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January 19, 2019  
FIBROIDS1 NEWS: Feature Story

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  • An Untapped Partnership

    An Untapped Partnership: Interventional Radiologists and Gynecologists

    June 27, 2005

    By: Diana Barnes-Brown for Fibroids1

    With the advent of uterine fibroid embolization (UFE) and other minimally invasive treatments for a variety of conditions involving the reproductive tract, interventional radiologists are becoming increasingly involved in women’s health. However, it is rare to see them working in organized partnership with gynecologists or other women’s health care providers.
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    Do you have these fibroids symptoms?

    Heavy bleeding or painful periods

    Bleeding between periods

    Pelvic pressure (feeling of fullness in the lower abdomen

    Frequent urination

    Pain during sex

    Lower back pain

    Reproductive problems including infertility, multiple miscarriages or early onset of labor during pregnancy

    If you are experiencing any of these symptoms, make an appointment with your doctor to discuss treatment.

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    In the past, women who suffered from fibroids were routinely told that hysterectomy (complete removal of the uterus) was the best – or the only – way to deal with this troubling condition. Fibroids are benign tumors in the uterus or uterine wall, and can lead to bleeding problems, infertility or miscarriage, urinary or bowel disturbances and frequent or constant pelvic pain.

    For many years, the party line was to completely remove the uterus in response to the growths, but in recent years, physicians and medical scientists have argued that for some patients, hysterectomy can cause more problems than it resolves.

    It is important to note that hysterectomy may in fact be the best treatment for some women, such as those whose fibroids have failed to respond to all other treatments, or who show signs of cancer in the area. But studies and other research have found that many others could receive the same benefits from alternate treatments, while suffering from far less post-procedure fallout.

    With findings like these now on record, many women’s health experts are asking the same question: Shouldn’t women be presented with all the options? More treatment options could mean a greater number of women would seek treatment, because the more options available, the greater the likelihood that one treatment will offer maximum benefits with minimum drawbacks. Ideally, fewer women will decline treatment for fear of either failure or post-treatment effects that are too disruptive for the treatment to bring about a net gain in overall health.
    Be Prepared
    Questions to ask your doctor:

    What options do I have for treating my fibroids?

    Can you explain the risks and benefits of each option?

    What is your recommendation?

    What is the recovery period for the recommended option?

    What about short term versus long term treatment options

    Remember, you can always seek a second opinion if you feel your doctor did not answer your questions fully or appropriately.

    When more women begin seeking treatment, there will be a higher need for procedures like UFE, myomectomy, and others that utilize interventional radiology techniques such as minimally invasive surgery and high-tech optical (viewing) devices.

    In response to the trend, gynecologists may find they are being called on to explain the ins and outs of a specialty outside of their own area of expertise. But the importance of discussing all possibilities for patients remains, and most gynecologists feel an ethical responsibility to present all treatment techniques available – not just the ones they themselves perform.

    While in some cases, this means referring a patient to another specialist, the benefits for gynecologists will come in the form of happy, healthy patients, not to mention word of mouth praise as open-minded innovators, concerned for their patients’ health above all else.

    Doctors already refer women to massage, yoga, and physical therapy specialists for treatment that cannot be performed in-house, so why not work to build similar partnerships with interventional radiologists? An added benefit of being involved in the referral process is that gynecologists get to choose the specialist they feel is best suited for the job, and shares similar ideals about medical care.

    On the patient side, this means less tension between cooperating specialists and better overall care. Also, alternative treatments for fibroids have received enough press that most women have at least heard of them, if not heard the specifics of how they work – why not have this knowledge come from their current GYNs? Patients who feel that they don’t have to “sneak around” to find alternatives to hysterectomy or other procedures are more likely to have trusting, open relationships with their GYNs, leading in turn to a more positive, fruitful care experience on all sides.

    It is also important for GYNs to understand that IRs have no intention of “stealing” their patients: A typical treatment plan involving an IR would have patients start and finish with evaluation and treatment by their own GYN, leaving only for the specialized IR procedure, decided upon based on consultation with both physicians.

    In spite of the growing acceptance of IRs and the procedures they perform, many GYNs remain resistant to care models involving partnership with IRs. According to Linda Bradley M.D., a gynecologist and past Fibroids1 Hero, up to 70 percent of women with fibroids are candidates for UFE. And, she herself has referred upwards of 300 patients. Yet, in a recent interview with the Wall Street Journal, Bradley said many gynecologists don’t share her passion for the procedure. Bradley does spend time talking to fellow gynecologists about the value in the partnership for both doctor and patient.

    Forward-thinking healthcare providers are already working to chip away at this way of thinking, but there is still a lot to be done. GYNs and IRs can help to improve the situation by taking advantage to enforce dialogs between the two specialties, and encourage their students and colleagues to do the same. Patients should also continue to ask questions and request information about all their possible options. In the end the realization of this untapped partnership will lead to increased numbers of happier, healthier, fibroid-free women.

    Last updated: 27-Jun-05


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