How Are Fibroids Diagnosed and Treated?

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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