Also see: Inova Alexandria Pelvic Floor program

Inova Alexandria Hospital Fibroid Program

Our multi-disciplinary program draws on the expertise of both gynecologic surgeons and interventional radiologists to provide the best in fibroid treatment

The Inova Alexandria Hospital Fibroid Program offers comprehensive fibroid care for women in our community. This ongoing collaboration between gynecologic surgeons and interventional radiologists includes use of a standardized screening tool to determine the best option for every woman in need of fibroid treatment. We continually monitor our performance to ensure we provide the highest quality of patient-centered care.

What are fibroids?

Uterine fibroids are noncancerous growths that develop from the muscle tissue of the uterus that often appear during childbearing years. The size, shape, and location of fibroids can vary greatly. They may be present inside the uterus, on its outer surface or within its wall, or attached to it by a stem-like structure. Women can have only one fibroid or many of varying sizes. Fibroids may remain very small for a long time and suddenly grow rapidly over a number of years.

Fibroids and infertility

Fibroids may cause infertility, although other causes of infertility are more common. Other factors should be explored before fibroids are considered the cause of a couple’s infertility. When fibroids are thought to be a cause, many women are able to become pregnant after they are treated.

What are the symptoms of fibroids?

Many women with fibroids have no obvious symptoms and may not know that they have fibroids. Other women experience symptoms such as pain, heavy bleeding or abdominal swelling. Symptoms depend on the size and location of the fibroid, but may include one or more of the following:

Menstrual changes

• Heavy, prolonged menstrual periods, sometimes with clots
• Menstrual pain (cramps)
• Vaginal bleeding at times other than menstruation
• Anemia (from blood loss)

Pain

• Pelvic pain, pressure or heaviness that may be sharp
• Pain in the back or legs
• Pain related to sexual intercourse

Pressure

• Pressure on the bladder causing a constant urge to urinate
• Pressure on the bowel causing constipation and bloating

Other possible symptoms

• Abnormally enlarged uterus and abdomen
• Miscarriages

Types of fibroids

Most fibroids grow in the wall of the uterus. Physicians categorize them into four groups based on where they grow:

• Intramural fibroids grow within the wall of the uterus
• Subserosal fibroids grow on the outside of the uterus
• Submucosal fibroids grow in the inner lining of the uterus
• Pedunculated fibroids grow on the stalks that grow out from the surface of the uterus or into the cavity for the uterus

Treatment options

The Inova Alexandria Hospital Fibroid Program provides comprehensive care for women with fibroids. We offer many different treatment options for fibroids, including surgical and minimally invasive interventions. Some treatments preserve the uterus, while others do not.

For more information about the program call 703-504-3326.

Treatments that preserve the uterus

Hysteroscopy
During a hysterocopy, the gynecologist inserts a long, thin telescope with a light through the vagina and cervix (the opening of the uterus). The doctor then uses electricity or a mechanical device to cut or destroy the fibroids. Although it cannot remove fibroids deep in the walls of the uterus, it often can control the bleeding these fibroids cause.

Myomectomy
Myomectomy is a surgery which removes only the fibroids, not the uterus. Since the woman keeps her uterus, she may still be able to have children. This surgery is performed using a hysteroscope (a small scope inserted through the vagina and cervix), a laparoscope (a scope inserted through small incisions in the abdomen), or abdominal surgery (requiring incisions through the abdomen and the uterus). Fibroids may regrow after surgery or women may develop new fibroids. If symptoms recur, patients may require another procedure.

Uterine fibroid embolization (UFE)
UFE is a non-surgical, minimally invasive procedure performed by an interventional radiologist, a doctor who specializes in the use of imaging techniques to see inside the body and treat conditions without surgery.

The interventional radiologist inserts a catheter through a tiny incision in the skin, less than a quarter of an inch, into an artery at the top of the leg. The doctor guides it into the uterine arteries and inject tiny, round particles into the blood vessels leading into the fibroids. These particles cut off the blood supply to the fibroid. Blocking the blood flow to the fibroids causes them to shrink and alleviates symptoms. After an overnight stay in the hospital, patients are back to their normal activities within an average of 5-7 days.

Inova Alexandria Hospital’s Cardiovascular and Interventional Radiology (CVIR) program treats a variety of medical conditions without traditional surgery. The nationally recognized, board-certified interventional radiologists perform minimally invasive procedures that are generally less traumatic to patients than surgery, and result in less pain and shorter hospital stays. This CVIR team were some of the first doctors in the Mid-Atlantic region to perform uterine fibroid embolization (UFE). Inova Alexandria Hospital currently has one of the largest and most successful UFE programs in the country.

Surgical treatments that do not preserve the uterus

Hysterectomy
Hysterectomy removes the entire uterus either by a laparoscopic procedure through the vagina, or by an open surgical procedure. Uterine fibroids are the most common cause of hysterectomy in the United States.

Minimally invasive hysterectomy
Some women are good candidates for a less invasive hysterectomy. Using laparoscopic techniques, a gynecologist removes the uterus with far smaller incisions. This minimally invasive technique results in less blood loss, fewer complications and a quicker recovery.