HCA Virginia Physicians - March 18, 2022

Ayatallah M. Khafagy, MD

If you’ve been diagnosed with endometriosis or uterine fibroids, you have many treatment options to consider. For some women, surgical treatments can help improve their symptoms or fertility. So how do you know if surgery could be right for you? Our experts can help.

Have a conversation about your goals

When talking with your obstetrician/gynecologist (ob/gyn) or a gynecological surgeon, start by defining your goals. Do you want to improve chronic pain or other symptoms? Are you wanting to get pregnant in the future? By sharing this information with your provider, you can find the best treatment to help achieve your goals.

If you have endometriosis, nonsurgical treatments such as hormonal birth control pills, an intrauterine device (IUD), or other medications that influence hormone levels may be your best choice. However, these treatments also prevent pregnancy which means you may choose a different treatment if you’re planning to conceive. Surgery is a treatment option for people who want to relieve chronic pain or improve their fertility.

If you have uterine fibroids, hormonal IUDs, birth control pills, or medicine may help with heavy periods. You may consider surgery as a treatment option to remove a larger fibroid, relieve chronic pain, or reduce heavy bleeding.

“It’s important to know what all your options are in order to make an informed decision about what treatment might be most suitable for your needs,” said Obstetrician and Gynecologic Surgeon Ayatallah M. Khafagy, MD, with StoneSprings Ob/Gyn in Northern Virginia. “It’s not one size fits all.”

Types of surgical procedures for fibroids and endometriosis

Surgical treatments for uterine fibroids and endometriosis can often be done using laparoscopic, minimally invasive techniques with robotic tools. During laparoscopic surgery, the surgeon makes small incisions (cuts) in the stomach. They then insert a laparoscope (small camera) in one cut and surgical tools in the other.

Dr. Khafagy is fellowship-trained in minimally invasive surgery using robotics for precision. Compared with traditional, open procedures, minimally invasive surgery often leads to less pain, less bleeding, and a quicker recovery.

Surgical treatments for uterine fibroids and endometriosis include:

  • Endometrial ablation: To reduce heavy menstrual bleeding, this procedure ablates (destroys) the tissue that lines the uterus, called the endometrium. Doctors perform the procedure through the vaginal opening. This is an option for patients who do not want to get pregnant in the future.
  • Hysterectomy: Complete removal of the uterus may be a good treatment option for patients who do not want to get pregnant in the future and have large fibroids or very heavy periods. Depending on each patient’s situation, this surgery can be done through the vagina, through small cuts in your stomach, or through a large incision.
  • Myomectomy: A surgeon removes uterine fibroids and leaves the healthy tissue of the patient’s uterus intact. Depending on the size of the fibroids, the surgeon may remove them laparoscopically (through small cuts in the stomach) or with a more traditional open procedure. Your doctor may recommend this option if you want to get pregnant in the future.
  • Uterine fibroid embolization: An embolization starves the fibroid of its blood supply, which can result in the fibroid becoming smaller and bleeding less. Most patients’ symptoms improve or disappear, and recovery is quick. This is a treatment option for patients who do not want to get pregnant in the future.
  • Removal of endometrial implants: Surgery to remove endometrial tissue, often done laparoscopically, can alleviate endometriosis pain and symptoms. It also preserves your fertility and can often increase your chances for pregnancy.

Every surgical treatment comes with its own benefits and risks. Talk to a gynecologic surgeon to discuss which treatment options would be best for you and your goals.

Make an informed decision

If you have endometriosis or uterine fibroids, talking to a gynecologic surgeon can help you understand if surgical options might improve your symptoms or support your goals.

Dr. Khafagy is a board-certified obstetrician and gynecologic surgeon who specializes in minimally invasive gynecology as well as menopause management, vulvar diseases, and high-risk obstetrics. She sees patients at two locations that often offer same-day and next-day appointments. To schedule an appointment at Stone Springs Ob/Gyn - Dulles, call (703) 665-2430. To schedule an appointment at Stone Springs Ob/Gyn – Gainesville, call (571) 284-5520.