Women struggling with fibroids often face challenges when they try to become pregnant. Fibroids can make conception difficult, they can cause miscarriages and preterm labor. Many times they have waited too long and hysterectomy is the only option for treatment as there is no uterus left to salvage. It’s important that women are aware of the risks and seek treatment early, before extensive damage occurs.
LOOKING FOR THE BEST TREATMENT FOR FIBROIDS
A popular approach is to “watch and wait”. This is an outdated method as fibroids can grow very fast and it becomes harder to repair and preserve the uterus for fertility. Fibroids can obstruct fallopian tubes or the cervix making it harder for women to get pregnant. Fibroids that grow within the uterine lining, or develop within the muscle, can distort the uterine cavity. Removal of fibroids that distort the uterus dramatically reduces the risk of miscarriage.
Some medical professionals recommend uterine fibroid embolization, which can be appealing to women due to the non-invasive nature of the approach. This procedure however has limitations. In younger patients, long-term control is limited: additional fibroids can grow or the fibroid that was embolized could re-establish a blood supply. Embolization can also affect implantation of the embryo into the lining of the uterus where the baby grows. Read more in this WTOP article.
When it comes to surgical treatment, it should be performed by a laparoscopic specialist, with minimally invasive approach. With advanced surgical techniques like LAAM myomectomy, fibroids any number and size can be removed laparoscopically, in outpatient settings, and recovery is less than 2 weeks. The LAAM technique allows surgeons to feel the fibroids, even those localized deep in the muscle of the uterus, so they can be removed. Thorough removal is important to achieve long-term relief from symptoms and to increase the chances of a healthy pregnancy.
CIGC PATIENTS TALK ABOUT THEIR JOURNEY WITH FIBROIDS
CIGC patient Tonya suffered for years from fibroids and adenomyosis, and her symptoms got progressively worse.
“One month, I was hemorrhaging, and then all of a sudden, the bleeding stopped but the pain didn’t. I remember being in the house, and I was very weak. I was very anemic. I walked across the street to a Starbucks, I thought I needed something to eat. As soon as I was in Starbucks, I had to sit down, because I was feeling really dizzy, and really shaky. I went next door to an urgent care and they had to put me into a wheelchair because I couldn’t stand any longer. After all of the tests, they determined I was dehydrated from losing so much blood.”
Endometriosis symptoms can start as early as teen years and are often dismissed by medical professionals. It currently takes an average of 10 years for a woman to get diagnosed. Talking about the condition to increase awareness and educate the medical community is essential to help women manage the disease. Early diagnosis is important to help achieve a better quality of life and maintain the ability to conceive. Although there is no cure, hysterectomy has proven to alleviate symptoms and is often considered as treatment.
“I had a complete laparoscopic hysterectomy. After surgery with Dr. Danilyants I could tell this time was different. Nothing is slowing me down now, it doesn’t seem like I’m juggling a lot of things. I feel jubilant! Now, I can do anything! ” said Dorran, after her surgery with Dr. Natalya Danilyants. You can read her story here.
“In October 2013 I had my last surgery to remove scar tissue and endometriosis excision to prepare for IVF. I look over to my son Landon right now tearing up and smiling. We are beyond blessed with a beautiful healthy baby boy.” said Janelle, who was able to conceive after minimally invasive endometriosis excision. You can read her story here.
Dr. Valinda Nwadike, Maryland based OBGYN, has been referring patients to CIGC for years. When she needed to undergo a hysterectomy herself due to fibroids, she chose the DualPortGYN approach.
“Even though I had these symptoms for a few years (heavy bleeding, anemia, and fatigue), I didn’t want to have to take time off of work. I’m a doctor, I’m a mother, and I run. I’m always very active.”
“At work, a nurse on labor and delivery told me she had a robotic procedure with five incisions. LAVH is four incisions. With DualPortGYN there are only 2 incisions and they are practically invisible now. When I went back to work I was showing my colleagues and they couldn’t believe I was walking in the hallways. It really didn’t feel like I had surgery.”
“I would recommend DualPortGYN to anyone. It is the procedure women deserve. It’s revolutionary. If you laid out all the types of hysterectomy that women can have side by side, why wouldn’t you choose this? I was showing my teeny incisions to my colleagues and they were amazed. They all have the CIGC number now and are making appointments.”
The DualPortGYN approach was developed by Dr. Paul MacKoul MD and Dr. Natalya Danilyants MD to improve surgical outcomes and shorten recovery time for patients. The two 5 MM incisions are virtually invisible once they heal, and women are usually back to work within 1 week. You can hear more about the technique from our patients: Women Talk About DualPortGYN
To discuss your hysterectomy surgery, call 888-SURGERY or contact us online to schedule an appointment.
