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Uterine Fibroids

Uterine fibroids are noncancerous growths that form inside, outside or within the uterus wall. In some people, they cause mild but tolerable discomfort. Others experience bothersome symptoms that disrupt daily life. If you think you have uterine fibroids, come to the experts at Virginia Mason Franciscan Health. 

Our providers regularly care for difficult-to-treat cases. We help many people feel better with medical therapies and minimally invasive procedures. You don't have to have severe uterine fibroid symptoms to get help. Our compassionate team carefully listens to your concerns and works with you to develop a personalized treatment plan.

Uterine fibroid care at Virginia Mason Franciscan Health: Why choose us?

You receive services from experienced gynecologists, nurse midwives and nurse practitioners. We provide exceptional care that helps you get relief so you can move forward with your life. 

Highlights of our program include: 

  • Accurate diagnosis: A comprehensive exam helps us confirm or rule out fibroids. We use sophisticated techniques, such as hysteroscopy, to detect fibroids from inside the uterus. We also determine whether you have conditions like endometriosis and adenomyosis that may occur in people with fibroids.
  • Personalized care: Your provider tailors fibroid treatments to your medical needs and personal goals. We offer a range of birth control options for mild uterine fibroid symptoms. For advanced cases, you may benefit from fertility-sparing options, like myomectomy, which removes fibroids while preserving the uterus.
  • Sophisticated options: When a procedure is necessary, we use techniques that are gentle on your body and offer a quick recovery. Our team includes some of the region's most experienced minimally invasive gynecologic surgeons. You may also have the option of procedures that access the fibroid through a tiny incision in your groin.

Nonsurgical fibroid treatment and a short recovery: Melody's story
Melody, a fitness instructor, gives her all to her students. But fibroid symptoms were slowing her down. She opted for uterine fibroid embolization, a nonsurgical procedure, to shrink them. After a brief recovery, she was back in the gym where she belonged. Read more about Melody's story.

Uterine fibroid symptoms

Pelvic pain is a common fibroid symptom. It may range from a dull ache to sharp pain that doesn't respond to prescription medications.

Additional signs of fibroids may include:

  • Bladder concerns, including painful, frequent urination or difficulty emptying your bladder
  • Heavy menstrual bleeding
  • Long-lasting periods
  • Lower back pain
  • Painful sex or discomfort after intercourse
  • Rectal and bowel concerns, such as constipation, hemorrhoids and painful bowel movements
  • Swollen belly that can make you look pregnant

Evaluation and diagnosis of uterine fibroids

Your provider starts by discussing your symptoms, how long you've had them and whether they affect your daily activities. 

You may also need tests. We discuss the options that are best for your needs and answer your questions. Experts then develop a comprehensive assessment plan that reflects your preferences. It may include:

  • Pelvic exam: Sometimes, we can detect abnormal growths during a pelvic exam. Your provider inserts a gloved finger into your vagina and gently presses on your pelvic organs.
  • Blood tests: This information enables us to rule out concerns like thyroid issues or complications of heavy bleeding, such as anemia.
  • Transvaginal ultrasound: Your provider passes a small ultrasound probe through your vagina to reach the uterus. This method provides detailed images of uterus tissue layers, enabling us to pinpoint the fibroids' precise size and location.
  • MRI: This test uses a powerful magnet and radio waves to detect small fibroids that might not be visible with ultrasound.
  • Hysteroscopy: We use a thin tube with a camera at the tip (hysteroscope) to check the uterus lining. Your provider passes the hysteroscope through your vagina and cervix to access the uterus without incisions.

Nonsurgical uterine fibroid treatments

Our experts treat mild or moderate uterine fibroid symptoms with medical therapies. We offer:  

  • Medication: Over-the-counter or prescription pain relievers may ease discomfort.
  • Birth control: Various birth control options, including pills, implantable devices and patches, may help. This option quiets fibroid symptoms by regulating hormone levels.
  • Gonadotropin-releasing hormone (GnRH) agonists or antagonists: These drugs shrink fibroids but can lead to bone loss. We typically recommend them as short-term therapy until you can have a procedure.

Surgery and other procedures for uterine fibroids

If medical therapies are not successful, you may need a procedure. We offer the full range of options, including:

Fertility-sparing uterine fibroid procedures

Your care may include minimally invasive options that get rid of fibroids while preserving your ability to become pregnant: 

  • Embolization: Specially trained radiologists (interventional radiologists) use real-time imaging and tiny tubes to access specific blood vessels in your uterus. They deliver substances to close the arteries feeding the fibroid.
  • Myomectomy: Minimally invasive gynecologic surgeons use small incisions and tiny instruments to access the affected area of your uterus. They then remove tissue growths and repair the uterine wall, making it possible to have a safe pregnancy. For complicated cases, you may need an open procedure with an incision similar to a cesarean section. 

Additional uterine fibroid procedures

If you do not wish to become pregnant or your family is complete, you may opt to have: 

  • Transcervical fibroid ablation: Transcervical fibroid ablation is an incisionless, fibroid treatment that preserves the uterus for patients. This outpatient procedure usually takes less than 90 minutes and uses a unique intrauterine ultrasound to locate the fibroid. The treatment delivers radiofrequency energy to shrink the fibroid over time and reduce symptoms. The fibroids are treated from inside the uterus, which means the treatment requires no incisions to the abdomen. This is a breakthrough alternative to hysterectomy and myomectomy treating a wide range of fibroid types, sizes and locations.

    Virginia Mason Medical Center currently has three attending surgeons performing this procedure including: Megan Loring, MD, Elena Wagner, MD, and Marisa Dahlman, MD. They are supported by their surgical fellows Angela Qu, DOMichelle Gruttadauria, MD, and Parisa Khalighi, MD.
  • Laparoscopic Radiofrequency Ablation (Lap-RFA):  Lap-RFA is a minimally invasive procedure recommended for premenopausal women (typically younger than 55 years old). This outpatient procedure is performed under general anesthesia and works by applying controlled heat (radiofrequency) directly into a fibroid to destroy the proteins of the fibroid tissue. The consistency of the fibroid changes from being hard to soft, causing it to shrink and be absorbed by the body over time and ultimately relieving fibroid symptoms and pain. In most cases, this option allows for women to keep their uterus and most patients report a quick recovery time. Lap-RFA requires only three small incisions, one in the belly button, one above the bikini line and one small incision that does not typically leave a scar by the bikini line. 

    Virginia Mason Franciscan Health is proud to be the first to offer Lap-RFA in the South Sound region at St. Anthony Hospital in Gig Harbor by Irene Grias, DO. Dr. Grias is a board-certified obstetrician and gynecologist (OB/GYN) who is fellowship-trained in minimally invasive gynecological surgery (MIGS).
  • Endometrial ablation: Interventional radiologists access your uterus through a blood vessel. Using a tiny heat source, they create scar tissue on the top layers of the uterus. Surgeons also perform this treatment using hysteroscopy.
  • Minimally invasive hysterectomy: Surgically removing the uterus offers permanent relief from fibroid symptoms. But our record of success with embolization and myomectomy means fewer people need a hysterectomy.

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