Presents

1
Presents

• Endometriosis Uterine Fibroids

2
Chronic Pelvic Pain

• Do you, or someone you know, have endometriosis
  or uterine fibroids?
• Heres information you can use to help.

3
News Flash!

• MRI May Help Find Deep Endometriosis
• New endometriosis treatment - surgeries are now
  being performed by surgeons using medical
  robots
• Robotic Surgery Leaves Women Facing Hysterectomy
  New Option
• Surgery is not the only answer.

4
Are you Experiencing?

• Painful periods Dysmenorrhea
• Pelvic pain
• Excessive bleeding Anemia
• Infertility

5
Endometriosis

• Symptoms begin in teens
• Worsen until menopause
• May run in families
• Can cause chronic pain /or infertility even if
  periods are normal.

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Endometriosis

• A disorder of the endometrium, which normally
  lines your uterus.
• Tissue grows in other places. Most often, this
  growth is on your fallopian tubes, ovaries or the
  tissue lining your pelvis.
• Occurs in 7-10 of women.
• Can be mistaken for other conditions that cause
  pelvic pain.

7
You may have Uterine Fibroids

• The most common benign (not cancerous) tumor of a
  woman's uterus (womb).
• Occurs in about 25 of all women.

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Fibroids

• Common in women of color.
• Begin in late twenties or later.
• Progress through menopause.
• May be detectable by pelvic exam, but may need
  imaging to diagnose.

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Tests and Procedures

• Pelvic Exam
• Pelvic or Transvaginal Ultrasound
• Laparoscopy
• Blood Work

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Surgical Endometriosis Treatment

• Electrocautery or Laser via laparoscopy (a
  minimally invasive, camera-guided procedure)
• Excise Endometrioma or adhesions
• remove or drain the cyst or lesion
• Laparoscopic Uterine Nerve Ablation (LUNA) or
  Presacral Neurectomy
• used to relieve severe dysmenorrhea
• Hysterectomy with Oophorectomy
• total removal of the uterus and ovaries radical
  approach

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Non-Surgical Treatment

• Continuous OCP
• GNRH analogs
• Older therapies Danazol
• Pregnancy

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Treatment Options for Uterine Fibroids

• Guided Ultrasound Surgery - newest approach,
  ultrasound waves are used to destroy fibroids.
• Endometrial Ablation - destroys the lining of the
  uterus. This treatment is for women with small
  (less than 3 centimeters) fibroids.
• Uterine Fibroid Embolization - the blood vessels
  to the fibroid are blocked, stopping the blood
  flow that allows them to grow.
• Myomectomy - surgical removal of fibroids while
  leaving the uterus in place (traditional or
  laparoscopic)
• Hysterectomy with or without Oophorectomy total
  removal of the uterus and ovaries (traditional or
  laparoscopic).

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Non-Surgical Approach to Fibroids

• Progestin eluting IUD
• GNRH analogs
• Low dose OCPs

14
Local Resources

• Lancaster General Health Womens Health clinical
  team
• Your Doctor
• Lancaster General Health affiliates

15
National Education Resources

• Brochures from ACOG
• Uterine Fibroids http//www.acog.org/publications
  /patient_education/bp074.cfm
• Endometriosis http//www.acog.org/publications/pa
  tient_education/bp013.cfm
• Online Material
• eMedicine's Pregnancy and Reproduction Center and
  Women's Health Center. Also, see eMedicine's
  patient education articles Birth Control
  Overview, Birth Control FAQs, Female Sexual
  Problems, and Endometriosis.