Uterus myomatosus. 10-May-15. Clinical presentation. Incidence. Causes? 3 out of 4 women. Growth rate vary. Most common solid pelvic tumor in women

Size: px
Start display at page:

Download "Uterus myomatosus. 10-May-15. Clinical presentation. Incidence. Causes? 3 out of 4 women. Growth rate vary. Most common solid pelvic tumor in women"

Transcription

1 Uterus myomatosus A.J. Henriquez March 14, 2015 Uterus myomatosus Definition, incidence, clinical presentation and diagnosis. New FIGO classification for uterine leiomyomas Brief description on treatment modalities and what do we have available in Curacao. Should we treat asymptomatic leiomyomas and what are the recommendations for follow up. GnRH agonist use preoperatively. Is it necessary? Ulipristal: a promising new preoperative treatment modality When to suspect a uterine sarcoma Saludos, Igor Introduction Causes? Introduction Genetic changes Hormones Race Family history Higher education Incidence Clinical presentation 3 out of 4 women Most common solid pelvic tumor in women Solitary vs multiple Growth rate vary Range in size 1

2 Symptoms: Clinical presentation Symptoms: Clinical presentation Heavy menstrual bleeding Prolonged menstrual periods, > 7 days Pelvic pressure or pain Frequent urination / difficult to empty bladder Constipation Backache or leg pain Acute pain: rarely Heavy menstrual bleeding Prolonged menstrual periods, > 7 days Pelvic pressure or pain Frequent urination / difficult to empty bladder Constipation Backache or leg pain Acute pain: rarely Terminology & location Terminology & location Traditional classification Traditional classification Submucosal Submucosal Intramural Intramural Subserosal Subserosal Terminology & location FIGO classification Pelvic exam Speculum exam 2

3 Imaging Ultrasound (transabdominal / transvaginal) Imaging Saline infusion sonography 3

4 Imaging Diagnostic hysteroscopy Imaging MRI 4

5 When to treat? Medical: Myomectomy: Birth control pills Depo-provera GnRH-agonist LNG-IUD Progesterone-modulator Laparotomy Preservation of the uterus Recurrence of fibroids 5

6 Myomectomy: Laparoscopic < 6 cm, not too much, not too deep Increased risk of uterine rupture during subsequent pregnancy Myomectomy: Hysteroscopic Submucosal fibroid 1 or more tempi Uterine artery embolization: 40% reduction of the largest fibroid Quicker return to routine activities Beneficial effect on menstrual duration, dysmenorrhea Reoperation rate 30% vs 3% in myomectomy group first 5 years Pregnancy after UAE? 6

7 MRI-guided focused ultrasound surgery: Non invasive approach Ultrasound energy produces regions of cell damage / necrosis Use in research setting Hysterectomy: Last option? Fibroids leading cause of hysterectomy for larger uteri Definitive treatment 7

8 Abdominal hysterectomy Vaginal hysterectomy Laparoscopic hysterectomy Abdominal myomectomy Laparoscopic myomectomy 1 1 Hysteroscopic myomectomy Asymptomatic leiomyomas Uterine sarcoma Expectative management Small fibroids Nearing menopause Growing fibroids Desire for pregnancy in the future 2 3 cases / 1000 Rapidly growing fibroids? Endometrial biopsy MRI Uterine sarcoma Uterine sarcoma leiomyoma leiosarcoma Risk factors: Fibroid growth during postmenopausal period Age History of prior pelvic radiation Use of Tamoxifen Renal cell carcinoma syndrome Int J Womens Health, 2014 Jan 29;6:95-114, Khan AT et all 8

9 Uterine sarcoma Necessity to treat leiomyomas pre-operatively Do leiomyomas progress to sarcoma? No, sarcomas arise independently GnRH-agonists, given 3-4 months preoperatively -30 to 40% volume reduction Is it necessary to treat all patients planned for hysterectomy / myomectomy? Necessity to treat leiomyomas pre-operatively Necessity to treat leiomyomas pre-operatively Cochrane Database: Personal opinion: GnRH before surgery for leiomyomas, if Pre-and postoperative hemoglobin and hematocrit were significantly improved by GnRH agonist therapy prior to surgery Uterine volume, uterine size and fibroid volume were all reduced Hysterectomy appeared to be easier after pre-treatment with GnRH-agonist therapy Operating time was reduced Duration of hospital stay was reduced Blood loss and rate of vertical incision were reduced both for myomectomy and hysterectomy multiple or large fibroids If the uterus is huge If the Hb is low Jehovah witness To gain some time Cochrane Database Syst Rev. 2001;(2):CD000547, Lethabt et all Ulipristal (UPA): promising treatment modality? Advantages of UPA Pearl I Randomized, double blind, placebo-controlled Inclusion criteria: heavy menstrual bleeding, anemic, Iron During 12 weeks Hysterectomy myomectomy uterine artery embolization It s faster than the GnRH-agonists in reducing bleedings Significantly improves Hb and Ht in anemic patients Significant reduction in fibroid size, lasting > 6 months after treatment Better tolerated compared to GnRH analogues Estradiol levels in midfollicular range UPA 5mg UPA 10mg placebo Uterine bleeding controlled 91% 92% 19% Amenorrhea 73% 82% 6% Changes in fibroid volume -21% -12% +3% Pain reduction Headache / breast tenderness: not significantly more frequent than with placebo Drug Des Develop Ther, 2014 Feb 20; 8: , Biglia et all 9