Years ago Washington DC area radio host Chilli Amar lost her mother and grandmother to ovarian cancer. It’s important that women whose immediate family developed ovarian cancer consider genetic testing, as they are at a higher risk to develop the disease. Chilli was genetically tested for mutations in her genes so she can make an informed decision about her health.
“I wanted my story to be different than my mom’s.” Amar said. “The genetic testing showed that I am positive for the BRCA-2 mutation.”
Chilli decided that preventative surgery is the best path for her to take. She spoke candidly in a Washington Post article about her decision to have a complete hysterectomy, to eliminate the risk of her developing ovarian cancer.
“The first time I ever thought about the surgery was when I read Angelina Jolie’s story in the New York Times and I thought how brave she was. Our stories were similar. Her willingness to be open about her procedures made me go to my doctors and ask if this was an option for me.”
“We put off things because it’s not the right time. When you have such a positive experience, you think ‘Why did I wait?’ My experience at The Center for Innovative GYN Care was incredible. I had a surgery on a Friday morning, and I was off all pain meds in three days, I wasn’t even taking ibuprofen.By the end of the first week, I was able to drive myself on an errand. I was stunned at how fast I had bounced back. You can’t even see the incisions and it’s only been 2 weeks.”
“When you hear minimally invasive, many women don’t really know what that means. I had a consultation with another doctor, and they too had said minimally invasive, 2 incisions. What sets CIGC apart is the placement of the incisions. With DualPortGYN, he doesn’t go through the abdominal muscle. He has a very unique method of performing the surgery. This is why I was driving a week out. I was doing all of those things that other women who had other types of laparoscopic surgery wouldn’t be able to for several weeks.”
“Everything was sent to Pathology, everything is clear and I have nothing to worry about. I have this complete relief because I’m no longer carrying the fear. To have had the knowledge of what I needed to do, as well as the fortune of being able to be proactive, that is relief I can’t put a price tag on. Now, I can focus on other things and truly live my life.” Chilli said.
One of the benefits of recovering quickly after her DualPortGYN hysterectomy was being able to play with her son and pick him up soon after the surgery.
“I didn’t want to have to miss out on time with Donato while I was home. I was doing this so I can be a mom for a long time, so being able to enjoy that time with him soon after surgery was wonderful.”
TALK TO CIGC
To discuss your hysterectomy surgery with a CIGC physician, call 888-SURGERY or contact us online to schedule an appointment. With the advancement of surgical techniques, women shouldn’t still have to undergo open or more invasive hysterectomies, with up to 6-8 weeks recovery time. Patients travel to the Washington DC are from around the country through CIGC’s travel program to benefit from an advanced surgery, with faster recovery. After DualPortGYN hysterectomy, women are usually back to work within 1 week.
CIGC’s hysterectomy patient from Maryland – Tracy J. – was struggling with fibroids that caused severe GYN symptoms. Tracy had not been sick before and she first ignored the signs when she first experienced pain and discomfort back in 2012. As years passed, she became extremely anemic due to very heavy bleeding and developed a small embolism in her leg that could have been fatal.
“The day I had to call my family and tell them that I was in the hospital with a blood clot, the hospital staff kept telling them that I could have died, which didn’t help their fears. I had an 8-week course of iron infusions. I had a baseline of 5. It’s supposed to be 12. I realized after that I had adapted to the amount of iron in my system.” Tracy said.
A friend spoke to Tracy about us years ago and she decided to reach out and seek surgical treatment when her symptoms got truly severe.
“At this point, I was having this horrendous bleeding, even though the clotting was managed, the bleeding was out of control and my stomach was always swollen. I now had a new job and great insurance, so I called The Center for Innovative GYN Care.”
“After the surgery, I am a one-woman marketing team, a grassroots campaign manager. I took a stack of business cards and I give them to people who I know have GYN problems. I’m happy to be here. I don’t believe in wasting a day. I’ve lost friends at young ages and have known people who have lived into their hundreds. I want to be one who lives a long life.”
Regina R. from Los Angeles, CA was diagnosed with fibroids years ago and was told she needs to have a hysterectomy. At the time, she was not ready to consider this procedure and decided to wait. She actually found a doctor in Beverly Hills, CA who said he could shrink fibroids with a tool that he had invented. When Regina went to see this doctor, he raised several red flags for her.
