What is the Uterus?

The uterus is the hollow, pear-shaped organ that resides in the pelvic region of a female.  The uterus is a part of the reproductive system and is the place where a baby grows during pregnancy.  The uterus holds the cervix, which is the lower, narrow area of the uterus, and the fallopian tubes that extend from both sides of the organ.  The uterus contains two layers of tissue: the inner layer is known as the endometrium; the outer layer is called the myometrium. It is within this lining that a woman’s body prepares itself for menstruation as the walls within the uterus are lined and thickened with blood and then released monthly through the vagina.

What Conditions Can Exist in the Uterus?

Fibroids (benign tumors), endometriosis (endometrial tissue that grows inside the body, outside of the uterus) and endometrial hyperplasia (an increase of cells in the lining of the uterus) are all benign conditions that can affect the uterus. Another condition that can exist within the uterus is Adenomysis—in which the endometrium exists in the muscle of the uterus. Endometrial polyps can also exist in the uterus and is another source of abnormal bleeding. These conditions should be monitored and treatment for each condition is available.

What is Uterine Cancer?

Uterine cancer is a type of cancer that affects the uterus; it most often occurs when abnormal or cancerous cells begin to develop and multiply in the endometrium lining of the uterus.  When cancer occurs within the lining of the uterus, it is known as endometrial cancer.  Endometrial cancer is the most common type of uterine cancer. If the cancer develops in the tissue and muscles that make up the uterus, the cancer is known as a sarcoma.  Sarcomas are the most rare of uterine cancers.

What Causes Uterine Cancer?

The exact cause of uterine cancer is not known; however, studies have shown that there are some risk factors:

• Age.  Uterine cancer, endometrial cancer and sarcomas of the uterus most often affect women over the age of 50
• Obesity.   Obese women have higher levels of estrogen in their bodies because the body makes some of its estrogen naturally in fatty tissues.  Higher levels of estrogen create a higher risk for uterine cancer.
• Untreated Conditions.  Certain uterine conditions, if left untreated, could increase the chances of a woman getting uterine cancer. Chronically irregular periods, especially going more than three months between periods will increase the risk.
• Race.  White woman are more likely to get uterine cancer than African-American women.
• Diabetes and hypertension.
• Certain hormone-related therapies. Women who are on estrogen replacement therapy and unbalanced hormonal therapy should be monitored closely. These specific therapies, as well as “natural” therapies such as estrogen cream, if not balanced by progesterone, can increase the risk of uterine cancer.
• Starting menstruation early (before age 12)
• Never being pregnant

What are the Symptoms of Uterine Cancer?

It is important to note that the majority of diagnosed uterine cancers (including endometrial cancer and sarcomas) occur near or after menopause.  Abnormal and ongoing vaginal bleeding is typically the first symptom of uterine cancer. Other symptoms may include heavy discharge, painful urination, and pain in the pelvic area or pain during intercourse.

How is Uterine Cancer Diagnosed?

If a woman has unusual symptoms, a pelvic exam, pap test or biopsy may be administered. Once uterine cancer is in fact diagnosed, your doctor will work to determine the stage.

What are the Stages of Uterine Cancer?

In most cases, a hysterectomy is the first step and the most reliable way to stage uterine cancer. It allows the surgeon and the pathologist the opportunity to look closely at where the cancer has invaded and spread.  Staging uterine cancer occurs in 4 ways:

• Stage 1:  The cancer is isolated in the uterus and has not spread to the cervix
• Stage 2:  The cancer has spread to the cervix
• Stage 3: The cancer has spread outside the uterus; however it has not spread outside of the pelvic region. Lymph nodes in and around the pelvic may or may not contain cancer cells.
• Stage 4:  The cancer has spread to other organs in the body

What Treatment Options are Available for Uterine Cancer?

