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, NYBook Online
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: 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.
FREQUENTLY ASKED QUESTIONS
Is endometriosis an infection?
No. It is not caused by a bacterium or virus. In fact, no one knows for certain how it comes about. It may have something to do with the open pathway from the inside of your uterus through your tubes and into your pelvis. Perhaps the tissue can “leak upward” and pass into your pelvis, rather than exit onto a pad or sanitary napkin. Regardless, it has nowhere to escape and continues to thrive, even invade the tissue exposed to it.
Does its ability to invade make it a cancer?
No. True, cancers invade other tissues and are abnormal and malignant, meaning they can spread and skip to other parts of your body at the expense of your normal tissue, eventually causing death. Instead, endometriosis invades locally with its benign cells, although the process is fraught with a lot of pain, suffering, and even organ dysfunction, such as problems with bladder or bowel function.
What signs and symptoms make the likelihood of endometriosis increase?
- Any pelvic pain. Emphasis on “any,” because even mild pain can mean future infertility and must not be ignored.
- Painful periods. Yes, periods can be inconvenient, but a discussion with your friends and relatives can help you draw the line between what is typical and what is unacceptable.
- Lower back pain, pain with urination, pain with bowel movements. Wherever endometriosis lands, it can cause symptoms, as above, involving ligaments, bladder, rectum, or bowel, respectively.
- Painful sex. Sex should not be painful; if it is, there is something wrong and it must be explored.
- That is, actively trying to get pregnant without success for over 6 months, or as for longer than 3 months in women over 30-35.
- Bleeding from unusual sites, such as lung (coughing up blood), rectum, bladder, or vagina. This is rare, but possible.
- Tender nodules anywhere, especially if they “flare” during your period. They can be in the soft tissue of your arms or abdomen, in muscle, or elsewhere. They have commonly been seen in previous C-section scars.
Could something else cause any of these symptoms?
Yes, but in a thorough evaluation endometriosis must be ruled out. Cancer, cystitis, hemorrhoids, uterine fibroids, adenomyosis, sexually transmitted infections, and other conditions need to be considered in anyone with any of these signs and symptoms but, still, endometriosis has to be ruled out.
How can endometriosis be ruled out? How can it be diagnosed? How should it be treated?
Endometriosis can only be confirmed surgically, which is certainly a concern, especially for doctors who emphasize a conservative approach. However, this may offer too-little, too-late for a woman fighting infertility. Today’s same-day, minimally invasive and robotic techniques, the kind in which Dr. Bozdogan is a specialist, offer the additional advantage of treating it at the same time. His state-of-the-art technology also makes possible complete excision while sparing nerves and other important structures affected by endometriosis. While some may advise giving hormone-manipulating medication to shrink endometriosis—which can be a rough ride—treating it by excising it at the same time as the diagnosis is made seems prudent. Certainly the young woman who can avoid a second surgery or a menopause-like state thrust upon her (with medication) will see definitive surgery at the same time as diagnosis as a superior approach. After all, the recovery from definitive surgery is no different from that of a diagnosis-only surgery.
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.