Alternatives to Treatment of Fibroids

August 18, 2006
Herbert A. Goldfarb, MD

From the 34th Annual Meeting - Chicago, Illinois - November 2005

Barbara Nesbitt: Hi, I am Barbara Nesbitt and I have the privilege and the pleasure of talking with Dr. Herbert Goldfarb today. He is from New York Downtown Hospital and he is going to talk about his book on treatments for women with fibroids.

Herbert Goldfarb: Good afternoon, I am Dr. Herbert Goldfarb and I am the Chairman of the Department of Obstetrics and Gynecology at the New York Downtown Hospital. For many years I have been interested in the treatment of fibroids and have published the book called No-Hysterectomy Option, which is still available on Amazon.com. In addition, my website is called www.nohysterectomy.com.

On this website, under the alternatives section you will see an extensive list of alternatives to hysterectomy. You have just heard that Paul Indman, who is from the west coast, talk about the alternative treatments for fibroids, and I try to carry the load on the east coast. Our desire is to help women avoid hysterectomy. To that end there are a number of different options, Dr. Indman has mentioned some of them, including hysterectomy, myomectomy, ablation and as well as uterine embolization. Firstly I would like to say that fibroids need to be symptomatic before they need to be treated, unless of course, large fibroids happen to be present in women who want to be pregnant. Often times these fibroids need to be removed if they are impacting the cavity and the problem is not infertility but the problem is prematurity. Having a premature child could be a real problem. We specialize in treating these types of cases by using a minimally invasive approach combined laparoscopic approach and one of the interesting things that we have discovered is that often times, after myomectomy surgery there are adhesions that develop, which causes the bowel to stick to the back of the uterus and the incision sites.

For women who are interested in fertility we routinely bring them back ten days later for a laparoscopic approach, which then removes the adhesions and our fertility rates are quite high. This has been well documented in the literature. We have been very successful.

In addition, we have found a number of women who have severe hemorrhage requiring blood transfusions. For those women, we are able to treat them using the new ablation technique called Hydrothermal Ablation using the hot water technique to stop their bleeding. Then we can use iron and other medicines, we can build up their blood, avoid transfusions, and then perform either hysteroscopic or laparoscopic treatments.

The point being that we have available to us all the possible techniques to help women avoid hysterectomy. Whatever we do, we do using minimally invasive techniques, large incisions are out, very small are incisions are in. The important thing is that we have to treat the woman as a whole, not just a uterus. We have to find out what the woman needs, what she desires, and then try to offer that treatment.

So, again, the website is www.nohysterectomy.com and all the information will be available on that website. Thank you very much.

Barbara Nesbitt: Thank you.

For more information on Dr. Goldfarb's book, "No-Hysterectomy Option" please click here for the Amazon.com information and ordering page.