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Gynecological Conditions Information

A woman’s reproductive system, which consists of the uterus, vagina, ovaries, and fallopian tubes, can be affected by a wide array of benign (non-cancerous) conditions. Most of these conditions affect the uterus, which is the hollow, muscular organ that holds a baby as it grows inside a pregnant woman.

Common types of gynecologic conditions can cause chronic pelvic pain, excessive menstrual bleeding, and/or other disabling symptoms. These conditions include:

  • Fibroids: Non-cancerous growths in the uterine wall
  • Prolapse: Falling or slipping of the uterus

When medication and other non-surgical options are unable to relieve symptoms, minimally invasive robotic surgery at AdventHealth may provide a more effective, long-term solution for a range of gynecologic conditions.

Fibroids

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Fibroids Treatment

Uterine fibroids are non-cancerous tumors that develop within or attach to the wall of a woman’s uterus and are the most common non-cancerous pelvic tumor. Fibroids may be present in 15 - 20% of women in their reproductive years -- the time after starting menstruation for the first time and before menopause. Fibroids may affect 30 - 40% of women over age 30. Fibroids occur 2 to 3 times more frequently in African-American women than in Caucasian women.

The cause of uterine fibroid tumors is unknown, but the use of oral contraceptives and pregnancy lower the risk of developing new fibroid tumors. The growth of a fibroid seems to depend on the hormone estrogen. As long as a woman with fibroids is menstruating, the fibroids will probably continue to grow, usually slowly, but they rarely affect females younger than 20 or who are postmenopausal.

Fibroids begin as tiny, microscopic seedlings that spread throughout the muscular walls of the uterus and over time can grow quite large, eventually filling the entire uterus, and weigh several pounds. Although it is possible for just one fibroid to develop, usually they occur as multiples.

Sometimes, a fibroid hangs from a long stalk, which is attached to the outside of the uterus. Such a fibroid is called a pedunculated fibroid. It can become twisted and cause a kink in blood vessels feeding the tumor. This type of fibroid may require surgery.

Signs and Symptoms
  • Sensation of fullness or pressure in lower abdomen
  • Pelvic cramping or pain with periods
  • Abdominal fullness, gas Increase in urinary frequency
  • Heavy menstrual bleeding (menorrhagia), sometimes with the passage of blood clots
  • Sudden, severe pain due to a pedunculated fibroid
Robotic Treatment for Uterine Fibroids

Uterine Fibroids can be treated effectively and precisely with a robotic myomectomy or robotic hysterectomy.

With a myomectomy, fibroids are removed from the uterus wall, and leave the uterus completely intact. Since the surgery is minimally invasive and uses the precision of the da Vinci® robot, patients who undergo a robotic myomectomy have a quicker recovery time and less complications than they would experience with traditional open and laparoscopic procedures.

A robotic hysterectomy involves the removal of the entire uterus, along with the fibroids. Again, this surgery is performed with the minimally invasive da Vinci® robot—allowing patients quicker recovery times and fewer complications than they would experience with traditional open and laparoscopic procedures.

Prolapse

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Overview

The uterus is normally supported by pelvic connective tissue and the pubococcygeus muscle, and held in position by special ligaments. Uterine prolapse is the weakening of these tissues which allows the uterus to descend into the vaginal canal. Tissue trauma sustained during childbirth, especially with large babies or difficult labor and delivery, is typically the cause of muscle weakness.

Uterine prolapse occurs most commonly in women who have had one or more vaginal births, and in Caucasian women. The loss of muscle tone and the relaxation of muscles, which are both associated with normal aging and a reduction in the female hormone estrogen, are also thought to play an important role in the development of uterine prolapse.

Signs and Symptoms
  • Sensation of heaviness or pulling in the pelvis
  • A feeling as if "sitting on a small ball"
  • Low backache
  • Protrusion from the vaginal opening (in moderate to severe cases)
  • Difficult or painful sexual intercourse

These signs are often accompanied by protrusion of the bladder and front wall of the vagina (cystocele) or rectum and back wall of the vagina (rectocele) into the vaginal space. The ovaries and bladder may also be positioned lower in the pelvis than usual.

Prolapse

Depending upon age, general health, desire for future pregnancy, degree of prolapse and other associated conditions, a minimally invasive robotic hysterectomy may be used to treat the condition. The da Vinci® robot is utilized to perform this highly precise procedure. The minimally invasive nature of a robotic hysterectomy allows patients quicker recovery times with fewer complications when compared to conventional open or laparoscopic surgery.