Most women who have been diagnosed with uterine cancer will have surgery.  A hysterectomy (removal of the uterus) is generally the first course of treatment; during this procedure the ovaries are typically removed as well. During the hysterectomy, lymph nodes will most likely also be removed so that tests can be administered to see if and where the cancer has spread. Depending on the stage of the cancer, radiation therapy, chemotherapy and/or hormonal therapy will be recommended.

What is the Prognosis for Uterine Cancer?  Can it be Prevented?

Prognosis is first related to the depth of cancer invasion into the myometrium—the less the invasion, the better the prognosis.  The cervix and surrounding tissues are then screened and tested for cancer. If uterine cancer is found early, the prognosis is excellent.  The 1-year survival rate is about 92% if the cancer has not spread.  That number does drop significantly if the cancer has spread to nearby organs. Women should have annual and routine physical examinations including pelvic exams, Pap smears and blood work. If you are experiencing any abnormal bleeding, pain in the pelvic area, bleeding lasting longer than a full week and bleeding that occurs every 21 days or more, please consult with your doctor.

The doctors that make up the Women’s Specialists of Plano offer uterine cancer treatment in Plano, TX.  Visit them on the web at www.obgynplano.com

“I Have Uterine Fibroids.  Should I be concerned?”

The doctors that make up the Women’s Specialists of Plano (972.379.2416) see their fair share of uterine fibroids weekly at their North Texas OBGYN office. Uterine fibroid tumors are one of the most common gynecological conditions affecting American women today—in fact, this year alone, almost 1 in 4 will be diagnosed with these benign uterine tumors.  While the majority of uterine fibroid tumors are non-cancerous, there is the incidence of malignancy (cancer) in about 1 in 10,000—making fibroids a worrisome diagnosis for thousands of women.

Not too long ago, most American women were sent down the road of having a hysterectomy when diagnosed with uterine fibroids.  I recently interviewed a group of Plano, Texas-based gynecologists—as well as some of their patients—and was pleasantly surprised to learn that there are in fact several options for patients suffering from uterine fibroids.

Fibroids are tumors that develop in the uterus, most often, affecting women over the age of 30 and still in childbearing years. They can be very small, exist as one or in groupings, can be slow or fast growing, and for many, symptoms will be almost non-existent. For many women, on-going and at times continuous cramping, bloating, constipation, heavy bleeding and a feeling of pressure and pain in the uterus can exist.  For women with a personal or family history of cancer, knowing that these tumors exist within the uterus can be troublesome making the treatment of uterine cysts a very important decision for them.

When I met with Patricia, a patient of Dr. Murray Fox, a physician with the Women’s Specialists of Plano practice, she described symptoms that sounded more like a pregnancy than a uterine fibroid.  Her non-cancerous uterine tumors presented themselves years earlier and over time began to grow until the end result was a cantaloupe size tumor.  With a growth so large, she decided to have a full hysterectomy because once the tumor was removed, much of her uterus would have to be removed with it. Since Patricia was past her child-bearing years, a hysterectomy was an acceptable route to take.

According to Dr. Jules Monier, a gynecologist with Women’s Specialists, most women will be diagnosed in the earlier stages through routine pelvic exams.

“We are able to diagnose uterine fibroids early on in most cases and monitor them with each patient.  During this time, conservative treatment of uterine cysts can be provided.  It’s important for women to be cognitive of their symptoms and pay attention to what their body is telling them so that a more aggressive treatment option can be considered if necessary.  No woman should be expected to endure the harsher symptoms that can come along with uterine fibroids.”

The exact causes of fibroid tumors are unknown. The Women’s Specialists of Plano experts agree that treatment of uterine cysts is not necessary with uterine fibroids unless at least one of the following conditions are occurring:

• The uterine fibroid is greater in size than a 12-week pregnancy
• The uterine fibroid(s) is growing
• The uterine fibroid(s) is causing bleeding
• The uterine fibroid(s) is causing pain
• The uterine fibroid(s) is associated with pregnancy loss

Treatment options available today are vastly different than years ago.  “Before our patients have to consider a hysterectomy for their uterine fibroids, they do have other treatment options, that in most cases, are successful.  Uterine artery embolization and myomectomy procedures are highly effective treatment options and are generally recommended before a hysterectomy,” Says Dr. Daryl Greebon, a Plano, Texas-based OBGYN.

