The specialists of the Gynecology Department at Herzliya Medical Center apply their vast, integrated experience in treating uterine fibroids by utilizing the latest techniques and organ-sparing surgeries.
Our clinic specializes in all endoscopic and minimally invasive surgical procedures, guaranteeing that our patients receive the foremost professional and outstanding service.
Uterine Fibroids and Their Cause
A uterine fibroid (leiomyoma, fibromyoma) is a benign tumor that evolves from the smooth muscle tissue of the myometrium (the muscle layer of the uterus)
- Uterine fibroids are most common among women of reproductive-aged
- Uterine fibroids do not spread to other organs
- Large fibroids can cause severe symptoms like secondary infertility
- Uterine fibroids usually remain benign and have a low risk of becoming malignant
Among the main causes of uterine fibroids are:
- Genetic changes – fibroids are often hereditary with a distinct familial predisposition. Genetic testing of fibroids found hereditary mutations in some of the genes.
- Hormonal changes – the uterine lining is very sensitive to hormonal changes. Histological analysis of fibroids indicated a larger quantity of estrogen and progesterone receptors than in healthy myometrium (middle layer of the uterus).
Uterine Fibroids Symptoms
Small fibroids usually have no clinical signs and are discovered accidentally during a routine ultrasound of the uterus. The symptoms of a uterine fibroid:
- Heavy bleeding during menstruation
- Severe iron-deficiency (anemia) – as a result of the heavy bleeding
- Large fibroids may cause infertility by obstructing the connection of the fallopian tubes to the uterus or by interfering with the fetus implantation in the uterus
- Miscarriages may be caused by fibroids
Uterine Fibroids Diagnosis in Israel
Our specialists use the following methods for diagnosing uterine fibroids:
- Abdominal or transvaginal ultrasound of the uterus
- X-ray methods – hysterosalpingography with contrast and a CT scan of the pelvic organs
- MRI of the pelvic organs
- Hysteroscopy – endoscopic visualization of the uterus
- Laboratory tests: Hormones and coagulation factors
- Biopsy of the fibroid to ensure it’s benign. The procedure is performed during the hysteroscopy
Treatment of Uterine Fibroids in Israel
Following a comprehensive diagnostic process, the most effective method of treatment will be implemented by one of our specialists. In some cases, hormonal treatment (Lupron and Synarel, for example) is enough to block the effect of progesterone and estrogen on the fibroid’s receptors. Hormonal intrauterine devices are also an option and have proven to effectively shrink existing fibroids.
A rather innovative method of treating uterine fibroids is focused ultrasound waves (FUS) that destroy the fibroid’s tissue. The procedure is performed under MRI control and is a great alternative to surgical techniques or in cases where hormonal treatment was ineffective.
Minimally Invasive Treatment of Uterine Fibroids in Israel
The main goal of minimally invasive treatment methods is preserving the uterus and reproductive function of the patient, which is especially vital to young women. The OB/GYN specialists at HMC’s Gynecology Department use the following methods:
- Embolization of the uterine arteries and their branches in order to cut off the blood supply to the fibroid. The fibroid then stops growing and eventually its cells die.
- Laparoscopic myolysis – the fibroid is destroyed by a medical laser, cryotherapy or high-frequency ablation.
- Hysteroscopic myomectomy – a minimally invasive endoscopic procedure that allows the removal of fibroids from the submucosal layer of the uterus.
- Endometrial ablation and submucosal resection – significantly reduce the clinical symptoms of submucosal fibroids, which include heavy bleeding during the menstrual cycle.
Surgical treatment of Uterine Fibroids in Israel
In cases where the aforementioned methods are unsuitable for the patient, HMC can offer either of the surgical treatment options:
- Hysterectomy – complete resection of the uterus. The procedure can be performed through both laparoscopic and open surgery. It is effective in cases of multiple fibroids which are accompanied by severe clinical symptoms. In most cases, uterine fibroids do not require removal of the ovaries or postoperative hormonal treatment.
- Myomectomy – organ-sparing method, which involves only the removal of the fibroids and without affecting the patient’s fertility. This surgery is suitable in cases of several fibroids. Today, this procedure has been performed by gynecologists using the effective da Vinci Surgical System for great precision.
The vast majority of gynecological surgeries at HMC are performed laparoscopically. This method does not require a large abdominal incision, thereby significantly reducing both the risk of complications and the hospitalization period.