Disease terminology

For your reference, we’ve included below a summary explanation of many of the diseases and conditions we treat in our practice. While these are by no means comprehensive, we list them to offer you an introduction to many of the female health issues that might occur, and which you may be seeking treatment for at our practice.

Fibroids occur in 40 percent of women at some point in their lives. They tend to run in families, so if your mother and sister had fibroids, you have a good chance of developing them too. They are almost always benign, but nevertheless can cause very heavy menstrual bleeding, bleeding between periods or simply pain and pressure, due to the space they take up. A woman can have just one fibroid or many. Sometimes, one fibroid can grow quite large.

The most common reason for having a hysterectomy is because of fibroids. If the fibroid uterus is large, a vaginal hysterectomy can be difficult. A laparoscopic hysterectomy is generally possible in these cases, unless the uterus is enormous. But even if the uterus is very large, drugs such as Lupron can be used for a few months before the procedure to shrink the uterus and make a laparoscopic hysterectomy possible.

You might ask, “Why not just use Lupron to shrink my fibroid and not do surgery?” It’s because Lupron will only temporarily shrink a fibroid uterus. As soon as the Lupron is stopped, the uterus will go back to its previous size. Likewise, Lupron is not a drug that can be used over a long period of time due to its side effects. It creates a temporary state of menopause which causes hot flashes, night sweats, mood swings and bone loss. For a short period of time, Lupron is tolerable and safe, but not for more than a few months.

Women with fibroids are the largest group of females who undergo laparoscopic hysterectomies. Thankfully, most fibroid uteri can be removed laparoscopically, and the recovery is much shorter than a hysterectomy that involves a large incision.

Interested in knowing a little more about some of our medical and surgical procedures at Dr. Deborah Wilson & Associates? Following is a summary explanation—and a video—regarding laparoscopic hysterectomy surgery.

Adenomyosis is a disease in which the glands that normally line the muscle of the uterus, and bleed off monthly during periods, grow backwards into the muscle. Adenomyosis is a benign condition, but can cause cramping and bleeding that can become quite severe and debilitating. A uterus affected by adenomyosis might be only slightly enlarged or it can expand to become very large. Again, laparoscopic hysterectomy is a good solution for this problem.

Endometrial polyps are growths of uterine-lining tissue that do not shed off with the monthly period and can cause abnormal bleeding. They can be removed during a D&C, but tend to grow back. A laparoscopic hysterectomy removes the uterus so that this cannot occur again.

Hyperplasia is overgrowth of the uterine lining. Hyperplasia can cause heavy bleeding and bleeding between periods. If left untreated, it can develop into cancer. Simple hyperplasia is an early, benign form of the disease. As it progresses, the condition can develop into complex hyperplasia, complex hyperplasia with atypia and ultimately, cancer of the uterus.

A woman with simple hyperplasia is a candidate for a laparoscopic hysterectomy. It is generally recommended that a laparoscopic total hysterectomy be performed in this case. If any cancer cells do exist inside the uterus, they can be spread throughout the abdominal cavity during the morcellization process, unless the morcellation is performed “in a bag.” This procedure is called contained morcellation and it prevents the potential spread of cancer.

If the hyperplasia is noted on biopsy to be “atypical,” then the chance of cancer cells existing inside the uterus are significant, and the patient will be referred to a gynecologic oncologist.

Pelvic adhesions can make a vaginal hysterectomy difficult or impossible. Adhesions can result from prior surgery, endometriosis or infection. If the adhesions are not severe, a laparoscopic supracervical hysterectomy is possible. If the cervix needs to be removed, a laparoscopic total hysterectomy or a laparoscopic assisted vaginal hysterectomy can be performed.

Abnormal bleeding is a condition that describes either heavy menstrual bleeding and/or bleeding between periods. It can be due to fibroid tumors (benign muscle tumors of the uterus), adenomyosis (a process in which glands normally lining the uterus grow into the muscle of the uterus) or abnormalities of the uterine lining, such as hyperplasia (overgrowth of the uterine lining) or polyps (clusters of uterine lining tissue that grow inside the uterus).