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I want to give a tip to women desiring to be mothers one day who are currently dealing with uterine fibroids. I have recently had a conversation with 3 different women about fibroids who were all in their reproductive years. None of these women were in a relationship where she was currently planning to have children but each was wanting to preserve her ability to have a family one day. Each woman was investigating the different management options for uterine fibroids. The question of surgery came up in every one of our conversations with the concern of how to entertain the concept of removing fibroids without increasing their pregnancy risk from such a surgery, should she get pregnant one day. Each woman had had a conversation with an Obstetrician Gynecologist about fibroid removal. Each woman wondered whether the surgeon may have been a little too eager for surgery or would go further in surgery than they would appreciate afterwards. Additionally, these women all happened to be Black. In the United States of America, Black mothers have greater risk of poor Obstetric outcomes compared to White women; fibroids as well as fibroid removal surgery can influence those risks. I gave each woman the same tip: consider getting a second opinion from a master Gynecologic Surgeon, a Gynecologic Oncologist.
While I am first and foremost an Obstetricians Gynaecologist, I have much respect for the surgical expertise and execution of my peers in Gynecologic Oncology. Women may not routinely know some of the areas of expertise of the different subspecialties within Obstetrics and Gynecology. Within the umbrella of female pelvic/reproductive organ surgery, Gynecologic Oncologists are often considered the best surgeons. It may not be common knowledge that these specialists not only deal with cancers of the reproductive tract but also non-cancerous [benign] conditions such as fibroids and endometriosis. Being quite learned and abreast of advancements in medical literature these professionals can be some of the best to go to for a second opinion on options for treating conditions such as uterine fibroids. Whether or not you choose to have surgery, you could learn a lot from a consultation and walk away better informed for your decision making on what to do next. They may echo the advice you have previously received, strengthening your confidence in your personal Gynecologist; they present options that may be new to you; you may decide that you want them to manage the issue instead.. Additionally, these surgeons may talk about different approaches to surgery, the pros and cons of each, as well as the potential benefits and pitfalls of medication treatment. As surgeons that work with very risky scenarios such as female reproductive cancers their approach/management usually has to be pristine to achieve the best outcomes. As such, getting advice from these types of professionals can help avoid certain scenarios that may increase the risk of a future pregnancy secondary to how uterine fibroids were managed prior to or outside of pregnancy. You should have confidence after a consultation. The goal is not to feel pressured into a decision but to be informed and choose what seems like the best option for you even the option of doing nothing for right now.
I hope you found this content helpful. If you would like to read or hear more on this topic please feel free to send us comments and suggestions.
Yours truly,
Your approachable, relatable, Maternal Fetal Medicine physician,
Dr. Kia