Fibroids

Fibroid treatment in Miami.

Most women with fibroids never need surgery. Of those who do, most do not need an open operation. The first visit exists to work out which you are.

The options

How this is approached here

  1. 01

    Watchful waiting

    If they are small, symptoms are tolerable and menopause is close — we re-scan at six months.

  2. 02

    Medical management

    Tranexamic acid or hormonal treatment for heavy bleeding, GnRH modulators to shrink fibroids before surgery.

  3. 03

    Uterine artery embolisation

    Performed by an interventional radiologist we refer to and co-manage with, not by us.

  4. 04

    Myomectomy

    The fibroids come out, the uterus stays. Hysteroscopic, laparoscopic or open depending on size and position.

  5. 05

    Minimally invasive hysterectomy

    Laparoscopic or vaginal. Definitive, not reversible, and last on this list for that reason.

Symptoms

What fibroids actually feel like

Periods that soak through protection in an hour

Or last more than seven days.

Clots larger than a coin

And the planning of your life around where a bathroom is.

Pressure low in the abdomen

Or a feeling of fullness that is not bloating.

Needing to pass urine often

Or waking at night to do it, because a fibroid is sitting on the bladder.

Pain during sex

Usually described as deep rather than at the entrance.

Tiredness that does not resolve with sleep

Which is anaemia from the bleeding, not the fibroid.

When it is worth being seen

Four reasons not to wait

  • You are changing protection hourly or bleeding through at night.
  • You have been told you are anaemic, at any point, and bleeding is heavy.
  • The pressure or the bulk is new, or it is growing noticeably.
  • You are trying to conceive, or may want to — the order of treatment changes entirely if so.

How the decision is made

What actually determines which option fits

Where the fibroid sits

Submucosal fibroids distort the cavity and cause the bleeding; subserosal ones cause pressure. The treatment follows the position, not the size alone.

How many there are. A single fibroid and a uterus with fifteen are different problems with the same name.

Whether you want a pregnancy

Embolisation is generally not offered to anyone planning one; myomectomy is.

How close you are to menopause

Fibroids shrink after it, which sometimes makes waiting the right answer rather than a fobbing-off.

What you are willing to accept

A smaller operation with a chance of recurrence, or a definitive one that ends fertility, is a judgement only you can make.

Fibroids: common questions

Will I need a hysterectomy?
Usually not. It is one of five options and the only irreversible one, so it is the last considered rather than the first offered. If you have been told elsewhere that you need one and want another view, that is a normal appointment to book.
What happens at the first visit?
History, examination and an ultrasound in the office the same day. Number, size and position are what decide the options, and you leave with those written down.
Where would surgery happen?
At Baptist Hospital of Miami or Mount Sinai Medical Center, depending on which office you are under.
Will fibroids come back after a myomectomy?
They can. Roughly a quarter of women have another fibroid needing treatment within five years, and the risk is higher the more fibroids were removed. We say this before the operation, not after.
How long until periods settle?
After embolisation or myomectomy, expect two or three cycles before judging the result. Judging it on the first one is the most common reason people think a treatment failed when it has not.
Is a fibroid cancer?
Almost never. Leiomyosarcoma is rare, on the order of one in several hundred fibroid operations, and rapid growth after menopause is the sign that prompts a closer look.

Know before you book.

Vireo opens in 2027. Until then the plan list, panel status and first-available wait for every office are published on this site and kept current. Questions can go to the practice office on (305) 555-0180.

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