During a uterine artery embolization procedure, physicians use an x-ray camera to inject small particles through a catheter directly aimed at the fibroid. These particles block the arteries that provide blood flow and essentially cause the fibroids to shrink.

A myomectomy is a surgical procedure where the fibroid tumors are surgically removed.  This procedure can be done with an open incision or using a more minimally-invasive technique such as the robotic myomectomy. The robotic method reduces the side effects of the surgery and overall recovery.  A myomectomy, in general, is considered one of the only surgical treatment options that preserve fertility.

In the procedures mentioned above, a large majority of women experience relief with their symptoms.

Robin is another patient of Women’s Specialists I interviewed and one who had a dramatically different outcome than my earlier subject.  She also battled uterine fibroid tumors since she was in her late 20’s and because she still desired to have children, she opted to have a robotic myomectomy. Dr. Dennis Eisenberg performed the surgery robotically and today, she remains symptom free from her fibroid tumors.  Although the risk of them returning does exist; she has not had any real significant growths or reoccurrences.

Dr. Murray Fox explains, “Uterine fibroid tumors can affect the quality of life.  I have had young women who are afraid to go to their places of business for fear they will soak through their clothes due to heavy bleeding caused by fibroids, and others who have experienced weight gain in the abdominal area because of fast growing and oversized tumors. The question I go over with my patients first is should the fibroid tumors be treated?  If the answer is yes, we discuss how.”

It is extremely important to talk to your gynecologist, get all of the facts revolving around your specific uterine fibroid tumors and review all of your options to help you decide the best outcome for your particular situation, future desires and current lifestyle.

About the writer:

Kristy Theis is the Medical Content Editor for eMedical Media and is a Dallas-based freelance communications writer.

The gynecologists and patients of the Women’s Specialists of Plano contributed to this article.Visit them on the web at www.obgynplano.com.

Women’s Specialists of Plano offer the da Vinci robotic hysterectomy as an effective alternative to general hysterectomy surgery.

They recently offered the following physician feedback and patient reviews for da Vinci Robotic Surgery. The majority of these reviews were collected and written by Intuitive Surgical—the developers of the da Vinci robotic system based out of Sunnyvale, CA.

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“The recovery process using the robotic technique is night and day compared to general hysterectomy surgery. There were zero complications, minimal scarring and absolutely no side-effects.  The da Vinci system is a true amazement and in my opinion the wave of the future in hysterectomy surgery.”  da Vinci Robotic Hysterectomy Patient

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“The potential payoffs [of the da Vinci Surgical System] are impressive: Smaller incisions, less pain, fewer infections and other complications, shorter hospital stays, faster recovery, even improved odds that the outcome of the procedure will be a success.”   U.S. News & World Report

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“The precision and flexibility of this type of computerized system will allow us to do things we haven’t even thought of yet.”  Dr. William Kelley, Henrico Doctors Hospital, Richmond, VA

“Once you see the way patients recover, there is just no way you want to go back to larger incisions….”  Douglas A. Murphy, M.D., Cardiac Surgeon Saint Joseph’s Hospital, Atlanta, GA

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“This is a significant milestone to minimize the trauma of surgery.”   Dr. Craig Smith. Columbia-Presbyterian Medical Center, New York, NY

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“Robotic assisted surgery is safe and effective, and is a new reality for American surgery.”  Mark A. Talamini, M.D. et al”A Prospective Analysis of 211 Robotic Assisted Surgical Procedures,” Surgical Endoscopy

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“As a trained surgical oncologist, the da Vinci System has allowed me to offer my patients a better cancer operation with improved clinical outcomes.”    Thomas E. Ahlering, M.D., University of California Irvine Medical Center

