June 1, 2012 Saint Peter's Healthcare System Community Calendar Featured Article.

Many women suffer from the effects of uterine fibroids and polyps. Fibroids are non-cancerous tumors that grow within or extending from the muscles of the uterus. Exactly what causes them is still unknown. Polyps are the result of the overgrowth of cells in the lining of the uterus. Like fibroids, polyps can be present alone or in groups, and their size can vary from very small, almost microscopic, to the size of a golf ball or larger. Uterine polyps most often affect women in their 30s and 40s but half of all women have fibroids by the time they are 35.

The symptoms associated with polyps include bleeding between menstrual periods as well as irregular menstrual bleeding. Women with fibroids often experience lower back pain, heavy or painful periods and frequent urination. Both fibroids and polyps can cause infertility.

Francine Sinofsky, M.D.

There is now a more efficient and safe method for removing polyps and fibroids that in addition to providing relief for women, carries less risk. Called the Truclear Operative Hysteroscopy System, it is being used by physicians at the CARES Surgicenter, part of Saint Peter’s Healthcare System.

“The real true advantage of this system is how efficient it is,’’ says Francine Sinofsky, M.D., an obstetrician and gynecologist affiliated with Saint Peter’s in practice at Ob-Gyn Group of East Brunswick. “Before you had to cut off little pieces at a time and remove those pieces manually, inserting and taking out the instrument. Truclear is hooked to a suction device, so you can get everything in one pass from the uterine cavity. Not having little pieces of tissue in the surgical area means you can see the area you are working with better too.”

Steven Karanikolas, M.D.

The Truclear System features a first-of-its kind device that uses a small blade inserted through a tube called a hysteroscope to simultaneously cut and remove tissue. The system pairs the visualization capabilities of the hysteroscope with the tissue removal capabilities of a morcellator - the device that eliminates tissue – which allows doctors to quickly capture and remove the polyps and fibroids. “This allows for more rapid removal of polyps and fibroids sometimes decreasing operation times by about 75 percent,” explains Steven Karanikolas, M.D., an obstetrician and gynecologist affiliated with Saint Peter’s in practice at Brunswick Hills Obstetrics and Gynecology.

There are other advantages. Besides its speed, it lowers the risk of injuring surrounding tissue. Physicians are not required to make multiple, time-consuming insertions into the uterine cavity, reducing the risks of uterine damage. Unlike other treatment options that use a high-frequency electric current to break up any unwanted tissue, the Truclear System uses a simple mechanical approach. Instruments used during the procedure required physicians to enter the uterine cavity more than once, and once they were at the site of removal, they often had an obstructed view of the surrounding area. “Because it doesn’t use an electrical current, it eliminates injuries and decreases the risk of damage from internal and external burns,” says Dr. Karanikolas.

Until recently, invasive surgical procedures that carried a greater risk of bleeding were among the options available to women suffering the common symptoms of fibroids and polyps, heavy bleeding included. “There is no question this system is advantageous to patients,’’ adds Dr. Sinofsky. “Because it is efficient, patients spend less time in the OR, which means less anesthesia and less risks.”

Consult a physician if you experience any of these symptoms:

UTERINE FIBROIDS

• Heavy or painful periods or bleeding between periods
• Feeling “full” in the lower abdomen
• Frequent urination
• Pain during sex
• Lower back pain
• Reproductive problems, such as infertility, multiple miscarriages or early labor

UTERINE POLYPS

• Irregular menstrual bleeding—for example, having frequent, unpredictable periods of variable length and heaviness
• Bleeding between menstrual periods
• Excessively heavy menstrual periods
• Vaginal bleeding after menopause
• Infertility

Sources: Mayo Foundation, National Institutes of Health

The CARES Surgicenter, located in the Center for Ambulatory Resources at 240 Easton Avenue, next to The Children’s Hospital at Saint Peter’s University Hospital, can be reached at 732- 565-5400 or at www.saintpetershcs. com/CARESSurgicenter.