To view this content you must have Adobe Flash Player installed and JavaScript enabled.
0:00:00.000,0:00:03.000
(text on screen): Fertility Authority. Your Most Trusted Source
0:00:03.000,0:00:05.000
Ask the Experts
0:00:05.000,0:00:10.000
How are fibroids diagnosed and treated?
0:00:10.000,0:00:14.000
Dr. Jenna McCarthy, South Florida Institute for Reproductive Medicine: Most of the time, fibroids are initially diagnosed on ultrasound.
0:00:14.000,0:00:23.000
And then they can be definitively diagnosed from a fertility standpoint by either a saline infusion sonogram, or an HSG.
0:00:23.000,0:00:28.000
If the fibroid is well away from the cavity, and it's not changing the shape of the cavity at all,
0:00:28.000,0:00:32.000
and it's not causing you any other symptoms, there's no reason you need to have it taken out.
0:00:32.000,0:00:37.000
So, doctors typically will recommend that you have the fibroid taken out if it's changing the shape of the cavity,
0:00:37.000,0:00:41.000
or if it's causing some of the other symptoms.
0:00:41.000,0:00:43.000
Fibroids are typically removed one of two ways.
0:00:43.000,0:00:47.000
You can either have them removed by having a surgery, either laparoscopically
0:00:47.000,0:00:52.000
or an open surgery where they make an incision in the belly, and have the fibroids removed.
0:00:52.000,0:00:57.000
Alternatively, fibroids that are completely within the cavity can sometimes be removed vaginally.
0:00:57.000,0:01:03.000
It depends on where the fibroid is. So, let's start with a large fibroid that's large enough that it's changing the shape of the cavity.
0:01:03.000,0:01:10.000
That type of fibroid might be removed laparoscopically, which is a couple of small incisions on the belly, nothing big.
0:01:10.000,0:01:15.000
The procedure is usually performed as an outpatient procedure, which means that you can go home the same day,
0:01:15.000,0:01:20.000
sleep in your own bed, take your pain medicines yourself, instead of having to be in the hospital.
0:01:20.000,0:01:26.000
The healing time from that is typically two to six weeks, depending on the woman and how active she is.
0:01:26.000,0:01:30.000
And then we usually ask you to wait three months before trying to get pregnant.
0:01:30.000,0:01:35.000
Some doctors will err on the side of caution and say as much as six months before trying to get pregnant.
0:01:35.000,0:01:41.000
And then, typically, if the fibroid that was removed was large enough that we actually went all the way through the wall
0:01:41.000,0:01:45.000
of the uterus to take it out, we'll recommend a c-section for delivery,
0:01:45.000,0:01:51.000
to help prevent the chance that the scar that's left in its place doesn't pop open during labor.
0:01:51.000,0:01:57.000
The other way to remove fibroids is hysteroscopically, or vaginally. Those are fibroids that are completely within the cavity.
0:01:57.000,0:02:02.000
So, basically, they can put a little camera inside the uterus and look around; you can see the whole fibroid.
0:02:02.000,0:02:08.000
Those, the recovery time is even faster. The surgery itself, again, is outpatient. You go home the same day.
0:02:08.000,0:02:11.000
The pain is much, much less associated with it.
0:02:11.000,0:02:15.000
Most women are back to work within a week to two weeks. Some women don't even need that much time.
0:02:15.000,0:02:19.000
And we usually don't ask you to wait more than one normal period before you try and get pregnant.
0:02:19.000,0:02:26.000
And neither of the two surgeries make it so that you can or cannot have fertility treatments.
0:02:26.000,0:02:29.000
Some gynecologists are extremely skilled at removing fibroids.
0:02:29.000,0:02:37.000
Other gynecologists prefer to refer those patients to either a reproductive endocrinologist or a minimally invasive surgeon.
0:02:37.000,0:02:45.000
The advantage to doing that is most REs and minimally invasive surgeons are trained in doing laparoscopic myomectomies.
0:02:45.000,0:02:50.000
The difference between a laparoscopic myomectomy and an abdominal myomectomy is the recovery time.
0:02:50.000,0:02:55.000
With a laparoscopic, most women, really, are up and around and doing for themselves in about two weeks.
0:02:55.000,0:03:00.000
It may be six weeks before they feel 100 percent, but they're usually at 80 percent or better by two weeks.
0:03:00.000,0:03:05.000
With an abdominal myomectomy, you've actually gone through the big muscles of the abdominal wall,
0:03:05.000,0:03:12.000
so, just like a c-section or any other major abdominal surgery, it takes you that full six to eight weeks to feel like yourself again.
0:03:12.000,0:03:14.000
(text on screen): Fertility Authority. Your Most Trusted Source
This site complies with the HONcode standard for trustworthy health information: verify here. 