Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Some of the reasons for surgical removal of uterine fibroids include:
If there is still concern that the uterine growth could be cancer: In
these cases, the doctor is not certain that the growth is actually a benign
fibroid. Unusually rapid growth is a sign that a uterine growth may be
cancerous. The growth must be removed and closely examined for signs of more
dangerous conditions.
If other pelvic surgery is already being done: There are other reasons for
pelvic surgery, such as ovarian disease.
If all medical treatments have failed to stop bleeding complications.
Surgery for fibroids
There are three major categories of surgery for fibroids.
Hysterectomy: Removal of the uterus is called a hysterectomy. Fibroids are
the most common reason that hysterectomies are performed in the United States.
Advantages are that: (1) the fibroids never return (the only "cure" for
fibroids); (2) the women will never have another menstrual period (which some,
but not all women, find to be an advantage); and (3) contraception is no longer
a concern. It is easy to understand, therefore, that the best candidates for
hysterectomy have already finished their childbearing.
Myomectomy (Local Resection): This surgery involves the removal of the
fibroids themselves without removal of the whole uterus. Myomectomy is not
permanent in the sense that fibroids can grow back after the procedure. The
fibroids grow back in about 25 to 50% of women, and about 10% of women will need
a second surgery. Although myomectomy is a sure temporary measure, it is less
guaranteed to be a permanent solution. Thus, this procedure is often used to
"buy time" if the woman is
planning to become pregnant in the next few years.
The advantages of this surgery are that it preserves the uterus for childbearing
and involves less extensive surgery, which implies less extensive recovery
periods. Certainly, in the short term, bleeding tends to be much improved after
myomectomy (in about 80% of women).
Other Procedures: Some treatments have involved boring holes into the
fibroid with laser fibers, freezing probes (cryosurgery), and other destructive
techniques that do not actually remove the tissue but try to destroy it in
place.
Another technique for treating fibroids is known as uterine artery embolization (UAE). This technique uses small beads of a compound called
polyvinyl alcohol, which are injected through a
catheter into the arteries that
feed the fibroid. These beads obstruct the blood supply to the fibroid and
starve it of blood and oxygen. Uterine artery occlusion (UAO), which involves
clamping the involved uterine arteries as opposed to injecting the polyvinyl
alcohol beads, is currently under investigation as a potential alternative to
UAE.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
An ectopic pregnancy is a pregnancy located outside the inner lining of the uterus. The majority of ectopic pregnancies occur in the Fallopian tube. Symptoms include abdominal pain, amenorrhea, and vaginal bleeding. Treatment options include observation, medication, or surgery.
Though uterine cancer's cause is unknown, there are many factors that will put a woman at risk, including: over age 50, endometrial hyperplasia, using hormone replacement therapy, obesity, using tamoxifen, being Caucasian, having colorectal cancer. Symptoms of cancer of the uterus (endometrial cancer) include abnormal vaginal bleeding, painful urination, painful intercourse, and pelvic pain. Treatment depends on staging and may include radiation therapy or hormone therapy.
A miscarriage is any pregnancy that ends spontaneously before the fetus can survive. Miscarriage usually occurs before the 13th week of pregnancy. The cause of a miscarriage cannot always be determined. The most common causes of a miscarriage in the first trimester are collagen vascular disease (lupus), hormonal problems, diabetes, chromosomal abnormalities, and congenital abnormalities of the uterus.
Uterine fibroids are benign tumors that originate in the uterus and are usually round or semi-round in shape. The most common symptom of a uterine fibroid is abnormal vaginal bleeding. Other symptoms include pressure, pelvic pain, pressure on the bladder, or pain during a bowel movement. Treatment options vary from surgery to medication.
Polycythemia (elevated red blood cell count) causes are either primary (aquired or genetic mutations) or secondary (diseases, conditions, high altitude). Treatment of polycythemia depends on the cause.
Menstruation (menstrual cycle) is also referred to as a "period." When a woman menstruates, the lining of the uterus is shed. This shedding of the uterine linking is the menstrual blood flow. The average menstrual cycle is 28 days. There can be problems with a woman's period, including heavy bleeding, pain, or skipped periods. Causes of these problems may be amenorrhea (lack fo a period), menstrual cramps (dysmenorrhea), or abnormal vaginal or uterine bleeding. There are a variety of situations in which a girl or woman should see a doctor about her menstrual cycle.
Women's health is an important topic area to guide a woman through the stages of her life, as well as knowing the conditions and diseases that may occur. Educating yourself so that the transitions into different phases of life is key to a healthy, happy, and productive life.
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