10 Pearl II Randomized, double blind Inclusion criteria: heavy menstrual bleeding, anemic, Iron During 12 weeks Symptomatic patients 4 sequential courses of UPA 10mg Pearl III UPA 5mg UPA 10mg Lupron Uterine bleeding controlled 90% 98% 89% Median time to amenorrhea 7 days 5 days 21 days Volume reduction -36% -42% -53% Hot flashes 11% 10% 40% UPA longer sustained effect on the reduction of fibroids during 6 months, compared to Lupron Control of bleeding achieved sooner after each course Amenorrhea rate increased after every additional course With each additional course significantly more patients with fibroid reduction > 50% QoL Pain Treatment with UPA Treatment with UPA Take home message(s) Fibroids are very common among our female population Non-cyclical abdominal pain is very seldom caused by fibroids When suspecting an uterine fibroid and diagnosis is needed, ask for the size and localization of fibroids 10

11 Update in Obstetrics and Gynecology 2015 Hilton Curacao March 13-15,

Uterine fibroids (Leiomyoma)

Uterine fibroids (Leiomyoma) Uterine fibroids (Leiomyoma) What are uterine fibroids? Uterine fibroids are fairly common benign (not cancer) growths in the uterus. They occur in about 25 50% of all women. Many women who have fibroids

More information

Uterine Fibroid Symptoms, Diagnosis and Treatment

Uterine Fibroid Symptoms, Diagnosis and Treatment Fibroids and IR Uterine Fibroid Symptoms, Diagnosis and Treatment Interventional radiologists use MRIs to determine if fibroids can be embolised, detect alternate causes for the symptoms and rule out misdiagnosis,

More information

SUBSEROSAL FIBROIDS TREATMENT

SUBSEROSAL FIBROIDS TREATMENT INTRODUCTION Uterine fibroids, also known as leiomyomas, are the most common pelvic mass found in women. Fibroids are benign tumors that arise from the uterine muscular tissue (myometrium). They occur

More information

Treating heavy menstrual bleeding caused by fibroids or polyps

Treating heavy menstrual bleeding caused by fibroids or polyps Treating heavy menstrual bleeding caused by fibroids or polyps With today s medical advances the outlook for successful treatment of fibroids and polyps has never been better. You don t have to live with

More information

da Vinci Myomectomy Changing the Experience of Surgery Are you a candidate for the latest treatment option for uterine fibroids?

da Vinci Myomectomy Changing the Experience of Surgery Are you a candidate for the latest treatment option for uterine fibroids? da Vinci Myomectomy Changing the Experience of Surgery Are you a candidate for the latest treatment option for uterine fibroids? Your doctor may be able to offer you a new, minimally invasive surgical

More information

AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE

AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE UTERINE FIBROIDS A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of the Patient

More information

Considering Surgery for Fibroids? Learn about minimally invasive da Vinci Surgery

Considering Surgery for Fibroids? Learn about minimally invasive da Vinci Surgery Considering Surgery for Fibroids? Learn about minimally invasive da Vinci Surgery The Condition: Uterine Fibroid (Fibroid Tumor) A uterine fibroid is a benign (non-cancerous) tumor that grows in the uterine

More information

From this site: http://www.energeticnutrition.com /vitalzym/fibroid_tumors.html Uterine Fibroid Tumors

From this site: http://www.energeticnutrition.com /vitalzym/fibroid_tumors.html Uterine Fibroid Tumors From this site: http://www.energeticnutrition.com /vitalzym/fibroid_tumors.html Uterine Fibroid Tumors Uterine Fibroid Tumors A woman s fibroisis condition usually associated with estrogen dominance. Uterine

More information

A potential treatment for your abnormal uterine bleeding

A potential treatment for your abnormal uterine bleeding TRUCLEAR System A potential treatment for your abnormal uterine bleeding Do You Suffer from Abnormal Uterine Bleeding? What is a Hysteroscopy? What is the TRUCLEAR Procedure? What Happens Before Your

More information

WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Endometriosis

WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Endometriosis Endometriosis WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 The lining of the uterus is called the endometrium. Sometimes, endometrial tissue grows elsewhere in the body. When this happens

More information

Uterine Fibroids. More than half of all women have fibroids. They are a common, benign, uterine growth.

