MIGS at UGSC

✨Happy patients make it all worth it!✨

This lovely patient is a few weeks out from her robotic hysterectomy.  She had an extremely large fibroid with symptoms including changes in her period, a hard mass that she could feel along her abdomen, and difficulties with urination due to the fibroid pressing on her bladder.  She was offered a variety of management options and elected for a hysterectomy! She is now pain-free, urinating normally, and has returned to all her normal activities!

Interested in learning more about treatment options for fibroid? Feel free to call our office to see if we can help at 559-321-2930. Pictures posted with patient consent

Lets take it back to basics…What is MIGS? 🤔

MIGS is an acronym for a sub-specialty of OB/GYN called minimally invasive gynecologic surgery. 

In terms of training, MIGS surgeons complete a 4 year residency in Obstetrics and Gynecology followed by a 2-3 year fellowship in MIGS.
Minimally Invasive Gynecologic Surgeons are trained in the management of complex benign gynecology which includes abnormal uterine bleeding, fibroids, endometriosis, chronic pelvic pain, ovarian cysts, Cesarean scar defects…just to name a few.  We often work closely with general OB/GYNs, REI (infertility doctors), and MFM (high-risk pregnancy doctors).
While our name makes it sound like all we do is surgery, we always offer conservative management options too, which depending on the condition, can include medication, procedures, physical therapy, and when appropriate surgery. 

✨Happy Fibroid Friday!✨

Today, we are going to talk about procedural options for treating uterine fibroids.  As we previously mentioned, there are always 3 types of treatments to consider: medical, procedural, or surgical based on your individual fibroid characteristics and symptoms, treatment goals, and future fertility plans. 

Procedural options include uterine artery embolization (UAE), radiofrequency ablation, and MRI-guided focused ultrasound.  Prior to proceeding with one of these procedures, we order an MRI to ensure that the size and types of fibroids are appropriate for the planned treatment. This schematic represents a UAE, a procedure performed by our colleagues in Interventional Radiology. Typically, a small incision is made in the wrist or groin and material is delivered to the uterine arteries, therefore limiting blood supply to the uterus and fibroids.  On average, patients experience significant reduction in bleeding and a 50% reduction in uterine and fibroid size over the next 6-12 months which can help with the bulk symptoms of fibroids, such as urinary frequency, constipation, or pressure.   Approximately 75% of patients report long-term satisfaction with their treatment.

Curious about whether a UAE is right for you? Want to know more about other fibroid treatment options? Please call us at 559-321-2930 to set up an appointment.  Also let us know if there are other gynecologic topics you’d like to hear more about!

Continuing to learn and grow is a crucial part of providing quality care to patients.  This week, we are heading to the American Academy of Gynecologic Laparoscopists (AAGL) National Conference in Aurora, Colorado.  

While most conferences focus on provider education, AAGL will also be having a session just for patients! “Everything you want to know about the “F” word: Fibroids, Facts, Fiction, and Fallacies on Saturday, December 3 via Zoom. Register here: https:// buff.ly/3X3HYi7

Meet our other docs!
Dr Steinberg and Dr Meade are fellowship-trained urogynecologists at UGSC. They see patients for a variety of problems including pelvic organ prolapse, pelvic floor dysfunction, interstitial cystitis, and urinary incontinence.

With the team approach at UGSC, patients are able to be seen for a variety of their gynecologic needs all in one place without leaving the Central Valley. Additionally we offer testing such as urodynamics, cystoscopy, and hysteroscopy all within the clinic as well as treatments including pelvic floor muscle therapy.

✨Happy weekend!✨ Did you know that aerobic exercise can help reduce the severity and length of symptoms for women with painful periods, also known as dysmenorrhea. Studies show that exercise has both therapeutic (while on your period) as well as preventative properties.

Meta-analyses, studies that pool all the data from smaller studies, are inconclusive regarding dysmenorrhea in patients with endometriosis, but many of the individual studies did show some improvement. Plus, exercise has been shown to improve mood and anxiety in endometriosis patients, conditions that often co-exist!

So let’s get moving 🏃🏽‍♀️, your uterus will thank you later!

On today’s fibroid Friday, let’s talk about some non-surgical options for fibroids. Not everyone with fibroids needs surgery for their fibroids. For some patients, especially those with mild to moderate symptoms or if approaching menopause, alternative therapies such as medications or procedures can do the trick to manage symptoms.

Medications are most helpful for bleeding symptoms and come in a variety of forms such as pills, shots, patches, rings, or even an IUD depending on where in the uterus the fibroids are. Unfortunately, bulk symptoms (such as having to go to the bathroom more frequently, constipation, or an enlarging abdomen) cannot be treated with medication. Similarly, while many patients’ bleeding symptoms will stop with menopause, fibroids will NOT shrink significantly and bulk symptoms can continue.  

There are other procedural options outside of surgery such as uterine artery embolization or radio frequency ablation that can help with both bulk and bleeding…but we’ll discuss those on another fun fibroid Friday!

Have topics you want discussed? Let me know!

✨Whatever we want!✨
But for patients with abnormal bleeding, whether heavy or unpredictable, it’s not that easy.  Bleeding that prevents you from wearing your favorite outfit, limits your ability to leave the house, or stops you from going to school or work is NOT normal.  

Your gynecologist can help determine what is causing your bleeding and find a treatment strategy that works with you, your life, and your goals!

Call to schedule an appointment at (559) 321-2930.  Appointments available within 1 week!

Welcome to our Instagram page. Let’s get acquainted!

Dr. Tara Brah is a Minimally Invasive Gynecologic Surgeon joining the Urogynecology Specialty Center.  Dr. Brah completed her residency here in the Central Valley at UCSF-Fresno in Obstetrics and Gynecology. She then went on to complete her Minimally Invasive Gynecologic Surgery fellowship at The Johns Hopkins Hospital in Baltimore, Maryland.  She is excited to return home to Fresno to provide innovative, patient-centered gynecologic care to patients in the Valley. Her interests are fibroids, endometriosis, ovarian cysts, and optimizing minimally invasive surgery.  

To schedule an appointment with Dr. Brah, please call (559) 321-2930.

Welcome to Fibroid Fridays!
Did you know that up to 80% of people will develop a fibroid (or multiple fibroids) by the age of 50!

Good news: not everyone will develop symptoms. Symptoms depend on the size, number, and location of the fibroids.  Fibroids that push into the cavity of the uterus, where a pregnancy would sit, cause bleeding symptoms.  While large fibroids can become heavy causing pelvic pressure, push on other organs such as your bowel or bladder, or make your abdomen look larger.  

Everyone’s fibroids are different (➡️ to see some examples); therefore, treatment needs to be individualized to a patient’s fibroids, symptoms, and life/reproductive goals!

Have questions about fibroids? DM me and I’d be happy to address them in upcoming Fibroid Fridays!

Welcome to Fibroid Fridays!
Did you know that up to 80% of people will develop fibroids by the age of 50!

Good news: not everyone will develop symptoms. Symptoms depend on the size, number, and location of the fibroids.  Fibroids that push into the cavity of the uterus, where a pregnancy would sit, cause bleeding symptoms.  While very large fibroids can become heavy causing pelvic pressure, push on other organs such as your bowel or bladder, or make your abdomen look larger.  

Everyone’s fibroids are different (➡️ to see some examples); therefore treatment needs to be individualized to a patient’s fibroids, symptoms, and life/reproductive goals!

Have questions about fibroids? DM me and I’d be happy to address them in upcoming Fibroid Fridays!