Uterine Fibroid Services

Fibroids are bundles of muscle and connective tissue that grow inside or outside the uterus, or within the uterine wall. Affecting up to 40 percent of women during their childbearing years, these noncancerous growths may cause heavy bleeding and severe pain.

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New fibroid remedies

At UC Irvine Medical Center, our specialists offer a variety of therapies to treat this troublesome condition. Treatment may begin with hormone therapy, non-steroidal anti-inflammatory agents and GnRH agonists. If these approaches do not bring about satisfactory results, other treatment options may eliminate the troublesome symptoms of fibroid tumors. UC Irvine Medical Center gynecologists were among the first in the country to use the following nonsurgical techniques to eliminate the symptoms of fibroid tumors while preserving the uterus:

• Myomectomy.  This procedure involves shaving individual fibroids from the wall of the uterus. There is no incision or loss of fertility. Recovery time is minimal, but there is one limitation: the procedure cannot be performed if the fibroids are inside the uterine wall or outside the uterus. In addition, the fibroids can grow back. However, 60 percent of women do not have problems with fibroids after a myomectomy.
• Uterine artery embolization. UAE entails shrinking fibroids by cutting off their blood supply. Tiny particles are delivered through the femoral artery to the two uterine arteries that nourish the tumors. As a result, the growths are deprived of their blood supply, destroying them while the uterus remains intact. Patients can expect a hospital stay of up to 48 hours to control pain. The long-term effect that this procedure will have on a woman's ability to have a child is not known.

  Minimally invasive hysterectomy

If less invasive treatments fail to eliminate fibroid tumors, a hysterectomy (surgical removal of the uterus) may be the only option. Our gynecologists are on the leading edge of a new movement toward minimally invasive hysterectomies. These procedures are still not widely performed in the United States because they require a high level of surgical expertise and specialized equipment.
Minimally invasive hysterectomies are possible due to the laparoscope - slender, fiber-optic tube equipped with a miniature camera, lights and surgical instruments. This instrument allows doctors to see inside the abdomen and gain access to the uterus, ovaries and fallopian tubes without having to make a large incision. This minimally invasive approach helps women avoid the discomfort and scarring caused by more invasive surgical approaches. Procedures include:

• Total laparoscopic hysterectomy (TLH). This operation is performed through three tiny abdominal incisions less than one-quarter of an inch in length. TLH patients usually spend one night in the hospital and are often back to a normal routine in a matter of days. They report less pain and a faster recovery time than women undergoing an abdominal hysterectomy.
• Laparoscopically assisted vaginal hysterectomy (LAVH). This procedure involves the removal of the uterus and related organs through an incision within the vagina. Only women with a wider vaginal opening, such as those who have given birth, are candidates for this procedure.

The daVinci surgical system ---a robotic device that enhances surgeons’ precision during laparoscopic procedures, is sometimes used during surgery. This advanced equipment allows doctors to work through tiny incisions with pencil-thin instruments. 

Conventional hysterectomy

The most appropriate type of hysterectomy for a woman depends on many factors, including the particular medical condition for which she is being treated. The most advantageous surgical approach should be determined through close consultation with her physician. Conventional surgical approaches usually involve a “bikini” incision across the lower abdomen. Most women are hospitalized for three to five days, followed by a six- to eight-week recovery.