Uterine Fibroids. More than half of all women have fibroids. They are a common, benign, uterine growth. Uterine Fibroids More than half of all women have fibroids. They are a common, benign, uterine growth. Fibroids are not a disease. Much like the genetic blueprint that determines the color of your eyes

More information

Gynecology Abnormal Pelvic Anatomy and Physiology: Cervix. Cervix. Nabothian cysts. cervical polyps. leiomyomas. Cervical stenosis

Gynecology Abnormal Pelvic Anatomy and Physiology: Cervix. Cervix. Nabothian cysts. cervical polyps. leiomyomas. Cervical stenosis Gynecology Abnormal Pelvic Anatomy and Physiology: (Effective February 2007) pediatric, reproductive, and perimenopausal/postmenopausal (24-28 %) Cervix Nabothian cysts result from chronic cervicitis most

More information

Clinical Policy Title: Leiomyosarcoma and Laparoscopic Power Morcellation

Clinical Policy Title: Leiomyosarcoma and Laparoscopic Power Morcellation Clinical Policy Title: Leiomyosarcoma and Laparoscopic Power Morcellation Clinical Policy Number: 12.03.01 Effective Date: January 1, 2015 Initial Review Date: August 20, 2014 Most Recent Review Date:

More information

Understanding Your Risk of Ovarian Cancer

Understanding Your Risk of Ovarian Cancer Understanding Your Risk of Ovarian Cancer A WOMAN S GUIDE This brochure is made possible through partnership support from Project Hope for Ovarian Cancer Research and Education. Project HOPE FOR OVARIAN

More information

Abnormal Uterine Bleeding FAQ Sheet

Abnormal Uterine Bleeding FAQ Sheet Abnormal Uterine Bleeding FAQ Sheet What is abnormal uterine bleeding? Under normal circumstances, a woman's uterus sheds a limited amount of blood during each menstrual period. Bleeding that occurs between

More information

How do I know if I need to have surgery?

How do I know if I need to have surgery? How do I know if I need to have surgery? Deciding whether or not to have surgery for your bladder, bowel and/or prolapse problems is an individual decision. The success or failure of someone else's operation

More information

Update on Abnormal Uterine Bleeding. Susan M. Sheridan, M.D., F.A.C.O.G Casper Obstetrical and Gynecological Associates Casper, WY

Update on Abnormal Uterine Bleeding. Susan M. Sheridan, M.D., F.A.C.O.G Casper Obstetrical and Gynecological Associates Casper, WY Update on Abnormal Uterine Bleeding Susan M. Sheridan, M.D., F.A.C.O.G Casper Obstetrical and Gynecological Associates Casper, WY Defining Abnormal Uterine Bleeding (AUB) Normal menstrual cycle Frequency

More information

Abigail R. Proffer, M.D. October 4, 2013

Abigail R. Proffer, M.D. October 4, 2013 Abigail R. Proffer, M.D. October 4, 2013 Topics Human Papillomavirus (HPV) Vaccines Pap smears Colposcopy Contraception Polycystic Ovary Syndrome (PCOS) Can I get pregnant? Miscarriage Abnormal Uterine

More information

HYDROSALPINX PATIENT INFORMATION

HYDROSALPINX PATIENT INFORMATION What is a Hydrosalpinx? Hydrosalpinx, derived from Greek, is a word literally meaning water tube. A Hydrosalpinx is a blocked, dilated, fluid filled-fallopian tube usually caused by a previous tubal infection.

More information

Abnormal Uterine Bleeding: Simple evaluation and management in premenopausal women

Abnormal Uterine Bleeding: Simple evaluation and management in premenopausal women Objectives Abnormal Uterine Bleeding: Simple evaluation and management in premenopausal women Provide a framework to evaluate abnormal uterine bleeding (AUB) Review medical and surgical management options

More information

Heavy periods (menstrual bleeding)

Heavy periods (menstrual bleeding) Heavy periods (menstrual bleeding) This information sheet has been given to you to help answer some of the questions you may have about heavy periods and the treatments that are available. This leaflet

More information

Frequently Asked Questions About Ovarian Cancer

Frequently Asked Questions About Ovarian Cancer Media Contact: Gerri Gomez Howard Cell: 303-748-3933 gerri@gomezhowardgroup.com Frequently Asked Questions About Ovarian Cancer What is ovarian cancer? Ovarian cancer is a cancer that forms in tissues

More information

K Raja/N Varol FPA 2013. FPA Sydney August 31 2013

K Raja/N Varol FPA 2013. FPA Sydney August 31 2013 FPA Sydney August 31 2013 Ms wilson 32 year old woman Presents with worsening, heavy menstrual and intermenstrual bleeding and pain for 6 months. Ms Wilson What is the differential diagnosis What are the

More information

Hysterectomy. What is a hysterectomy? Why is hysterectomy done? Are there alternatives to hysterectomy?