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“In my experience, robotics allows for greater surgical precision which leads to improvements in cancer control, potency and urinary function.”  Mani Menon, M.D., Director, Vattikuti Urology Institute, Henry Ford Health System

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“After … deciding upon a radical prostatectomy, I quickly did extensive research regarding my options. When I discovered information about the procedure using the da Vinci Surgical System, I was convinced that this was the only option for me. I was back to work after four and a half weeks and even played racquetball after six weeks.”     da Vinci Prostatectomy patient, aerospace design engineer

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“I was home maybe three days [after coronary revascularization surgery] when I went shopping at the grocery store.”     69 year-old da Vinci Coronary Revascularization patient

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“I have not taken a Tylenol throughout the entire process…”     da Vinci  patient

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“I would recommend the robotic hysterectomy to any of my friends or family who are faced with having to have a hysterectomy. After the procedure, I only took pain medications on the first day. My scar is so tiny that I forget it is even there. I’m about four weeks post-operative and looking back, I cannot think of a better experience in terms of a surgery and after-recovery.”   Robotic Hysterectomy Patient

Faith in Practice’s mission is to improve the physical, spiritual, and economic conditions of Guatemalan’s poor through short-term surgical, medical and dental mission trips and health-related educational programs

The large FIP team of surgeons, anesthesiologists, nurses, administrators, clergy, translators, oral surgeons, dental hygienists, and a photojournalist will travel to Reutealeahu, Guatemala from February 26, 2010 through March 7, 2010. The team will provide short-term surgical, medical and dental care. Prior to the mission, the team gathers all the supplies that will be required for performing surgery and post-operative care. Each team member typically brings 2 trunks of medical supplies. In total, 86 trunks arrived in Guatemala for this mission.

At the beginning of the trip, the FIP team will assess all surgery candidates and prepare a surgical schedule. The remainder of the week will be spent in surgery and providing after care.

To follow Dr. Fox and Dr. Greebon while they are on their medical mission, a Facebook Fan Page has been set up, Faith In Practice-Greebon Team 244.

Medpage Today, an online medical news site, published an article titled, “Robotic Surgery Benefits Seen for Hysterectomy.” The article highlights recent findings that robot-assisted hysterectomy may in fact be a safer surgical option for patients with a large uterus and underlying medical conditions. Historically, robotic surgery was seen as optimal for a patient with an average sized uterus and normal pathology. Patients with a large uterus and more complex pathology were seen as better candidates for a traditional hysterectomy.

A recent review of five community practices through the country found robotic surgery, specifically robot-assisted hysterectomy, can produce favorable outcomes for more complex cases. It was shown that robotic surgery could be associated with fewer complications and less blood loss compared to traditional open-abdomen hysterectomy.

The da Vinci robotic surgery allows 3D images of the pelvis and mirrors the precise hand and wrist movements of the surgeon while eliminating the possibility of slight hand tremors.

If you are interested in learning more about robot-assisted hysterectomy, please contact Women’s Specialists of Plano in Plano, Texas. Their modern office is conveniently located near the Medical Center of Plano. You can schedule an appointment by calling 972-379-2416 or by visiting their online appointment center.

Article source: Medpage Today

Dr. Daryl Greebon, Plano Gynecologist at WSOP, is a source for the article “Putting Self First is Vital to Good Health as Mom, Wife”.

Article Source: News OK

Endometrial Ablation: The Simple Way to End Heavy Periods (Menorrhagia) Without a Hysterectomy

Author: Kristy Theis

Dr. Jules Monier performs endometrial ablation in Plano, TX

If you are a woman who dreads her monthly menstrual cycle because of a relentless, long and heavy flow, you are not alone. In fact, more than 1 in 5 women experience a persistent and abnormal menstrual flow every month, a condition known as menorrhagia.

