Case study symptomatic fibroids

Case Study: A Challenging Fibroid Case—Avoiding Hysterectomy for Symptomatic Fibroids

Introduction

Sara K.* is a 39-year-old woman with symptomatic fibroids causing quality of life limitations. Wanting to avoid a second myomectomy or hysterectomy, which would have been required because of the large uterine size, the patient underwent successful Uterine Fibroid Embolization (UFE) in January 2020.     

Case Presentation

History

The patient had experienced long menstrual cycles with menorrhagia, clots, fatigue, and dysmenorrhea for two years. She also had urinary frequency and constipation.

The patient had never been pregnant and did not plan a future pregnancy. She had a family history of symptomatic fibroids in her mother.

She was anemic and taking prescription iron and vitamins. Other diagnoses included hypothyroidism and vitamin D deficiency. She was also experiencing some depression due to the negative impact of her menstrual cycle in her daily life.

She required a 2-unit blood transfusion due to menstrual blood loss in January 2018. Her Hgb was 3. Depo-Provera was given but the injections made the symptoms worse.

She underwent a hysteroscopic myomectomy in March 2019, which provided only minimal relief of symptoms.

The patient was scheduled for a hysterectomy but did not want to undergo open surgery and miss weeks of work. Her gynecologist referred her to Dr. Suzanne Slonim. The patient lives in New York state and traveled to the Fibroid Institute Dallas for an office consultation.

“Sara’s quality of life was severely reduced because of the size and location of her fibroids. Traditionally, the only approach to significantly alleviate her symptoms would be a major surgery with a large incision or an extended robotic surgery. She also did not want to take so much time off from work in order to recover from her surgery. I knew at that time a referral to Dr. Slonim was the right call. We discussed all of her options, and ultimately Sara decided to come from New York to have Dr. Slonim perform the procedure. I am delighted that Sara got the relief she needed. I have always been able to rely on Dr. Slonim to bring critical relief to my patients who are ideal candidates for a UFE.”

–Emil Tajzoy, MD, PLLC, Obstetrics & Gynecology in Dallas, 214-216-6713

Exam and MRI Findings

Dr. Slonim conducted a complete physical examination to determine the overall health of the patient, and to see if she was a candidate for Uterine Fibroid Embolization (UFE). A pelvic MRI with contrast showed an enlarged uterus and numerous fibroids. Most were small, but a dominant fibroid in the right posterior uterine wall measured 5.4 x 5.1 x 6.2 cm.

While predominantly intramural, the patient also had a submucosal component abutting the endometrium. There were also several smaller submucosal fibroids projecting into the endometrium. There were no apparent pedunculated subserosal fibroids and the endometrium was of normal thickness. The fibroids were predominantly iso-enhancing relative to the myometrium. The MRI also showed a small left ovarian cyst.    

Refer a Patient for UFE with Suzanne Slonim, MD

Management

Hormone treatment and myomectomy did not relieve the patient’s symptoms from her fibroids. If anything, they were getting worse. The patient consulted with her gynecologist for a hysterectomy, thinking it was her only remaining option. However, after realizing the magnitude of her fibroids would require an open hysterectomy, she pursued alternatives.

Her gynecologist referred her to the Fibroid Institute Dallas to help her find relief. Found to be a candidate after examination, Dr. Slonim recommend UFE and advised the patient on risks, benefits, and alternatives to the procedure. The patient decided to proceed with UFE.

Request Information

For more information on partnering with Dr. Suzanne Slonim, schedule a call or visit with Stacey West, VP of Marketing and Business Development.

Outcome/Results

The outpatient UFE procedure was successfully performed in January 2020. The patient experienced slight pain and nausea immediately after the procedure, but it did not last long.

Four months after UFE, the patient had a follow up tele-visit. She had intermittent bloating and vaginal spotting, but they were minor compared to her previous fibroid symptoms. She no longer needed prescription or over the counter pain medication. Her periods were much shorter and lighter, with greatly reduced cramping. She was able to resume an exercise routine and described feeling healthy. She is taking prescription vitamins and iron to build back up her blood supply.

Dr. Slonim advised the patient that her fibroids would continue to shrink, and her symptoms would continue to improve over time. She also advised the patient to follow up on the ovarian cyst and have it monitored locally.

“This case is a good example of how even large symptomatic fibroids can be treated without a hysterectomy. Providing the option of UFE allows you to offer a solution to your patient while accommodating her desire to avoid surgery.”

–Suzanne Slonim, MD, Founder and Medical Director, Fibroid Institute Dallas

Conclusion

Fibroid Institute Dallas instructed the patient to follow up as needed. Sara K. was thrilled with the results of her UFE and said “It has been six months since the surgery, and my period is now minor and an afterthought. I went from having extremely heavy 6-10 weeklong periods to 4 days. I have my life back. I am so thankful to have found Dr. Slonim.”

Dr. Slonim Welcomes Your Challenging Fibroid Cases

Suzanne Slonim, MD created Fibroid Institute Dallas with your fibroid patient in mind. A board-certified interventional radiologist for 25 years, she has performed over 30,000 procedures. Dr. Slonim provides the patient consultation and orders imaging, if needed. She has developed a specific algorithm in how she treats patients, so they have a high success rate with minimal discomfort. In addition, referring to Dr. Slonim ensures no loss of your patients to competitors. You continue routine medical care with patients who are now fibroid free. Dr. Slonim is available to partner with you on your challenging fibroid cases.

For an in-person visit about the benefits of UFE for your patients as well as a physician packet with additional information for you and your patients, request a session with our VP of Marketing and Business Development, Stacey West.

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Fibroid Institute Dallas serves the DFW area including Garland, Mesquite, Richardson, Addison, Carrollton, Plano, Frisco, McKinney, Allen, Dallas, Duncanville, DeSoto, Cedar Hill, Lancaster, Cockrell Hill, Grand Prairie, Arlington, Hutchins, Irving, Highland Park, University Park, Park Cities, and all of North Texas.

*names and/or photos may be changed to protect patient confidentiality

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