Hysterectomy. What is a hysterectomy? Why is hysterectomy done? Are there alternatives to hysterectomy? ROBERT LEVITT, MD JESSICA BERGER-WEISS, MD ADRIENNE POTTS, MD HARTAJ POWELL, MD, MPH COURTNEY LEVENSON, MD LAUREN BURNS, MSN, RN, WHNP OBGYNCWC.COM What is a hysterectomy? Hysterectomy Hysterectomy is

More information

Center for Menstrual Disorders, Fibroids and Hysteroscopic Services

Center for Menstrual Disorders, Fibroids and Hysteroscopic Services Center for Menstrual Disorders, Fibroids and Hysteroscopic Services If you experience heavy periods, there is no need to suffer in silence. And if you ve been told that hysterectomy is your only choice,

More information

Facing Hysterectomy? Learn why da Vinci Surgery may be your best treatment option for a benign gynecologic condition

Facing Hysterectomy? Learn why da Vinci Surgery may be your best treatment option for a benign gynecologic condition Facing Hysterectomy? Learn why da Vinci Surgery may be your best treatment option for a benign gynecologic condition The Condition(s): Chronic Pain, Heavy Bleeding, Fibroids, Endometriosis and/or Prolapse

More information

Understanding Your Diagnosis of Endometrial Cancer A STEP-BY-STEP GUIDE

Understanding Your Diagnosis of Endometrial Cancer A STEP-BY-STEP GUIDE Understanding Your Diagnosis of Endometrial Cancer A STEP-BY-STEP GUIDE Introduction This guide is designed to help you clarify and understand the decisions that need to be made about your care for the

More information

OB/GYN CONTEMPORARY EXPERT EXCHANGE

OB/GYN CONTEMPORARY EXPERT EXCHANGE IN ASSOCIATION WITH APRIL 2008 WWW.CONTEMPORARYOBGYN.NET CONTEMPORARY OB/GYN Translating science into sound clinical practice EXPERT EXCHANGE How to Formulate the Relationship Between the Ob/Gyn and the

More information

UNC FIBROID CARE CLINIC. Department of Obstetrics and Gynecology Division of Advanced Laparoscopy & Pelvic Pain

UNC FIBROID CARE CLINIC. Department of Obstetrics and Gynecology Division of Advanced Laparoscopy & Pelvic Pain The purpose of the Fibroid Care Clinic at the University of North Carolina is to provide up-to-date, comprehensive medical information and care for the treatment of women with uterine fibroids. We offer

More information

Abnormal Uterine Bleeding

Abnormal Uterine Bleeding Abnormal Uterine Bleeding WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 Abnormal uterine bleeding is one of the most common reasons women see their doctors. It can occur at any age and has

More information

Uterine Cancer. Understanding your diagnosis

Uterine Cancer. Understanding your diagnosis Uterine Cancer Understanding your diagnosis Uterine Cancer Understanding your diagnosis When you first hear that you have cancer, you may feel alone and afraid. You may be overwhelmed by the large amount

More information

Why would you need a hysterectomy?

Why would you need a hysterectomy? Why would you need a hysterectomy? Removal of the uterus is performed to prevent, alleviate, or treat pain, pressure, bleeding, or cancer. Each reason is described in detail in the following pages. Benign

More information

Hysterectomy. The time to take care of yourself

Hysterectomy. The time to take care of yourself Hysterectomy The time to take care of yourself The time to take care of yourself Women spend a lot of time taking care of others spouses, children, parents. We often overlook our own needs. But when our

More information

How To Perform Da Vinci Surgery

How To Perform Da Vinci Surgery Facing a Hysterectomy? If you ve been diagnosed with early stage gynecologic cancer, learn about minimally invasive da Vinci Surgery The Condition: Early Stage Gynecologic Cancer A variety of gynecologic

More information

How To Treat A Uterine Sarcoma

How To Treat A Uterine Sarcoma EVERYONE S GUIDE FOR CANCER THERAPY Malin Dollinger, MD, Ernest H. Rosenbaum, MD, Margaret Tempero, MD, and Sean Mulvihill, MD 4 th Edition 2001 Uterus: Uterine Sarcomas Jeffrey L. Stern, MD Uterine sarcomas

More information

WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Ovarian Cysts

WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Ovarian Cysts Ovarian Cysts WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 The ovaries are two small organs located on either side of a woman s uterus. An ovarian cyst is a sac or pouch filled with fluid

More information

WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Hormone Therapy

WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Hormone Therapy Hormone Therapy WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 At menopause, a woman's body makes less estrogen and she stops having menstrual periods. This is a natural stage in a woman's

More information

Once a woman has had a hysterectomy, she will no longer have menstrual periods and cannot have a child. She no longer needs to use contraception.

Once a woman has had a hysterectomy, she will no longer have menstrual periods and cannot have a child. She no longer needs to use contraception. Hysterectomy Summary Hysterectomy is the surgical removal of the womb (uterus), with or without the cervix. Hysterectomy is used to treat a number of conditions, including heavy or painful periods, fibroids

More information

What are the differences between fibroid and ovarian cyst?

What are the differences between fibroid and ovarian cyst? DR LEE KEEN WHYE MBBS (Singapore), FRCOG (U.K), FAMS (Singapore) Consultant Obstetrician & Gynaecologist Advisor, Endometriosis Association, Singapore KW Lee Clinic & Surgery For Women No. 6 Napier Road,

More information

Hull & East Riding Prescribing Committee

Hull & East Riding Prescribing Committee Hull & East Riding Prescribing Committee Guideline on Prescribing of Gonadorelin (GnRH) Analogues and Progesterone Receptor Modulators in treatment of Endometriosis or prior to Endometrial Ablation, or

More information

Summa Health System. A Woman s Guide to Hysterectomy

Summa Health System. A Woman s Guide to Hysterectomy Summa Health System A Woman s Guide to Hysterectomy Hysterectomy A hysterectomy is a surgical procedure to remove a woman s uterus (womb). The uterus is the organ which shelters and nourishes a baby during

More information

Understanding Endometriosis - Information Pack

Understanding Endometriosis - Information Pack What is endometriosis? Endometriosis (pronounced en- doh mee tree oh sis) is the name given to the condition where cells like the ones in the lining of the womb (uterus) are found elsewhere in the body.

