Uterine Conditions
The uterus, or the womb, is located between the bladder and the rectum. This pear-shaped part of the reproductive systems is where a baby grows when the patient is pregnant. Lining of the uterus is prepared by the estrogen produced by the ovaries. There are some uterine conditions such as abnormalities, hormonal imbalances, and heavy bleeding that can affect a uterus’ functionality.
Uterine Fibroids
Uterine fibroids, also known as leiomyomas, fibroid tumors, and myomas, are noncancerous growths on or in the uterus. It is unknown what causes these noncancerous tumors, but urologists see that progesterone and estrogen, which are female hormones, make them increase in size. Uterine fibroids are commonly seen in patients in their 30s and 40s. They can grow in the uterine wall (intramural fibroids), on the outer surface, or on the inside of the uterus (pedunculated uterine fibroid). The most common type of fibroid is an intramural uterine fibroid.
There are cases where patients have uterine fibroids, but do not experience symptoms. The following are some symptoms that patients may have:
- Pressure or bloating in the abdomen area.
- Low back and uterine pain.
- Long-lasting, heavy periods with cramping.
- Constant urge to urinate.
To diagnose uterine fibroids, a urologist will ask a patient about their symptoms to determine whether further tests need to be performed. A pelvic exam and ultrasound may be performed to see the location and size of the fibroids. Blood tests are done to see if the patient has anemia, which may result from heavy bleeding.
Treatment is recommended for uterine fibroids that cause notable symptoms. Patients with little to no symptoms will be carefully monitored by a urologist to see if the fibroids has grown and is causing more symptoms. Fibroids that cause heavy bleeding are treated with nonsteroidal anti-inflammatory drugs (NSAIDs), hormones, and iron supplements, but this treatment plan does not reduce a fibroid’s size.
Patients with severe fibroid symptoms have several treatment options:
- GnRH-a therapy – Using this hormone therapy begins a menopause-like state, which reduces the size of a fibroid temporarily. This is used for patients nearing menopause, or patients that will have surgery later on to remove the fibroids.
- Myomectomy – The fibroid is removed laparoscopically or through the vagina. This procedure keeps the uterus intact for patients who want to get pregnant sometime in the future.
- Hysterectomy – This treatment option is used for patients with long-term fibroid symptoms that have no future plans of becoming pregnant.
- Uterine fibroid embolization (UFE) – Also known as uterine artery embolization, this procedure prevents the fibroid from receiving blood, which causes it to shrink and break down. Although this procedure does not remove any part of the uterus, pregnancy after this procedure is rarely achieved.
Prolapsed Uterus
To learn more about a prolapsed uterus, click here.
Uterine Bleeding
Dysfunctional uterine bleeding (DUB) is irregular bleeding from the uterus, which results from unexpected changes in a patient’s hormone levels. This change in hormone levels can prevent ovulation, which causes uterine bleeding.
A patient can experience the following symptoms:
- Periods with heavier bleeding.
- Getting their period more often or more spread apart.
- Periods lasting longer than seven days.
A urologist will perform a pelvic exam and review a patient’s history to determine whether they have DUB. An endometrial biopsy may also be performed if the patient is nearing menopause, since abnormal uterine lining is common at that age. For this test, a urologist will take a sample of the uterine lining, or endometrium, which is then reviewed under a microscope. This sample allows the urologist to examine the patient’s uterine lining and hormone levels.
Hormones and medicine to decrease bleeding are regularly used to treat DUB. If the patient is not ovulating regularly, and has no future plans to have children, endometrial ablation is another treatment option. Endometrial ablation is a procedure that is performed to destroy the inner lining of the uterus, or endometrium. This procedure is done by a laser beam, electricity, heat, freezing, or microwave. Once the uterine lining is ablated, scar tissue forms, which stops or diminishes bleeding.
Uterine Cancer
To learn more about uterine cancer, click here.
Academic Urology Specializes in Uterine Conditions
The urologists at AUUA diagnose and treat a diverse range of urologic conditions. Our combined knowledge and experience allow us to provide the utmost care to our patients. Call us today to learn more about the conditions we treat at our seven convenient locations throughout Arizona.