Is My Period Normal?
Each month, as a woman’s body prepares itself for a possible pregnancy, the hormone levels estrogen and progesterone rise thus thickening the uterine lining in order to protect the egg released by the ovaries. If fertilization does not occur, a woman will shed this lining which will be visible as blood indicating the start of her period.

As the time nears for a woman to have her period, those suffering from menorrhagia will dread the days leading to the very first sign of blood that will eventually appear. A normal period is usually marked with less than 10 tablespoons of blood lost and a manageable flow for up to 4-7 days. When a woman has a consistently long and heavy period every month—severe enough to cause nausea, fatigue, moodiness, or a complete interruption of daily life, it might be time to check into a menorrhagia treatment in order to resolve the problem.

Curing Heavy Periods
Endometrial ablation is one such menorrhagia treatment procedure that can radically improve the symptoms associated with a prolonged and unrelenting menstrual flow. During the procedure, the endometrial lining is removed either by using freezing temperatures or a heated fluid. The removal of the lining, in essence, prevents the flow of blood to occur.

According to Dr. Jules Monier, a Gynecologist in Plano, Texas, “Endometrial ablation has been around in some form for more than 20 years. The procedure has been perfected and now an unprecedented number of women can enjoy normal menstrual cycles with a much lighter flow accompied by the usual, mild symptoms associated with having an average period.”

The NovaSure® method, an approved endometrial ablation procedure designed specifically as a menorrhagia treatment option over more drastic procedures such as a hysterectomy, uses radio frequency energy to permanently remove the lining of the uterus, which reduces, or eliminates, future bleeding. The procedure, which is carried out under local anesthesia, usually takes under an hour to complete and is typically performed either in the office on an out-patient basis or in a hospital as a day surgery procedure.

Dr. Jules Monier performs the procedure in his Plano, Texas office on a routine basis and consistently receives satisfactory feedback from the patients who have opted to have the treatment. “More than half of my patients experience a total absence of a period after the procedure is performed. Most others see a significant improvement in their menstrual flow and the symptoms that follow. I like to refer to the procedure as it’s like having a hysterectomy without having a hysterectomy.”

For the women that have visited this Plano, Texas office and the thousands of others who have undergone the NovaSure® procedure, 97% say they would recommend the treatment to their friends.

Who is the right candidate for this procedure?
Although the chances for pregnancy reduce greatly after the NovaSure® endometrial ablation procedure has been performed, it is still possible to become pregnant. Any woman who has completed child-bearing or who is menopausal can be a candidate for the treatment. Prior to performing the NovaSure® method, your gynecologist will do a sonogram and in some cases, an endometrial biopsy to ensure there is not another underlying condition present. Light cramping and bleeding may occur in the days or weeks following the procedure but will then disappear allowing the majority of women to enjoy either a normal or an absent menstrual flow.

To learn more about what may be causing you to have a consistently heavy period and to look at the treatments that are available, such as the NovaSure® method, be sure to discuss all of your options with your gynecologist.

About the Author:

Dr. Jules Monier was interviewed for this article and has been practicing gynecology in the Plano, Texas area for 25 years. He is currently in practice with Women’s Specialists of Plano. http://www.obgynplano.com/

Kristy Theis is a Plano, Texas-based communications freelance writer specializing in b2b, consumer and vertical trade copy suitable for both print and Internet. She has over 14 years experience in the fields of marketing, PR and copywriting and currently serves as the content editor for emedicalmedia.com.

Article Source: ArticlesBase.com – Endometrial Ablation: The Simple Way to End Heavy Periods (Menorrhagia) Without a Hysterectomy

Author: Dr Murray Fox

Bone metabolism in the human body is a very dynamic process. There is a constant lying down of bone by cells called oste

oblasts and resorbtion of bone by cells called osteoclasts. Initially the osteoblasts work much harder and faster that the osteoclasts and bone is laid down to facilitate growth.