More information

WOOD COUNTY SCHOOL OF PRACTICAL NURSING. Medical/Surgical Nursing: Reproductive

WOOD COUNTY SCHOOL OF PRACTICAL NURSING. Medical/Surgical Nursing: Reproductive WOOD COUNTY SCHOOL OF PRACTICAL NURSING Medical/Surgical Nursing: Reproductive Time: 19 Hours Theory; 1 Hour Pharmacology IV, (1 Diet Therapy - Integrated.) Placement: Nursing IV. Instructor: Toni Tennant,

More information

Laparoscopy and Hysteroscopy

Laparoscopy and Hysteroscopy AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE Laparoscopy and Hysteroscopy A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of

More information

Ovarian Cyst. Homoeopathy Clinic. Introduction. Types of Ovarian Cysts. Contents. Case Reports. 21 August 2002

Ovarian Cyst. Homoeopathy Clinic. Introduction. Types of Ovarian Cysts. Contents. Case Reports. 21 August 2002 Case Reports 21 August 2002 Ovarian Cyst Homoeopathy Clinic Check Yourself If you have any of the following symptoms call your doctor. Sense of fullness or pressure or a dull ache in the abdomen Pain during

More information

OVARIAN CYSTS. Types of Ovarian Cysts There are many types of ovarian cysts and these can be categorized into functional and nonfunctional

OVARIAN CYSTS. Types of Ovarian Cysts There are many types of ovarian cysts and these can be categorized into functional and nonfunctional OVARIAN CYSTS Follicular Cyst Ovarian cysts are fluid-filled sacs that form within or on the ovary. The majority of these cysts are functional meaning they usually form during a normal menstrual cycle.

More information

About the Uterus. Hysterectomy may be done to treat conditions that affect the uterus. Some reasons a hysterectomy may be needed include:

About the Uterus. Hysterectomy may be done to treat conditions that affect the uterus. Some reasons a hysterectomy may be needed include: Hysterectomy removal of the uterus is a way of treating problems that affect the uterus. Many conditions can be cured with hysterectomy. Because it is major surgery, your doctor may suggest trying other

More information

No Costly Hospital Stays. No Unsightly Incisions. Far Faster, Less Painful Recovery.

No Costly Hospital Stays. No Unsightly Incisions. Far Faster, Less Painful Recovery. No Costly Hospital Stays. No Unsightly Incisions. Far Faster, Less Painful Recovery. No Costly Hospital Stays. No Unsightly Incisions. Far Faster, Less Painful Recovery. Welcome to the Georgia Advanced

More information

Laparoscopic Hysterectomy

Laparoscopic Hysterectomy Any further questions? Please contact the matron for Women s Health on 020 7288 5161 (answerphone) Monday - Thursday 9am - 5pm. For more information: Royal College of Obstetrics and Gynaecology Recovering

More information

POST MENOPAUSAL BLEEDING CHECKLIST. Ultrasound. Information folder given to patient. Booking form faxed/emailed

POST MENOPAUSAL BLEEDING CHECKLIST. Ultrasound. Information folder given to patient. Booking form faxed/emailed POST MENOPAUSAL BLEEDING CHECKLIST Ultrasound Information folder given to patient Booking form faxed/emailed 1 BOOKING FORM - HYSTEROSCOPY FOR POST MENOPAUSAL BLEEDING Patient s Name: Surname: DOB: / /

More information

Gynecologic Cancer in Women with Lynch Syndrome

Gynecologic Cancer in Women with Lynch Syndrome Gynecologic Cancer in Women with Lynch Syndrome Sarah E. Ferguson, MD FRCSC Division of Gynecologic Oncology, Princess Margaret Hospital, University of Toronto June 11, 2013 Objective 1. To review the

More information

Why I don t recommend endometrial ablation

Why I don t recommend endometrial ablation Why I don t recommend endometrial ablation Endometrial ablation is a major operative procedure that: o Is ineffective because, according to all research, 40% will ultimately still need a hysterectomy,

More information

Abnormal Uterine Bleeding. Howard Herrell, MD FACOG

Abnormal Uterine Bleeding. Howard Herrell, MD FACOG Abnormal Uterine Bleeding Howard Herrell, MD FACOG Disclosures I, Howard Herrell, DO NOT have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a

More information

MINIMALLY INVASIVE SURGERY FOR WOMEN Back to Life. Faster.

MINIMALLY INVASIVE SURGERY FOR WOMEN Back to Life. Faster. MINIMALLY INVASIVE SURGERY FOR WOMEN Back to Life. Faster. Pictured above: UF gynecologists Sharon Byun, MD, Shireen Madani Sims, MD, and Michael Lukowski, MD, with the robotic surgery equipment. Make

More information

Are You at Risk for Ovarian Cancer?