“He said ‘I can’t do the procedure on you, because there is literally no room in your abdomen to even put the tool in there. Your uterus is the size of 30 week pregnancy. You should have back pain, acid reflux.’ and he was looking at me in disbelief. That freaked me out. He said ‘You really need to take care of this. You can damage your kidneys. Your organs don’t have any room. The fibroids have filled in whatever space was left.’” Regina recounted.
“I drove home so upset. All of a sudden I was feeling the fibroid, whereas before this I hadn’t even noticed it. I do yoga 4-5 times per week. I was doing backbends and running around. I do power yoga for an hour and a half every day. I was doing 50 sit-ups at one point, and doing arm balances and headstands. I’ve been doing it for 6 years and I’m pretty advanced.”
“Once I got home I knew I had to take care of this. The trauma of open surgery wasn’t something I wasn’t willing to go through, especially still not having any noticeable symptoms, except that I didn’t have a flat stomach. It was pure vanity that started the whole thing. I still kept feeling like I didn’t need to do this, but at the same time I knew I did.”
CHOOSING TO TRAVEL FOR MINIMALLY INVASIVE HYSTERECTOMY
Regina’s doctor was only able to perform an open surgery, with 4-5 days in the hospital and 8 weeks recovery time. She researched her options online hoping to find a better approach and discovered CIGC.
“Reading all of the blogs and hearing these women’s testimonials, I realized I could do that. There is the expense of flying and hotel, but in the end it’s my body. My only options were open surgery here or flying to Washington, D.C. It was a no-brainer. After reading every person’s comments and blogs, and procedures, and looking up reviews on both doctors, I felt comfortable enough to say ‘I’m doing it.’ Mentally, I was now feeling the fibroid. I was ready to get it out of me and move on.” Regina said.
“I have a friend who is a gynecologist, who just told me to have the open surgery in LA. She said there was no way they could remove a uterus that big laparoscopically. My husband is good friends with her husband, and he was at their house prior to it. She kept saying ‘There’s absolutely no way they can do that. Don’t let her go!’ My husband stood firm saying ‘She’s done her research, I trust her and back her up.’”
LAPAROSCOPIC HYSTERECTOMY WITH DUALPORTGYN AT CIGC
With the DualPortGYN technique, minimally invasive hysterectomy can be performed for a uterus up to 20 pounds. Because of the minimally invasive approach, only two 5 MM incisions, recovery is minimal – 7 days. DualPortGYN hysterectomies use a specialized technique called retroperitoneal dissection that helps control blood loss and maps the pelvic cavity so the surgeon is able to fully visualize the pelvis.
“Open surgery was never even discussed. He does this surgery all the time, and it was business as usual. The phone consultation was very direct. I wanted someone straightforward for whom this kind of surgery is no big deal. I want to be one of a thousand, not one of a few.”
“The surgery was complex. When Dr. MacKoul came back in to talk to me he said that the ureter was wrapped around the uterus on both sides and some of the other organs were on top of it. I definitely needed to take care of it. It was remarkable. I obviously had a stomach, but I didn’t realize that the fibroid was going past my hipbone or my rib cage. It was the shape of a giant jellybean. After the surgery, my stomach is totally flat now.”
HAPPY WITH HER DECISION TO TRAVEL FOR SURGERY
The decision to travel for surgery is not an easy one to make, especially when family and friends have their doubts and try to change your mind. Regina however felt confident in her choice and went all the way. She recovered quickly after her laparoscopic hysterectomy, with very limited pain.
“I’ve been taking it easy, I’m basically back to normal, I didn’t really take any pain medication except to go to sleep the first couple of nights home. I’m totally feeling fine! People come to see me and it’s so weird because you don’t look like you’ve had surgery! I keep forgetting that I’ve had major surgery, you feel the incision a little bit, but it’s not anything that keeps me from doing anything.”
“Coming from a large city in LA where you can find an expert on everything, and having family and friends not understanding why I was going literally across the country for this procedure, my family especially was very uneasy. We are used to having everything within driving distance and even when I explained it to them, they couldn’t understand.”
“As the time got closer, it was a mental thing, I hadn’t met the doctor in person, I haven’t been to this hospital before, of course you get nervous. However, from the time that I called, to get information, to get my insurance approved, to speaking to the doctor, to having Emily call me and schedule the surgery, to the follow-ups for the lab work I needed, to the email communication, everything was so professional and so perfect. I didn’t have to worry about thinking about anything. The only thing I had to worry about was getting a flight and getting a hotel room.”
