What are fibroids and what is a specialist who treats this condition?

Meet with Ulas Bozdogan, MD, FACOG

Endometriosis & Fibroids Specialist located in Hackensack, NJ and New York City, NY

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Fibroid (leiomyoma; pl., leiomyomata) is a swirl of fibrous tissue that occupies and interferes with the wall of your uterus (womb). It wastes space normally occupied by the muscular portion of the uterine wall, preventing it from contracting effectively; this leads to impaired ability to stop bleeding during a period and can also act as an obstruction to conception or increase the risk of miscarriage by acting as an irritant that provokes uterine contractions.

Fibroid Specialist NYC

Fibroid Specialist: Dr. Ulas Bozdogan is a specialist in diagnosing and in treating uterine fibroids. First, he is a gynecologist, board-certified by the American Congress of Obstetricians and Gynecologists; second, not only his intense interest in this condition, but also the thousands of hours’ and surgeries’ experience he has accrued treating them, eminently qualify him as a “specialist,” which becomes crucial when a woman wants to preserve her child-bearing potential. A specialist like Dr. Bozdogan uses the latest state-of-the-art technology and surgical techniques.


Is a fibroid a tumor?

Technically, yes, in that any lump, mass, or out-of-the-ordinary collection of tissue is a tumor, from the common wart to cancer. But fibroids are not malignant, i.e., are not cancer. Thus, “fibroid tumors,” as they’re sometimes called, cause problems by just being present, interfering with the normal function of the uterine wall’s layers within which they are positioned.

Where do fibroids come from?

No one knows. It may be a genetic thing. It is possible that women who develop them have had them all along—born with them—but too small to have been noticed or to have caused symptoms in the past until they reach a size that does. Many women who have no symptoms may escape detection of their fibroids only because no one checks for them.

What signs and symptoms increase the likelihood of fibroids?

    • Pelvic pain. Your uterus is poised in your pelvis in a certain position by ligaments, and fibroids add weight to your uterus, causing it to pivot. Such pulling irritates where these ligaments go, like to your back or inguinal areas.
    • Heavy periods. Because the muscular layer of your womb needs to squinch down on bleeding sites during a period to limit blood loss, and since fibroids interfere with this, your periods will be heavier and prolonged.
    • Painful periods. With more blood and menstrual debris accumulating, this stimulates stronger contractions (you feel them as cramps) to empty your uterus.
    • Urinary frequency and urgency. Your bladder cannot tell whether pressure is coming from the inside or outside of it. Therefore, a bulbous fibroid pressing on your bladder will make you think you have to urinate. It also makes likely frequent urination, as the increased pressure reaches the false sense of “fullness” sooner.
    • Urge to have a bowel movement. Just like pressure on the bladder can lead you to believe that you need to urinate, pressure on the rectum from a fibroid can lead you to have an urge to defecate.
    • Painful sex. The weight of the uterus causes it to mobilize against its ligaments more violently with the mechanical actions of intercourse. This contributes to ligament and inguinal pain that can last for days after sex
    • Infertility. A fibroid growing into the path to conception (where your tubes open into your uterus) can obstruct both an incoming sperm or a fertilized egg coming down the tube to implant in the uterus.
    • Recurrent miscarriage. Acting as an irritant, a fibroid could provoke contractions that can threaten an early pregnancy or interfere with implantation.
    • Urinary obstruction. Sometimes the fibroids can grow so large as to obstruct the flow of urine through the tubes (ureters) that take it to your bladder. This can cause urine to back up and endanger your kidney(s).
    • Cosmetic changes. When the fibroids grow so large that your uterus can no longer fit in your pelvis, it rises and can cause distention of your abdomen, just like a growing pregnancy can.

Could something else cause any of these symptoms?

Yes. Other conditions can cause some of these. For example, a condition called adenomyosis in which glandular tissue grows into the muscular layer of your uterus can cause heavier periods. An ovarian cyst can cause pain, and infection can cause painful intercourse. Pregnancy can cause abdominal distention.

How are fibroids treated?

Fibroids are fairly simple growths. Often they grow, only to stop growing at a certain size. Also, they usually grow slowly, so there is no real race to get them out unless they’re so large they interfere with kidney function or are the cause of infertility. A radiologist can thread a small tube to block the artery supplying the fibroid, which causes it to wither. Ultrasound can be focused toward them and they can also be slowed or even regress with hormonal treatment. Surgery is the definitive therapy, best done using minimally invasive technique such as the robotic approach. Today’s same-day, minimally invasive and robotic techniques, the kind in which Dr. Bozdogan is a specialist, shortens recovery time, important if fibroids are removed due to infertility. His state-of-the-art technology also makes possible complete excision while sparing the architecture of the uterus. When fertility is no longer desired, Dr. Bozdogan’s robotic approach can even perform a hysterectomy, which means a permanent removal of the uterus’ fibroids, too.

Why do fibroids sometimes come back?

Fibroids that are removed surgically can never “come back.” Most likely, when fibroids occur again it is that the tiny fibroids that were impossible to identify before eventually enlarged enough to be visible or cause symptoms.

Dr. Bozdogan prefers the surgical approach because:

      • it is successful;
      • it avoids wasting time waiting for hormones to take effect, if at all;
      • the ultrasound treatment, while seeming more conservative on first consideration, is not really a completely benign procedure, typically requiring a stay in the hospital and possible high fevers similar to the presentation of sepsis.

Why do fibroids sometimes come back?

Fibroids that are removed surgically can never “come back.” Most likely, when fibroids occur again it is that the tiny fibroids that were impossible to identify before eventually enlarged enough to be visible or cause symptoms.


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