Are You at Risk for Ovarian Cancer? Are You at Risk for Ovarian Cancer? A Woman s Guide Read this brochure to learn more about ovarian cancer symptoms, risk factors and what you can do to reduce your risk. ALL WOMEN HAVE SOME RISK OF OVARIAN

More information

Ovarian cysts Diagnosis and Management

Ovarian cysts Diagnosis and Management Ovarian cysts Diagnosis and Management Mr P K Athanasias MRCOG Consultant Gynaecologist St Anthony s Hospital pathanasias@gmail.com Introduction ovary is an ovum-producing reproductive organ located in

More information

The Management of Uterine Leiomyomas

The Management of Uterine Leiomyomas SOGC CLINICAL PRACTICE GUIDELINE No. 318, February 2015 (Replaces, No. 128, May 2003) The Management of Uterine Leiomyomas This clinical practice guideline has been prepared by the Uterine Leiomyomas Working

More information

Considering a Hysterectomy?

Considering a Hysterectomy? Considering a Hysterectomy? Learn more about virtually scarless surgery using da Vinci Single-Site technology { {Symptoms & Conditions: Chronic Pain, Heavy Bleeding, Fibroids, Endometriosis, Pelvic Prolapse

More information

Specialists In Reproductive Medicine & Surgery, P.A.

Specialists In Reproductive Medicine & Surgery, P.A. Specialists In Reproductive Medicine & Surgery, P.A. Craig R. Sweet, M.D. www.dreamababy.com Fertility@DreamABaby.com Excellence, Experience & Ethics Endometriosis Awareness Week/Month Common Questions

More information

Hormone Therapy with Tamoxifen

Hormone Therapy with Tamoxifen What is hormone-receptor-positive breast cancer? Many breast cancers need estrogen and/or progesterone (female hormones), to grow and spread. When breast cancer is found, the cancer is tested for two proteins,

More information

Laparoscopic Assisted Vaginal Hysterectomy

Laparoscopic Assisted Vaginal Hysterectomy Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at ChiaYi 嘉 義 長 庚 紀 念 醫 院 婦 產 科 Clinical Guideline Laparoscopic Assisted Vaginal Hysterectomy By Dr. CJ Tseng Laparoscopic assisted

More information

The main surgical options for treating early stage cervical cancer are:

The main surgical options for treating early stage cervical cancer are: INFORMATION LEAFLET ON TOTAL LAPAROSCOPIC RADICAL HYSTERECTOMY (TLRH) FOR EARLY STAGE CERVICAL CANCER (TREATING EARLY STAGE CERVICAL CANCER BY RADICAL HYSTERECTOMY THROUGH KEYHOLE SURGERY) Aim of the leaflet

More information

Menopause and Hormone Replacement Therapy

Menopause and Hormone Replacement Therapy Menopause and Hormone Replacement Therapy Daniel Breitkopf, MD Department of Obstetrics and Gynecology University of Texas Medical Branch Galveston, Texas USA Objectives Define the indications and contraindications

More information

Ovarian Cystectomy / Oophorectomy

Ovarian Cystectomy / Oophorectomy Cystectomy and Ovarian Cysts Ovarian cysts are sacs filled with fluids or pockets located on or in an ovary. In some cases, these cysts need to be removed surgically. Types of Cysts Ovarian cysts are quite

More information

Cancer of the Cervix

Cancer of the Cervix Cancer of the Cervix WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 A woman's cervix (the opening of the uterus) is lined with cells. Cancer of the cervix occurs when those cells change,

More information

Adjuvant Therapy for Breast Cancer: Questions and Answers

Adjuvant Therapy for Breast Cancer: Questions and Answers CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Adjuvant Therapy for Breast

More information

BELIEVE MIDWIFERY SERVICES, LLC

BELIEVE MIDWIFERY SERVICES, LLC , LLC TITLE: ADENOMYOSIS EFFECTIVE DATE: May, 2012 POLICY STATEMENT Adenomyosis is a common benign gynecologic disorder that any certified nurse-midwife who provides gynecologic care is likely to see on

More information

Use of Transvaginal Ultrasonography to Monitor the Effects of Tamoxifen on Uterine Leiomyoma Size and Ovarian Cyst Formation

Use of Transvaginal Ultrasonography to Monitor the Effects of Tamoxifen on Uterine Leiomyoma Size and Ovarian Cyst Formation Use of Transvaginal Ultrasonography to Monitor the Effects of Tamoxifen on Uterine Leiomyoma Size and Ovarian Cyst Formation Lisa Barrie Schwartz, MD, Nicole Rutkowski, BS, Camille Horan, RDMS, Lila E.

