At Ochsner, we’re on a mission to provide exceptional care for patients with uterine fibroids. Uterine fibroids can cause many problems, including heavy menstrual cycles, miscarriages, pelvic pain and pelvic pressure. You do not have to live with these problems. Ochsner Health has well-trained physicians and staff who can offer you a variety of solutions for problems linked to uterine fibroids. The Center for the Minimally Invasive Treatment of Uterine Fibroids provides access to a multidisciplinary team of specialists who collaborate to offer a range of treatment options.

To schedule an appointment for evaluation, please call 504-464-8506. You may also schedule online through the MyOchsner patient portal. This allows you to conveniently schedule your next appointment yourself.

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All patients are welcome to come to Ochsner for a second opinion on uterine fibroids. If you’d like a confirmation of your diagnosis and/or treatment plan, call 504-464-8506.

We are committed to working with providers both regionally and around the country to deliver the best possible care to their patients. We consult with referring physicians before, during and after the treatment process.

To refer a patient, contact Ochsner Clinic Concierge at:
Phone: (855) 312-4190
Fax: (504) 842-8416
Email: clinicconcierge@ochsner.org

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Attention providers: Veronica Gillispie-Bell, MD, section head of Women’s Services at Ochsner Medical Center – Kenner, recently hosted a webinar to discuss uterine fibroids. For those that attended, on behalf of our panelists, we hope you found the session informative and resourceful. The webinar provides a unique multi-disciplinary perspective into caring for patients with fibroids.

In case you missed it and would like to receive 1 CME credit for viewing: View the previously recorded Uterine Fibroid Webinar here. You may need this passcode access it: 2?MvLXW+

To earn CME credit after watching, register for the course titled “2023 Uterine Fibroid Provider Education Webinar” here.

Many women suffer from problems linked to uterine fibroids. In fact, 80% of African American women and 70% of Caucasian women will have fibroids by the time they are 50 years old. Fibroids are also very common among Hispanic women.

Fibroids are benign (not cancerous) tumors (abnormal cell growths) inside the uterus. Fibroids can be located in four regions of the uterus. They can be located in the cavity of the uterus (submucosal), within the muscle wall of the uterus (intramural), on the outside of the uterus (subserosal), or attached to the uterus by a stalk (pedunculated). Fibroids may be located in one or a combination of these areas.

The most common symptom associated with fibroids is heavy or irregular menstrual cycles. Some women may also have very painful menstrual cycles. Fibroids cause some women to feel pelvic pressure or heaviness from the weight of the uterus. Some women have pain during intercourse. If you have any of these problems, a solution may be available.

At the Center for the Treatment of Uterine Fibroids, we offer both medical and surgical treatments for fibroids. Our educated and experienced team is dedicated to finding the best treatment for you.

Depending on your symptoms, medical management may be the best way to treat your fibroids. Some treatments can control heavy menstrual cycles while others can also control symptoms related to the size of the fibroids.

• Oral Contraceptive Pills
  Oral contraceptive pills can control some of the symptoms associated with uterine fibroids. Oral contraceptives can make menstrual cycles more predictable, shorter, and lighter. Menstrual pain is often improved with the use of oral contraceptive pills.
• Levonorgestrel Intrauterine Device (IUD)
  An IUD that contains progestin can be used to treat heavy menstrual cycles. In fact, most women have little to no menstrual cycle after 3 months of use. IUDs are not recommended for the treatment of all types of fibroids. Submucosal fibroids can increase the rate of expulsion of the IUD.
• GnRH antagonists with add-back therapy
  There are two types of oral medications that can treat heavy menstrual bleeding associated with fibroids. Both medications work to decrease your estrogen and progestin production, the two hormones that feed the fibroids. Both medications work quickly and effectively.

• Tranexamic Acid
  Tranexamic Acid (TXA) is an oral medication that reduces heavy periods. It does not have hormones. It works with your clotting system to decrease bleeding. While TXA doesn’t treat fibroids directly, it does work well to decrease bleeding.

