IT only takes few minutes for Amber Olson to get the answer she's waited three years to hear.
Dr. Richard Boroditsky slides a slender cylinder equipped with a camera inside Olson's uterus to see what's causing her excessive bleeding and trouble getting pregnant.
Claire Benjamin undergoes a procedure to ease the effect of fibroids on her uterus. Dr. Richard Boroditsky of the Victoria Hospital's Mature Women's Clinic says the procedure is less invasive than a hysterectomy. It requires one day in the hospital and a patient can recover at home. The chance of serious complications is also reduced. Many women with excessive bleeding caused by fibroids are first told they must have a hysterectomy. However, Boroditsky says they should investigate alternative procedures.
Olson bleeds so heavily she's become anemic, and recently needed a blood transfusion to return her blood count to normal.
Ten years ago, doctors would have told the mother of one her only option was to have a hysterectomy -- an invasive surgery to remove her uterus.
But today Boroditsky has good news -- the fibroids that have been blocking her uterus and nearly doubling its size can be removed using new non-invasive procedures.
He also told the 27-year-old she should be able to conceive six months after they're removed.
"The funny thing is I was told I didn't need to see a gynecologist and they told me I wouldn't have a problem getting pregnant," Olson said.
Fibroids affect up to 70 per cent of women, and doctors still aren't certain what causes the hard, round bits of tissue that grow in or around the uterus. One third of women, like Olson, suffer severe problems because of fibroids, including heavy bleeding, pain or bladder problems.
Fibroids are also the main reason women have hysterectomies -- the most common major surgery for women in Canada, despite its potential for complications and the long period of time it takes women to recover.
But Boroditsky, a gynecologist who works at the Mature Women's Centre in Victoria Hospital, said many hysterectomies are unnecessary and could be avoided with new, less invasive procedures.
The problem is, most women don't know there are alternatives and think that a hysterectomy is their only solution.
Boroditsky said if more women asked their doctor about their options, they might be able to avoid the major surgery altogether.
"If your car's not running well you don't trade in the car or change the motor, you can go in there and fix up the spark plugs," Boroditsky said.
"If a woman is bleeding heavy from the lining of the uterus, then maybe we can do something about the lining of the uterus."
Five years ago, Boroditsky started using uterine artery embolization in Manitoba -- a minimally invasive procedure that cuts off the blood supply to a fibroid, causing it to shrink and thereby relieve symptoms. He makes a small incision in the groin and threads a tube to reach the uterine artery. The tube releases tiny plastic particles into the blood vessels to cut off the blood supply to the fibroid.
Fibroids can shrink up to 60 per cent, and the majority of women see an improvement.
In the past three years, 111 Manitoba women have had the procedure, and only 13 went on to need hysterectomies.
Women who have their fibroids embolized spend a day in hospital and about five days recovering at home -- a fraction of the recovery time as a hysterectomy.
Women who have a hysterectomy can spend up to five days in hospital and six weeks recovering from the surgery that can sometimes cause infection and hemorrhaging.
"We empower these women to make the decision. We don't tell them what to do," Boroditsky said.
"There's a lot of reasons why women want to preserve their uterus -- culturally, socially, sexually, emotionally -- they say I'm not ready for that."
Since hysterectomy alternatives such as uterine artery embolization became available, staff at the Mature Women's Centre has counselled more than 700 women on treatment methods for fibroids that don't involve removing the uterus.
Some fibroids can also be removed from the uterine wall by a tool inserted through the vagina, and certain drug therapies can be used to shrink them.
Although some women still choose a hysterectomy, Boroditsky said it's important women know all of their options before they make up their mind.
Cheryl Sul, 42, thought she was too young for a hysterectomy.
Last year, Sul's fibroids were putting intense pressure on her bladder -- making her excessively bloated and often unable to go to the bathroom.
The mother of three said her pants size would fluctuate depending on how much her fibroids made her abdomen bulge.
She decided to try uterine artery embolization last July and said she no longer has any discomfort or pain.
"I was feeling bloated and uncomfortable, like I had to wear clothes that were two sizes too big," she said.
Four years ago a doctor told Lesly Katz she would need a hysterectomy to put an end to the heavy bleeding that left her running to the washroom every 20 minutes. But after watching her mother and sister have the major surgery, she decided to see if embolization would work for her.
Within weeks of the procedure, Katz's bleeding stopped, her energy levels perked up, and she could finally leave her bulky pads at home.
"I have a life now," she said.
jen.skerritt@freepress.mb.ca
Hysterectomy facts:
* Hysterectomies are the most common major surgery for Canadian women.
* In Manitoba, 343 women per 100,000 have their uterus removed -- a rate that is slightly lower than the national average.
* Women can spend up to five days in hospital and six weeks recovering from a hysterectomy.
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