BOOK A CONSULT
If you would like to discuss your DualPortGYN hysterectomy with a CIGC specialist Dr. Paul J. MacKoul or Dr. Natalya Danilyants MD, call 888-SURGERY or contact us online. The Center for Innovative GYN Care has offices in Bethesda, MD, Annapolis, MD and Reston, VA. Patients who reside outside the Washington DC area travel to CIGC through our travel program.
Q. What is the recovery time after DualPortGYN procedures and what are common complications?
A. DualPortGYN gives you the fastest recovery possible. We’ve done thousands of these cases including a very large study in a local hospital which shows that the recovery time on average is 7 days back to work. That can be for a uterus the size of a grapefruit to a uterus the size of a watermelon. Recovery is typically 7 days and it can be 10 days with more extensive procedures. When you talk about robotic surgery it’s 2-4 weeks and with open it’s 6-8 weeks. The complication rate is the lowest possible compared to the other procedures.
“I had fibroids for 2 years and I had a GYN who was very laid back about them. I was trying to conceive. After about a year, the fibroids were clearly a problem. I switched doctors, but that doctor had the exact opposite advice, saying I needed surgery right away, I was infertile, and she was really harsh about it. She said I would need an open procedure, and that if I wanted to get pregnant down the line I would need to take 6-8 weeks off.” said Anne from Omaha, NE.
Anne had been dealing with fibroids for several years, and they were affecting her ability to get pregnant. She could not find the options she was looking for close to home, and decided to research fibroid removal procedures online. She found that a minimally invasive myomectomy for fibroids of any number and size, is possible at The Center for Innovative GYN Care.
Anne decided to travel to the Washington DC area for the innovative LAAM procedure developed by CIGC’s Paul MacKoul MD and Natalya Danilyants MD. She wondered if she will be a candidate as she had 13 fibroids to be removed. Anne had a successful laparoscopic myomectomy and was back to normal within days.
“After 10 days I was back to normal. No complications, no severe pain. I was working out after 2 weeks. I have my abs back now. I didn’t realize how uncomfortable I was until after I had the surgery. I literally feel like a concrete block has been removed from my abdominal area. I’m back to normal, but better than normal used to be.”
Pelvic adhesions (scar tissue) are usually caused by multiple pelvic/abdominal surgeries, infection, or endometriosis. Scar tissue can grow between two organs in the pelvic area making them stick together. These pelvic adhesions can occur around the bladder, bowel, ureter, uterus and ovaries. They are also more common after open surgery than laparoscopic surgery.
This scar tissue can be completely asymptomatic and not cause any problems. However, when it causes infertility, pain or gastrointestinal problems, such as bloating and constipation, surgical resection should be considered. Thorough resection of pelvic adhesions is essential in order to relieve pain and avoid new adhesions to form.
Pelvic adhesions can involve different organs:
Bladder adhesions: these usually form after cesarean delivery. Multiple cesarean deliveries lead to dense adhesions between the bladder and the uterus. In order to avoid recurrent adhesions and pain, removal of the uterus through laparoscopic hysterectomy is recommended.
Bowel adhesions: these form after abdominal and pelvic surgeries like myomectomies, or after severe pelvic infection from a ruptured appendix or bowel injury. Careful dissection of the bowel with special scissors is required, and this should only be performed by an experienced surgeon.
Endometriosis adhesions: these can form as a result of extensive or longstanding endometriosis and can cause pain and infertility. These adhesions are usually very dense and involve important structures such as the rectum, large pelvic vessels, and ureters, they can be very difficult to resect. If the patient does not wish to preserve fertility, removal of the uterus with or without the ovaries should be considered.
Ureteral adhesions: these are adhesions around the tubes that connect the kidneys to the bladder. They are found in severe endometriosis. In rare cases, the extent of damage to the ureter from endometriosis requires ureteral reimplantation.
Resection of pelvic adhesions can be a very complicated procedure. In the hands of an unexperienced surgeon, it can result in injury to surrounding organs and a higher risk of conversion to open surgery. Laparoscopic resection of adhesions is the preferred method because it is safer and leads to less pain and faster recovery for the patient. Patients with severe endometriosis should seek care from a surgeon that is experienced in advanced laparoscopic procedures. Gentle handling of the tissue, minimal blood loss, and minimally invasive surgery decrease the risk of adhesion formation.
The Center for Innovative GYN Care has offices in Bethesda, MD, Annapolis, MD and Reston, VA. Patients who reside outside the Washington DC area travel to CIGC for minimally invasive GYN surgery through our travel program.