasive surgery or laparoscopy) or through large, gapping incisions either like a c-section or up and down the abdomen. Most patients with minimally invasive procedures go home the same day of surgery and can return to their normal activities of daily living within one to two weeks. Patients with large, open abdominal surgery stay in the hospital for 2-4 days and can return to their ADLs in 6-8 weeks or longer.

The daVinci robot can be used for both myomectomies and hysterectomies; however it can add up to $15000 per case.

Over 650,000 hysterectomies are done each year, mostly for uterine fibroids, with the majority of uterine surgery, over 85%, done open with large, open incisions. Many doctors will tell patients that while they may start laparoscopically, they eventually ‘open’ their patients with large incisions.

Dr. Chudacoff exclusively performs minimally invasive surgery, which not only keeps costs down but allows his patients to get back to their activities of daily living quicker and with minimal pain. He successfully performs complete laparoscopic surgery on over 99% of his patients. In fact, he has not converted a laparoscopic procedure into an open procedure in the last 5 years.