Best Uterine Fibroid Treatment Doctors & Fibroid Center In Lanesboro,Iowa
Dr.Tanna Acosta, MD|
7152 Pacific Street
Phone: (130) 680-3144
Business Hours: 7:00 am - 4:00 pm
By Appointment Only: yes
Accepts Insurance: no
Practice Areas: Fertility,gynecological care,Internal Medicine
Dr.Jone Inman, MD
795 Prairie St.
Business Hours: 7:00 am - 4:00 pm
By Appointment Only: No
Accepts Insurance: yes
Practice Areas: Fertility,Family Practice,Family Practice
Dr.Judith Rivas, MD|
Lanesboro Fertility Care
8816 Tallwood Street
Phone: (553) 161-7235
Business Hours: 11:00 am - 4:00 pm
By Appointment Only: yes
Accepts Insurance: Yes
Practice Areas: Fertility,Internal Medicine,obstetrical care
Dr.Natasha Henson, MD
Lanesboro Family Practice
6 Goldfield Drive
Phone: (471) 859-1483
Business Hours: 8:00 am - 5:00 pm
By Appointment Only: no
Accepts Insurance: Yes
Practice Areas: gynecological care,obstetrical care,Family Practice
Local Resources For Uterine Fibroid Treatment
How Are Fibroids Diagnosed and Treated- Lanesboro, Iowa
(text on screen): Fertility Authority. Your Most Trusted Source Ask the Experts How are fibroids diagnosed and treated? Jenna McCarthy, South Florida Institute for Reproductive Medicine: Most of the time, fibroids are initially diagnosed on ultrasound. And then they can be definitively diagnosed from a fertility standpoint by either a saline infusion sonogram, or an HSG. If the fibroid is well away from the cavity, and it's not changing the shape of the cavity at all, and it's not causing you any other symptoms, there's no reason you need to have it taken out. So, s typically will recommend that you have the fibroid taken out if it's changing the shape of the cavity,.
Or if it's causing some of the other symptoms. Fibroids are typically removed one of two ways. You can either have them removed by having a surgery, either laparoscopically or an open surgery where they make an incision in the belly, and have the fibroids removed. Alternatively, fibroids that are completely within the cavity can sometimes be removed vaginally. It depends on where the fibroid is. So, let's start with a large fibroid that's large enough that it's changing the shape of the cavity. That type of fibroid might be removed laparoscopically, which is a couple of small incisions on the belly, nothing big. The procedure is usually performed as an outpatient procedure, which means that you can go home the same day,.
Sleep in your own bed, take your pain medicines yourself, instead of having to be in the . The healing time from that is typically two to six weeks, depending on the woman and how active she is. And then we usually ask you to wait three months before trying to get pregnant. Some s will err on the side of caution and say as much as six months before trying to get pregnant. And then, typically, if the fibroid that was removed was large enough that we actually went all the way through the wall of the uterus to take it out, we'll recommend a csection for delivery, to help prevent the chance that the scar that's left in its place doesn't pop open during labor. The other way to remove fibroids is hysteroscopically, or vaginally. Those are fibroids that are completely within the cavity.
So, basically, they can put a little camera inside the uterus and look around; you can see the whole fibroid. Those, the recovery time is even faster. The surgery itself, again, is outpatient. You go home the same day. The pain is much, much less associated with it. Most women are back to work within a week to two weeks. Some women don't even need that much time. And we usually don't ask you to wait more than one normal period before you try and get pregnant. And neither of the two surgeries make it so that you can or cannot have fertility treatments. Some gynecologists are extremely skilled at removing fibroids. Other gynecologists prefer to refer those patients to either a reproductive endocrinologist or a minimally invasive surgeon.