• GnRH Agonists
  GnRH agonists are injection medications given to decrease the production of estrogen. These are used as short-term treatments before surgery to help shrink the size of uterine fibroids.

Surgical Treatments that Preserve the Uterus

Medical management may not be the best treatment for all individuals with fibroids. Because of their symptoms, some may require surgical intervention. There are surgical options that preserve the uterus for childbearing and others that will allow an individual to keep their uterus but childbearing may be impacted.

A myomectomy is a procedure that removes the uterine fibroids while conserving the uterus for fertility. Fibroids may return after 2-3 years, but most people are symptom free for many years.

• Hysterectomy Myomectomy
  For people who have small submucosal fibroids, a hysteroscopic myomectomy may be a treatment option. A hysteroscopic myomectomy is an outpatient procedure. Your surgeon will place a camera through the vagina and into the uterus through the cervix. The doctor can see the fibroids and remove them.
• Robotic Myomectomy
  With robotic surgery, your surgeon can perform a myomectomy by making four small incisions each about 1 centimeter in length. This robotic system gives the doctor the visualization and precision of an abdominal myomectomy, and gives the patient the benefits of laparoscopic surgery. Those benefits include less blood loss, less postoperative pain and less scarring. Your doctor can determine if this procedure is appropriate for you based on the number, size, and location of your fibroids.

• Abdominal Myomectomy
  Patients with large or numerous fibroids may need an abdominal myomectomy. The surgeon makes a small incision above the pubic bone and surgically removes the fibroids from your uterus.

• Radiofrequency Ablation
  Radiofrequency ablation (RFA) is a minimally invasive procedure that burns the fibroids. Under ultrasound-guidance, RFA can be accomplished through the cervix or laparoscopic depending on the location of fibroids. While the uterus is preserved, there is no long-term data about pregnancy after the procedure.

Surgical Treatments that Do Not Preserve the Uterus

Those who are past their childbearing years have other surgical options for fibroid treatment: uterine artery embolization, endometrial ablation and hysterectomy.

• Uterine Artery Embolization
  Interventional radiologists perform uterine artery embolization procedures. After you are mildly sedated, the radiologist uses a slender, flexible tube to inject small particles into the uterine arteries that supply blood to your fibroids and uterus. These small particles block the blood flow to the uterus and to the fibroids. Blocking the blood flow causes the fibroids to shrink. While some successful pregnancies have been reported after this procedure, we recommend this procedure only for women who have completed childbearing.

• Endometrial Ablation
  Endometrial ablation is a treatment for heavy, prolonged vaginal bleeding. This procedure destroys the endometrial lining (the lining of the uterus). Most women who have this procedure are satisfied with the amount of bleeding that they have after the procedure. At Ochsner, we can perform endometrial ablations in the office or the operating room as an outpatient procedure.
• Hysterectomy
  During a hysterectomy, the surgeon removes your uterus and cervix. Depending on your age and your medical and family history, the surgeon may also remove your ovaries. Hysterectomy is the definitive treatment for fibroids.
  • Vaginal Hysterectomy
    Vaginal hysterectomy is a hysterectomy that is performed through the vagina. The surgeon makes no incisions on the abdomen.
  • Laparoscopic Hysterectomy
    Laparoscopic hysterectomies are performed through small incisions, each approximately 1 centimeter in length, on the abdomen. Similar to vaginal hysterectomy, there is less blood loss, less postoperative pain, and less scar tissue when compared to an abdominal hysterectomy. A laparoscopic hysterectomy can be performed even when the uterus is somewhat large.
  • Robotic Hysterectomy
    A robotic hysterectomy combines the benefits of laparoscopic surgery with the visualization and precision of an abdominal hysterectomy. These advantages allow your surgeon to perform a hysterectomy on an even larger uterus than can be accommodated with traditional laparoscopy.
  • Abdominal Hysterectomy
    For very large uteri, an abdominal hysterectomy may be the solution. The surgeon makes an incision on the abdomen and removes the uterus and cervix through the incision.