More information

Cancer Facts for Women

Cancer Facts for Women 2006, American Cancer Society, Inc. No.200700-Rev.03/08 The American Cancer Society is the nationwide community-based voluntary health organization dedicated to eliminating cancer as a major health problem

More information

What Athletic Trainers Need to Know About Gynecology

What Athletic Trainers Need to Know About Gynecology What Athletic Trainers Need to Know About Gynecology Mona M. Shangold,, M.D. Director The Center for Women s Health and Sports Gynecology Philadelphia, PA Main Topics Normal development and function Effects

More information

Reproductive Health Group

Reproductive Health Group Gynaecology Services & Treatments 2015 Fee Schedule Consultations - Assessment Initial gynaecology consultation 200-250 Follow-up gynaecology consultation 150-175 Initial fertility consultation *Harley

More information

Welcome to Loch Haven Center for Menstrual Disorders

Welcome to Loch Haven Center for Menstrual Disorders Welcome to Loch Haven Center for Menstrual Disorders The most common complaint that women have when they seek help from a gynecologist relates to problems with menstruation. Abnormal periods can cause

More information

I will be having surgery and radiation treatment for breast cancer. Do I need drug treatment too?

I will be having surgery and radiation treatment for breast cancer. Do I need drug treatment too? What is node-positive breast cancer? Node-positive breast cancer means that cancer cells from the tumour in the breast have been found in the lymph nodes (sometimes called glands ) in the armpit area.

More information

Breast Cancer Follow-Up

Breast Cancer Follow-Up Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Breast Cancer Follow-Up Breast Cancer Follow-Up Version 2002: Thomssen / Scharl Version 2003 2009: Bauerfeind / Bischoff /

More information

Endometriosis Obstetrics & Gynaecology Women and Children s Group

Endometriosis Obstetrics & Gynaecology Women and Children s Group Endometriosis Obstetrics & Gynaecology Women and Children s Group This leaflet has been designed to give you important information about your condition / procedure, and to answer some common queries that

More information

Timby/Smith: Introductory Medical-Surgical Nursing, 9/E

Timby/Smith: Introductory Medical-Surgical Nursing, 9/E Timby/Smith: Introductory Medical-Surgical Nursing, 9/E Chapter 59: Caring for Female Clients With Disorders of the Pelvic Reproductive Structures Slide 1 A Nurse s Role in All Reproductive Disorders Nurse

More information

Endometriosis: An Overview

Endometriosis: An Overview Endometriosis: An Overview www.bcwomens.ca Welcome to the BC Women s Centre for Pelvic Pain and Endometriosis. This handout will give you some basic information about endometriosis. It will also explain

More information

Considering a Hysterectomy?

Considering a Hysterectomy? Considering a Hysterectomy? Learn more about virtually scarless surgery using da Vinci Single-Site technology { {Symptoms & Conditions: Chronic Pain, Heavy Bleeding, Fibroids, Endometriosis, Adenomyosis,

More information

The Centre For Women s Reproductive Care HYSTERECTOMY

The Centre For Women s Reproductive Care HYSTERECTOMY The Centre For Women s Reproductive Care Baringa Private Hospital, 31 Mackays Rd Coffs Harbour NSW 2450 Harvey Ward MB ChB, BSc(Med), FCOG (SA), MMed (O&G), FRANZCOG Obstetrician & Gynaecologist Phone:

More information

Hysteroscopy. What is a hysteroscopy? When is this surgery used? How do I prepare for surgery?

Hysteroscopy. What is a hysteroscopy? When is this surgery used? How do I prepare for surgery? What is a hysteroscopy? This is a procedure where a doctor uses a thin tube with a tiny camera to look inside the uterus. There are no incisions. Saline solution is used to expand the uterus in order to

More information

Kate O Hanlan, M. D. F. A. C. O. G., F. A. C. S.

Kate O Hanlan, M. D. F. A. C. O. G., F. A. C. S. Kate O Hanlan, M. D. F. A. C. O. G., F. A. C. S. Gynecologic Oncology, Surgery and Endoscopy 4370 Alpine Road Portola Valley, CA 94028-7523 Phone: (650)-851-6669 FAX: (650) 851-9747 Regarding Ovarian Cancer,

More information

MHRI IUD Protocol. Migraine with aura Current DVT or PE History of or current breast cancer Active viral hepatitis Severe cirrhosis or liver tumors

MHRI IUD Protocol. Migraine with aura Current DVT or PE History of or current breast cancer Active viral hepatitis Severe cirrhosis or liver tumors Table of Contents A. Indications B. Contraindications C. Prior to Insertion D. Insertion E. Follow-Up Visit F. Removal G. Re-Insertion H. Complications/Side Effects I. Appendices MHRI IUD Protocol A. Indications

More information

Dysfunctional Uterine Bleeding

Dysfunctional Uterine Bleeding :{ic0fp'16 ACOFP 53 rd Annual Convention & Scientific Seminars Dysfunctional Uterine Bleeding Michele Tartaglia, DO Michele Tartaglia, DO, FACOOG, CS Assistant Professor and Residency Program Director

More information

PROVERA (medroxyprogesterone acetate) Product Monograph Page 34 of 38

PROVERA (medroxyprogesterone acetate) Product Monograph Page 34 of 38 PART III: CONSUMER INFORMATION PR PROVERA* (medroxyprogesterone acetate) This leaflet is part III of a three-part "Product Monograph" published when PROVERA was approved for sale in Canada and is designed

More information

Total Abdominal Hysterectomy

Total Abdominal Hysterectomy What is a total abdominal hysterectomy? Is the removal of the uterus and cervix through an abdominal incision (either an up and down or bikini cut). Removal of the ovaries and tubes depends on the patient.