Each person has a genetically determined peak bone mass which is attained in their twenties. By age 17 ninety percent of the bone mass has been obtained. The consequence of bone loss is the development of very weak and fragile bones, a medical condition known as osteoporosis. Osteoporosis is associated with compression fracture of the bones of the spine called vertebra(ae) and fracture of the hip. While these fractures from osteoporosis may be painful and cause shortening of

stature, even difficulty breathing, the major consequence is complications and even death from surgical repair of the hip fracture.

Calcium and Vitamin D Play a Critical Role

Adequate calcium, exercise and vitamin D are required to attain and maintain bone mass. This is important in the prevention of osteoporosis. Current data indicates that the majority of children do not receive adequate amounts of calcium or vitamin D.
Recommended amount of calcium vary for individuals.

Below is a table of adequate intakes as outlined by the National Academy of Science.

Recommended Calcium Intakes

Ages Amount mg/day
Birth–6 months 210
6 months–1 year 270
1–3 500
4–8 800
9–13 1300
14–18 1300
19–30 1000
31–50 1000
51–70 1200
70 or older 1200
Pregnant & Lactating 1000
14–18 1300
19–50 1000

Role of Vitamin D

Vitamin D also plays an important role in healthy bone development. Vitamin D helps in the absorption of calcium (this is why milk is fortified with vitamin D). In the past many people depended on the sun’s effect on the skin to make vitamin D. Since more emphasis has been place on sunscreen, there is less sun effect and a greater need for vitamin D supplement. The exact amount of vitamin D required is being debated, but the consensus is that Americans are generally deficient in vitamin D and require greater amounts than originally thought. 800 international units to 1000 international units is the current recommendation for adults.

Certain medical conditions may limit the amount of calcium that may be ingested. As always, consulting your physician is suggested regarding your personal specific calcium needs.

Exercise is Necessary to Maintain Bone Health

Weight bearing exercise (walking, running, etc.) is an excellent stimulus for bone growth. Current recommendations are:

Adults: Engage in at least 30 minutes of moderate physical activity [on] most, preferably all, days of the week

Children: Engage in at least 60 minutes of moderate physical activity [on] most, preferably all, days of the week

Bone Mineral Density

The evaluation of bone strength, the about of calcium in the bone, is measured by a dual density densitometer. The purpose of this is to measure the exact bone mineral density of the spinal vertebrae, usually the four lumbar (lower back) vertebrae, and the femur, the large thigh bone that connects to the pelvis in the hip socket.

The bone mineral density (BMD) is usually expressed as a “T” score which is a comparison of the patients BMD to a young person. A “T” score that is – 1 or higher is considered normal. A “T” score of – 2.5 or lower is considered osteoporosis. A “T” score between – 1 and – 2.5 is called osteopenia – a softening of the bone.
Bone mineral density testing should be recommended to all postmenopausal women aged 65 years or older. Bone mineral density testing may be recommended to postmenopausal women younger than 65 years who have 1 or more risk factors for osteoporosis (See Below). Bone mineral density testing should be performed on all postmenopausal women with fractures to confirm the diagnosis of osteoporosis and determine disease severity.

Risk Factors for Osteoporotic Fracture in Postmenopausal Women

• History of prior fracture
• Family history of osteoporosis
• Caucasian race
• Dementia
• Poor nutrition
• Smoking
• Low weight and body mass index
• Estrogen deficiency*
o Early menopause (age younger than 45 years) or bilateral oophorectomy
o Prolonged premenopausal amenorrhea (>1 year)
• Long-term low calcium intake
• Alcoholism
• Impaired eyesight despite adequate correction
• History of falls
• Inadequate physical activity

About the Author:

Dr. Murray Fox is a board certified gynecologist with Women’s Specialist of Plano. Dr. Fox has over 30 years of practice and expertise in his field. His special areas of interest include preventative medicine, pelvic floor abnormalities, adolescent gynecology, and robotic surgery. http://www.obgynplano.com/womens-doctors-physicians/dr-murray-fox-md/

Article Source: ArticlesBase.com – Bone and Calcium Metabolism: Prevention of Osteoporosis