Care · By concern
A uterine fibroid is a benign tumor of the muscle of the uterus — very common, often silent, sometimes a real burden. At the practice, 42 avenue Mozart, Dr Chaima Gatri, OB-GYN and gynecological (gynaecological) surgeon, manages fibroids at every stage: diagnosis by ultrasound during the consultation, medical treatment of the bleeding and, when that is not enough, surgery at the Clinique de la Muette, a five-minute walk away — preserving the uterus whenever the situation allows. English-speaking practice.
Recognizing it
A fibroid (or myoma) is a ball of muscle tissue that grows in the wall of the uterus. Often several at once, from a few millimeters to several centimeters, fibroids sit inside the cavity, within the muscle or on the surface of the uterus; their size and position determine the symptoms.
Many fibroids cause no symptoms at all: found on a routine ultrasound, they are simply monitored. What matters is the impact on your life — and that is what the consultation assesses first.
Assessment
The consultation begins with your symptoms, your history and your pregnancy plans if you have any, then a gynecological examination. The pelvic ultrasound is performed at the same time, at the practice, on the GE Voluson Expert 22 system: it counts the fibroids, measures them and locates them in relation to the uterine cavity, and Dr Gatri explains the images to you immediately. When fibroids reach the cavity or the bleeding remains unexplained, a diagnostic hysteroscopy completes the assessment, also at the practice, with a fine endoscope, with no operating theatre and no general anesthesia; a blood test checks for anemia.
You leave with a clear answer: which fibroids you have, whether they explain your symptoms, and what is proposed to you.
Treatments
These procedures are performed by Dr Gatri at the Clinique de la Muette, usually as day surgery, following the practice's surgical pathway: consultation, documents and quotation by e-mail, electronic signature, theatre booking, anesthesia consultation at the clinic, then a post-operative consultation at the practice. The information sheets of the French College of Gynecologists and Obstetricians (CNGOF), translated into English, are given to you: myomectomy, hysteroscopy, vaginal, laparoscopic or abdominal hysterectomy, second-generation endometrial ablation.
Frequently asked questions
No. A fibroid is a benign tumor of the uterine muscle. Ultrasound, completed by hysteroscopy if needed, distinguishes it from the other causes of bleeding.
No. A fibroid that causes no trouble is monitored; heavy periods are treated medically first. Surgery is proposed when medical treatment is not enough, when the fibroid presses on neighboring organs or when it stands in the way of a pregnancy.
Yes, in the great majority of situations. Myomectomy removes the fibroids while preserving the uterus, and therefore the possibility of pregnancy; operative hysteroscopy does the same for fibroids inside the cavity. Hysterectomy is reserved for situations where conservative treatments are no longer sufficient and there are no more pregnancy plans.
Yes, most of the time: most women with fibroids conceive and give birth normally. Some fibroids, because of their position in the cavity, interfere with implantation; they are then removed before pregnancy. If you are having difficulty conceiving, the couple's consultation reviews all the possible causes, fibroids included.
It depends on the route. After operative hysteroscopy you most often go home the same day; laparoscopy and open surgery involve a short hospital stay and a longer recovery. Dr Gatri tells you at the consultation how much time off to expect; the information sheet gives the details.
After a myomectomy the uterus is preserved and new fibroids sometimes form over the years; ultrasound monitoring continues. After menopause, they shrink. Only hysterectomy rules out any recurrence.
The consultation, the ultrasound, the diagnostic hysteroscopy and surgery are covered by the French health insurance (Assurance maladie) under the usual sector 2 conditions; for a procedure, the practice's quotation covers Dr Gatri's fees, while clinic charges and the anesthetist's fees are settled with the clinic. The full picture is in “Fees and reimbursement”, further down.
On Doctolib, with Dr Gatri: “Première consultation de gynécologie” (first gynecology consultation), or “Consultation pour myomectomie (fibromes)” if surgery has already been discussed; or by telephone through the secretariat.
Fees
The consultation, the pelvic ultrasound, the diagnostic hysteroscopy and surgical procedures are covered by the Assurance maladie under sector 2 (non-OPTAM) conditions; a detailed quotation, covering Dr Gatri's fees, is provided before any procedure, while clinic charges and the anesthetist's fees are arranged directly with the clinic. Fees are listed in the fee schedule and displayed at the practice. The information framework of this site is described on the Patient information and ethics page.
Appointments
Appointments can be booked online via Doctolib or by telephone through the secretariat.
Doctolib — Dr Chaima GATRI