More information

A Guide to Hysteroscopy. Patient Education

A Guide to Hysteroscopy. Patient Education A Guide to Hysteroscopy Patient Education QUESTIONS AND ANSWERS ABOUT HYSTEROSCOPY Your doctor has recommended that you have a procedure called a hysteroscopy. Naturally, you may have questions about

More information

Physician. Patient HYSTERECTOMY HYSTERECTOMY. Treatment Options Risks and Benefits Experience and Skill

Physician. Patient HYSTERECTOMY HYSTERECTOMY. Treatment Options Risks and Benefits Experience and Skill HYSTERECTOMY Physician Treatment Options Risks and Benefits Experience and Skill Patient Personal Preferences Values and Concerns Lifestyle Choices HYSTERECTOMY Shared Decision Making A process of open

More information

Acute pelvic inflammatory disease: tests and treatment

Acute pelvic inflammatory disease: tests and treatment Acute pelvic inflammatory disease: tests and treatment Information for you Information for you Published August 2010 Published in August 2010 (next review date: 2014) Acute What is pelvic inflammatory

More information

Safe and Effective Surgery for Endometriosis Including Detection and Intervention for Ovarian Cancer

Safe and Effective Surgery for Endometriosis Including Detection and Intervention for Ovarian Cancer Safe and Effective Surgery for Endometriosis Including Detection and Intervention for Ovarian Cancer Camran Nezhat,, MD, FACOG, FACS Stanford University Medical Center Center for Special Minimally Invasive

More information

Ovarian cancer. A guide for journalists on ovarian cancer and its treatment

Ovarian cancer. A guide for journalists on ovarian cancer and its treatment Ovarian cancer A guide for journalists on ovarian cancer and its treatment Contents Contents 2 3 Section 1: Ovarian Cancer 4 i. Types of ovarian cancer 4 ii. Causes and risk factors 5 iii. Symptoms and

More information

PSA Screening for Prostate Cancer Information for Care Providers

PSA Screening for Prostate Cancer Information for Care Providers All men should know they are having a PSA test and be informed of the implications prior to testing. This booklet was created to help primary care providers offer men information about the risks and benefits

More information

Surgical removal of fibroids through an abdominal incision-either up and down or bikini cut. The uterus and cervix are left in place.

Surgical removal of fibroids through an abdominal incision-either up and down or bikini cut. The uterus and cervix are left in place. What is an abdominal myomectomy? Surgical removal of fibroids through an abdominal incision-either up and down or bikini cut. The uterus and cervix are left in place. When is this surgery used? Treatment

More information

Smoking and Age of Menopause. Women who smoke experience menopause an average of 2 years earlier than women who do not smoke.

Smoking and Age of Menopause. Women who smoke experience menopause an average of 2 years earlier than women who do not smoke. Menopause Menopause Feared event To many, it indicates old age - a sign of life coming to a close. Many expect a difficult psychological adjustment to menopause (bad press, bad jokes). Menopause Effect

More information

New Medicine Recommendation for Ulipristal

New Medicine Recommendation for Ulipristal New Medicine Recommendation for Ulipristal acetate (Esmya ) for treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age Recommendation: Amber 0 - prescribing of

More information

CHAPTER 10 Uterine Synechiae

CHAPTER 10 Uterine Synechiae CHAPTER 10 Uterine Synechiae Uterine synechiae are intrauterine adhesions. They may involve small focal areas of the endometrium (Figures 10.1a e), or they can be so extensive that they obliterate the

More information

X-Plain Chemotherapy for Breast Cancer - Adriamycin, Cytoxan, and Tamoxifen Reference Summary

X-Plain Chemotherapy for Breast Cancer - Adriamycin, Cytoxan, and Tamoxifen Reference Summary X-Plain Chemotherapy for Breast Cancer - Adriamycin, Cytoxan, and Tamoxifen Reference Summary Introduction Breast cancer is a common condition that affects one out of every 11 women. Your doctor has recommended

More information

Introduction Ovarian cysts are a very common female condition. An ovarian cyst is a fluid-filled sac on an ovary in the female reproductive system.

Introduction Ovarian cysts are a very common female condition. An ovarian cyst is a fluid-filled sac on an ovary in the female reproductive system. Ovarian Cysts Introduction Ovarian cysts are a very common female condition. An ovarian cyst is a fluid-filled sac on an ovary in the female reproductive system. Most women have ovarian cysts sometime

More information

CERVICAL CANCER What every woman should know What is a cervix?

CERVICAL CANCER What every woman should know What is a cervix? CERVICAL CANCER What every woman should know What is a cervix? The cervix is the entrance to the womb from the vagina. It is the narrow, lower part of the uterus that is the passageway connecting the uterus

More information