The advantage to doing that is most REs and minimally invasive surgeons are trained in doing laparoscopic myomectomies. The difference between a laparoscopic myomectomy and an abdominal myomectomy is the recovery time. With a laparoscopic, most women, really, are up and around and doing for themselves in about two weeks. It may be six weeks before they feel 100 percent, but they're usually at 80 percent or better by two weeks. With an abdominal myomectomy, you've actually gone through the big muscles of the abdominal wall, so, just like a csection or any other major abdominal surgery, it takes you that full six to eight weeks to feel like yourself again. 0:03:12.000,0:03:14.000 (text on screen): Fertility Authority. Your Most Trusted Source.
Advantages of Prostate Artery Embolization with the Magellan Robotic System
All right. Thank you very much for the invitation. I'm excited to speak about the role of robotics in Prostate Artery Embolization. So a couple of things I'm going to cover here. First, is just review the literature for PAE and describe a little bit about who's the candidate for the procedure, then focus on what the challenges are with the procedure, because think that's the main obstacle that we face with PAE. And then, the transition of the Magellan Robot into our current practice with PAE, and then what those actual advantages are over the traditional method. And I'll show some case examples. So in terms of who is the candidate, there's really a few ways to break this down. The.
First is looking at what does the data support in terms of which patients to treat, who are poor traditionally urologic candidates, and let's talk about who's not really a candidate at all for PAE. So the data, when we look at a review article from 2014, this is published in CBIR, and it reviewed all the studies done up until mid last year. And as you'll see on the next slide, it looked at 562 studies through a PUBMED database study. They ended up narrowing it down to nine articles, in which they reviewed 706 patients that were actually included in the analysis. There was some possible overlap of data from European studies, and there were no randomized.
Control trials at that point published or studied longer than two years. All patients had moderatetosevere symptoms in terms of their prostate enlargement, or BPH, and the mean age of the patient in these studies is, as you would expect, in the mid to late 60s to early 70s. When they took all the data together and they pulled it all together, they found out that although these patients started in the moderatetosevere category, as you can see here in the dark blue line, this is an IPSS score, which is the severity of symptoms a man faces from their prostate enlargement. And you can see that it reduced by more than 50% in the first month after the procedure,.
Or PAE, and was durable to at least 12 months and then out to 36 months. Their quality of life, which is on a different scale of 0 to 6, did also improve by 50% or more. And this is also durable out to 36 months. So besides this really impressive al improvement, they also found that there was a decrease in prostate volume, PSA decreased, and importantly, there was no deterioration in sexual function. And they concluded that the overall benefit of PAE is very positive at 12 months and the procedure does seem safe. Now, subsequent to this, there were two randomized control trials that were published and presented at a national meeting. The first of this study that was published in radiology, it was a.
Chinese study. It was a randomized control study with up to 114 patients, in which half of the patients were randomized to get TURP, which is the traditional transurethral resection of the prostate, or a rotorooter type procedure. In this procedure, which is performed through the urethra, as most people may know, is associated with a significant complication rate anywhere from 5 to 15%, in terms of things like incontinence, impotence, bleeding, etcetera. And other complications, such retrograde ejaculation occur in up to 75% of patients. In this study, they wanted to randomize patients to TURP or PAE, and they looked at midsized prostate patients.
Which are 50 to 80 grams in size, and they followed them for two years. And what they found is both sets of patients have significant improvement in symptoms that did not differ. The PAE group, however, did have twice the failure rate compared to TURP. And that's important because that difference in failure rate was really related to the technical success of the procedure, which speaks to the challenge. Carnevale presented his data from Brazil at the 2014 American Urologic Association meeting in which they did 15 patients in each arm when they compared TURP and PAE. And they found also both arms demonstrated significant improvement, although there were less complications with PAE.
There was a better improvement in terms of quality of life and flow rates associated with the TURP arm compared with PAE. And you'll see here that in the Gao study, both red and blue, PAE and TURP, from 0 months to two years on both left and right. Left is the al score of IPSS, how do people do. And you can see they both have significant al improvement and there's no difference at 24 months. And in their study, there was no difference in flow rates, as you can see on the right, at two years. In the Carnevale study, you'll see that they both improved in terms of symptom improvement, however, there was a greater symptom improvement in the TURP arm compared with PAE.