Fibroid and Minimally Invasive Gynecologic Surgery
Fibroid and Minimally Invasive Gynecology
Our highly experienced team of board certified specialists provide a unique, patient-centered approach to diagnose and treat uterine fibroids and other gynecologic problems. We also specialize in less invasive procedures that can help preserve a woman’s fertility.
Our office is conveniently located at:
30055 Northwestern Hwy, Suite 270
Farmington Hills, MI 48334
Carolyn Clifford's Warning for Women with Uterine Fibroids
The Warning Signs of Uterine Fibroids
We understand that your individual situation is different and requires a personalized care plan that fits your needs. Together, we will discuss treatment options, including watchful waiting, medical therapy and surgery, to create a care plan that meets your medical goals and helps promote long term health.
Our specialists provide a complete range of services for the following:
- Abnormal uterine bleeding and heavy menstrual bleeding
- Ovarian cyst
- Overgrowth of the uterine lining (Hyperplasia)
- Pelvic pain
- Hysterectomy alternative
Our Team of Specialists
- Nick Chobanian, M.D. is the Chairman of the Department of Obstetrics and Gynecology at Ascension Providence Southfield and Novi Campuses. He is a board certified, fellowship trained gynecologist oncologist.
- Nabila Rasool, M.D. is the Director of the Division of Gynecologic Oncology at Ascension Providence Hospital Southfield and Novi Campuses. She is a board certified, fellowship trained gynecologic oncologist.
- Omar Zwain, M.D. is a fellowship trained minimally invasive gynecologic surgeon with Ascension Medical Group. He is board certified in Obstetrics and Gynecology.
- Denis R. Lincoln, M.D. is board certified by the American Board of Radiology and is the section Chief of the Musculoskeletal Radiology Department at Providence Hospital.
- Matthew L. Osher, M.D. is board certified and fellowship trained in Interventional and Diagnostic Radiology.
- Adam Forman, M.D. is a board certified, fellowship trained Hematologist and Oncologist at Ascension Providence Hospital.
Fibroids are benign tumor-like growths in the muscle walls of the uterus. There are several different types, classified by where they grow:
- Just below the lining of the uterus (submucosal)
- In the middle of the uterine wall (intramural)
- Under the outer covering of the uterus (subserosal)
- On a stalk either inside or outside the uterus (pedunculated)
Fibroids are often the cause of heavy menstrual bleeding, pelvic pain and pelvic pressure and are most commonly diagnosed in women ages 40 to 44. In rare cases, depending on the location of the fibroids, they may interfere with a woman’s ability to become pregnant.
Fortunately, there are several treatment options that can help suppress, shrink or remove fibroids altogether.
When is surgery needed?
In many women, fibroids cause no symptoms and do not require any treatment. Some women may choose to have treatment because they are bothered by discomfort from fibroids or by consequences such as bladder pressure. However, the only fibroids that actually require treatment are those that cause medical problems, such as severe bleeding and anemia and uncontrollable cramping with bleeding.
There are a number of approaches for treating fibroids, including medications, surgical procedures and even some newer non-invasive and nonsurgical techniques. The location, number and size of your fibroids will play a role in determining which method is best for you.
Uterine fibroid embolization (UFE) is a nonsurgical technique that cuts off the blood supply to fibroids, thereby causing them to shrink and die. Shrinkage continues over 3 to 6 months. UFE is usually performed by an interventional radiologist.
Minimally Invasive Procedures
Laparoscopic myomectomy: By using a robotic-assisted platform, a slender telescope is inserted through the umbilicus to view the internal organs. From there, other instruments are inserted through the quarter-inch incision to accomplish cutting and maneuvering of the fibroids.
Hysteroscopic myomectomy: A technique that requires no incisions and is available to only women who have submucosal fibroids. The hysteroscope is a slender telescope that is inserted into the uterus through the cervix. The surgeon then uses a hysteroscope with an electric cutting device, called a resectoscope, to remove the fibroid. Hysteroscopic myomectomy has been shown to be 90% effective for reducing heavy bleeding and 50% effective in restoring fertility in women whose fibroids rendered them infertile. Recovery usually takes only one or two days.
Open Surgical Procedures
Abdominal myomectomy is open surgery using a four to six-inch “bikini” incision in the lower abdomen and another incision in the uterus to gain access to the fibroids.
Hysterectomy is the removal of the uterus. Because it is a major surgery, hysterectomy has greater risks of complications such as infection, anesthesia complications and possible injury to other organs. It also involves the longest recovery periods. Hysterectomy eliminates the chance that new fibroids will recur, and of course, it also eliminates the possibility of bearing children.
Abnormal Uterine Bleeding
Women vary greatly in their menstrual cycles. Adolescents in particular may have tremendous variability in their cycles until their hormone levels balance out after several years of menstruation. Abnormal uterine bleeding is defined as:
- Having a period less often than every 35 days
- Having a period more often than every 21 days
- Bleeding or spotting between periods
- Bleeding very heavily (menorrhagia), that is, saturating a pad or tampon hourly for more than several hours
Heavy Menstrual Bleeding (Menorrhagia)
Menorrhagia is the medical name for very heavy menstrual bleeding (soaking through a sanitary pad or tampon every hour for more than a few hours) that lasts longer than seven days. It is a common form of abnormal uterine bleeding.
Adenomyosis is the presence of uterine lining cells growing within the muscle wall of the uterus. It is a benign condition that is often mistaken for fibroids, but is much less common than fibroids. Adenomyosis occurs in about 10% of women.
The lining tissue of the uterus is called the endometrium. Each month (except during pregnancy) this lining is shed through the cervix and into the vagina during the menstrual period. However, some of the blood and lining cells may exit the uterus in the wrong direction, flowing up through the fallopian tubes and into the abdominal cavity. For unknown reasons, in some women these uterine lining cells may grow outside the uterus. This condition is called endometriosis. The blood and other biochemicals released by the endometriosis cells begin to irritate the surrounding tissues, which can lead to more pain.
An ovarian cyst is a collection of excess fluid in the ovary. The formation of fluid around a developing egg is a normal process in all ovulating women, but sometimes it can cause an excess of fluid, the reason of which is still unknown to doctors. The follicle containing the egg expands, forcing the ovary to expand as well, and this may be experienced as a pressure or pain in the pelvic area. On the other hand, some women do not feel the cyst at all and it may only be discovered during a routine gynecological exam.
Uterine Overgrowth (Hyperplasia)
Hyperplasia or overgrowth of the uterine lining is an accumulation of uterine lining cells that can occur when periods are infrequent or too light. The condition is also known as endometrial hyperplasia, because the technical word for lining of the uterus is endometrium.
Uterine polyps are small, benign protrusions of tissue that grow on the uterine lining (endometrium). They are overgrowths of the same kind of cells as the lining itself and may appear as finger-like projections or little mushrooms. As they grow, they become fragile and bleed, and as such, they are a common cause of abnormal uterine bleeding.