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For Cassandra, Choosing The Best Large Fibroid Removal Meant Traveling To Maryland

best large fibroid removal

Cassandra DV, New York Sought Minimally Invasive Fibroid Removal at CIGC

“I didn’t realize how much [the fibroid] was affecting me,’ Cassandra DV, Stoneridge, NY. “I can do floor postures in yoga now without it getting in the way.”

Cassandra was diagnosed with a fibroid five years ago. “My initial gynecologist sent me in for a sonogram to gauge the size. At that point I didn’t have any symptoms. He said ‘At some point this is going to make you look pregnant, and you are going to have to do something.’ For a couple of years, though, I didn’t really think about it.”

Even when they are not overtly symptomatic, fibroids can have a tremendous impact on a woman’s life, and they can become a problem without much warning.

“Two years ago I noticed that my cycle had changed, and I blamed it on changing my birth control. I started bleeding half the month. I would have terrible blood clots. Even after my period was over, I would start bleeding out of nowhere. Then it would stop and go away.”

Choosing The Best Large Fibroid Removal Procedure Can Be Confusing

There are many techniques available, but many are not long-term solutions.

“I’ve been athletic and active my whole life. I have exercised three or 4 times a week since high school, but now, nothing was fitting me the way it had. Laying down in yoga, I saw that my abdomen was misshapen. I was freaked out. At the time, surgery wasn’t even something I thought I should consider. I started looking into embolization.”

Cassandra had an MRI, and only then did she realize how large the fibroid was. “The specialist said that while he could do the embolization procedure, he wasn’t sure it would make enough of a difference.”

Why Embolization Is Not An Effective Treatment For Large Fibroids

Uterine artery embolization (UAE), also known as UFE (uterine fibroid embolization), blocks the blood supply to the artery, using plastic particles or some other method to eliminate blood flow to the fibroid. A needle is inserted into the large artery of the groin. A small plastic tube is then inserted through the needle, and the blood supply to the uterus and fibroids is located. Small plastic particles or “beads” are then inserted into the blood supply of the fibroid, blocking the supply. This causes “necrosis” or death of the fibroid. Since there are two uterine arteries – one on each side of the uterus – both arteries need to undergo UAE to achieve the best results.

Large fibroids are not as well-treated with UAE as with a myomectomy or a hysterectomy. Larger fibroids may have multiple blood supplies and larger-sized vessels that cannot be completely treated with UAE procedures. They have a much higher chance of continued or regrowth after UAE treatment.

Other types of fibroids have complications with UAE.

  • Submucosal fibroids can detach from the uterine wall, and then pass out through the vagina or require removal if they are larger in size. Passage can happen up to a year or longer after the procedure, and can be associated with foul smelling discharge or severe pain.
  • Fibroids on stalks, also called pedunculated fibroids, are not treated very well with UAE. Higher complications are seen when UAE is conducted on these types of fibroids, including twisting of the fibroid and pain, separation of the fibroid from the uterus and others.
  • UAE should never be conducted on any patient that may have a pre-cancer or cancer of the uterus. This includes uterine and cervical cancer, as well as overgrowth of the uterine lining called endometrial hyperplasia. Pap smears to check for cervical cancer, and uterine biopsy or D&C should be done for those patients in which cancer may be an issue.

Minimally Invasive Fibroid Removal At CIGC

Cassandra met with Paul MacKoul MD at The Center for Innovative GYN Care. “I had a friend who mentioned that she recently had surgery with the surgeons at CIGC for a massive fibroid, and she was back at work in two weeks.”

Many women choose to undergo a minimally invasive myomectomy for large fibroid removal, especially if they are not finished with childbearing. Cassandra agreed with Dr. MacKoul however, that a minimally invasive supracervical hysterectomy was the better option, as it would prevent future fibroids from growing, and her uterus was distorted from the size of the current fibroid. A normal uterus weighs approximately 60 grams. Cassandra’s was upwards of 1100 grams.

“When I talked to Dr. MacKoul, I was relieved that I had a plan. It felt like I had an alien in my body. I had a week or so before getting my insurance cleared and I spent a lot of time on the website which was incredibly helpful to me. Seeing all of the patients who had had surgery on the blog and the videos reassured me that this was where I needed to be.”

Cassandra had a laparoscopic supracervical hysterectomy and removal of the fallopian tubes. According to the most recent research on preventing ovarian cancer, removal of the fallopian tubes decreases the risk by 30%.

“The word hysterectomy still upsets me. The surgery my mother had was so different. Back then, they took everything, and she immediately went through menopause. She was shell shocked after. I kept my ovaries so I wouldn’t go through menopause.”

Bleeding From Fibroids Can Cause Anemia

“When I did all my prep for the surgery, they said that my blood count was a bit low. When you have a busy life and you just keep going not realizing how it affects you. I didn’t feel like myself and it did start to bleed into how I felt about myself. I’ve always been a pretty secure person. I’m a pretty happy person. I’ve always felt pretty grounded. Then, I started to feel not so great. I was just like one of those few things. I was petrified that someone would come up and ask me if I was pregnant. I’m in a wonderful relationship, but I internalized a lot of it. Only in the last few months did he notice how much it was affecting me.”

Fibroids can cause unpredictable bleeding even when a woman is not on her period.

Learn The Dangers Of Anemia Due To Large Fibroids

“I was in NYC going to a meeting and I started bleeding in the middle of the day, no warning. The more I’ve told people in my life, every other woman has walked up to me and said I think I have this. I think people think that it’s something that happens to you after menopause.”

After The Surgery

“The first thing I did when I started to come out of it, I started to look under the sheet and I said ‘Yay, my stomach’s flat!’ and then went back to sleep. The staff was so nice, they went out and brought my mother back in a wheelchair to see me. I was happy to see they took care of her.”

“Traveling to CIGC was easy for me since my family is in the area, but I went back to New York on the second day after my surgery, and I felt fine to travel.”

“The first week I took it easy. But by the third day, I felt really good. I didn’t feel inhibited about going about my normal life. But I had to keep reminding myself not to pick up anything heavy. I feel like I sleep a lot better now, my sleeping pattern has returned, I have energy. And I haven’t changed anything else. That part has been very gratifying.”


Doctors are taking advantage of new communication techniques to consult with patients in advance of travel. Communication apps make conversations between patients and medical professionals around the world possible. Increasingly, as specialists are coming up with new and safer techniques to treat conditions, patients are seeking ways to take advantage of these better procedures.

Women travel from around the world to CIGC for our modern techniques that are safer and more thorough than open, robotic or non-invasive approaches.


GYN surgical specialists can often see women sooner because they are focused entirely on surgery. Each patient gets detailed, in depth attention from Dr. Natalya Danilyants and Dr. Paul J. MacKoul. This personalized care helps patients understand their condition and the recommended treatment so that they can have confidence from the very start. Our surgeons have performed over 20,000 GYN procedures and are constantly finding better ways to improve outcomes for patients.

Book a consultation today with Paul MacKoul MD or Natalya Danilyants MD.

Offices are conveniently located throughout the Washington D.C. area in Rockville, Reston, and Annapolis, MD. Women looking for a GYN specialist for a laparoscopic hysterectomy, endometriosis excision or fibroid removal travel to CIGC from around the world.


Vitals, RateMDs, Google Plus, Wellness, and UCompareHealthCare.


Vitals, RateMDs, Google Plus, Wellness, and UCompareHealthCare.



Even if you are not from the DC area, many patients travel to The Center for Innovative GYN Care for our groundbreaking procedures. We treat women from around the world who suffer from complex GYN conditions.

Learn more in our travel program.