Dr. Quezada is bringing to the women in Longview and East Texas his concept of advanced gynecological care called
FP3 Center of Excellence.
FP3 stands for
Fibroids,
Pelvic
Pain and
Prolapse; issues that plague women of various ages and require additional expertise and experience to provide effective, evidence based approaches. More important that bringing theses skills to Longview is bringing choice and options, things that lacking in offices across the country. Too often these issues or either ignored, dismissed or improperly treated leading to delay in care, expense and loss of hope in achieving " your best life"
FIBROIDSFibroids (medical term is Leiomyoma) are smooth muscle cell tumors of the uterus that can grow in various places within the uterine body or cervix. They vary in size and location and can be asymptomatic or lead to symptoms that include: bloating, heavy menstrual cycles, increased abdominal girth (can't fit into my jeans like a I used to), pelvic pressure, back pain, leg pain, pain with sex, constipation, urge to pee and/or poo all the time, infertility or recurrent pregnancy losses. Some women can have a few or all of the above symptoms. Unfortunately most women don't find out they have these issues early enough before they create a BIG problem. Fortunately the risk of malignancy (Leiomyosarcoma is only 1:374 to 1:000 women.
All too often
fibroids can be missed unless an experienced OBGYN knows how to look for them through questions, physical exam and/or ultrasound. Even when discovered patient are offered very little options, typically nothing, birth control or hysterectomy. At times, even the hysterectomy is via an archaic open approach. Women of color especially black women are disproportionately afflicted with fibroids and more often than not only given options of hysterectomy disregarding if they've completed childbirth or not .
Dr. Quezada is a leader in diagnosis and treatment of
fibroids. He offers a full spectrum approach for treatment. He can inform you of dietary supplements offered to help reduce growth. Introduce you to medical therapies recently approved by the FDA for treatment of fibroids (
Oriahnn) or using more effective medications like Luprolide acetate that simply using birth control pills. He can introduce you to minimally invasive techniques such as Uterine Artery embolization offered by his Interventional Radiology colleagues. Dr. Quezada also offers the premier of minimally invasive techniques to remove or destroy fibroids using Hysteroscopy (for fibroids placed within the cavity, Type 0 and Type 1) or robotic assisted myomectomy for external fibroids such as Type 6, 7 and 8).
He is the leading surgeon in the United States that offered Radiofrequency ablation of
fibroids using the
Acessa technique, only offered by doctors in Houston or Metroplex. He also combines
Acessa with myomectomy to offer the most comprehensive way to treat a variety of fibroids without having to remove the uterus. This combination also helps to reduce the recidivism (recurrence rate) of fibroids and offers patient's a longer break from fibroids symptoms and pain. Not to forget, these procedures are minimally invasive only requiring 2-5 small keyhole type incisions and offer fast recovery to get back to your life.
He also offers minimally invasive robotic hysterectomy to remove an tumor afflicted uterus even if large in size. All of the these offerings provide real choices to women suffering from
fibroids to make the choices for their body, to help incorporate their plans and desires. Even women not considering childbirth are given the full spectrum of options to choose what is best for them
PELVIC PAINPelvic pain is caused by a multitude of different causes or pathologies.
Fibroids can cause pain but so too can issues like
ovarian cysts, ovarian masses, or
adhesions. Some less frequent causes such as
pelvic congestion syndrome or obturator hernias can cause pain and be very difficulty to initially diagnose. Several conditions not related to the reproductive tract can cause pain and wrongfully be treated with hysterectomy with no pain relief to be seen. These conditions like interstitial cystitis afflict the bladder or inflammatory or Irritable bowel disease afflict the gastrointestinal tract. Proper questions and open mind can help on OBGYN find the true cause of pain.
More common sources of pain include
Endometriosis and
Adenomyosis This is a condition where cells from the endometrial cavity (where menstrual blood or flow comes form and is a part of) can migrate to backwards through the tubes to grow on the ovary, tubes, pelvic sidewall or bowel. This can lead to pelvic pain, specifically pain several days before a menstrual cycle, pain with intercourse and is strongly associated with infertility.
This condition if very hard to treat effectively Many times women are placed on birth control pills that sometimes work or are forced into a hysterectomy. Dr. Quezada provides other options including medical therapy such as
Luprolide Acetate or
Elagolix if covered by insurance to treat pain from endometriosis or after surgery to prevent recurrence. He also offers minimally invasive techniques such as
Robotic assisted excision or fulguration (burn) of the endometriosis. Sometime endometriosis can establish itself over very delicate structures like the ureter or bowel; this requires an experienced and delicate hand to treat the disease without harming the underlying structure. Dr. Quezada also employs Firefly technology during his surgery to identify smaller nearly microscopic endometriosis that may have been missed to the naked eye and be the cause of next year or following year recurrence of endometriosis related pain. This addition reduces the recidivism (can return) rate of endometriosis.
Adenomyosis is a form of endometriosis where the cells invade the muscle of the uterus leading to large uterus, heavy menstrual cycles and very severe cramping. This diagnosis is very hard to treat but can be aided with use of oral contraceptives, GnRH antagonists/agonists like
Lupron or
Elagolix and have seen promising results using
Acessa in treating
adenomyosis. This indication is NOT FDA approved but is a special interest of Dr. Quezada in advancing this surgical approach for adenomyosis. Hysterectomy is also another option especially if completed childbearing and seeking pain relief
PROLAPSEPelvic Organ Prolapse or POP is a condition where one or more parts of the reproductive tract or vagina loose structural integrity and begin to fall out of position. Depending on the location, this can universally lead to feeling vaginal pressure and/or bulge, feel something on self exam coming out of the vagina, pain with intercourse, leakage of urine with straining, laughing, coughing or sneezing. Less often symptoms such as recurrent urinary tract infections, constipation, splinting (using fingers to place pressure in or around the vaginal to allow pee or stool to come out) or in more severe forms inability to empty the bladder. The hardest part of this diagnosis is the embarrassment with having or talking about this issue and thus can be missed or not diagnosed for years, even decades. Some women, especially in Latino communities are given misinformation by other family members. Using the right questions, questionnaire and Pelvic Organ Prolapse Quantification system can help diagnose the type and severity of the prolapse.
Risks factors include age, history of pregnancy (vaginal more so than cesarean), obstructed labor, history of straining (chronic constipation or job involving heavy lifting), family history, obesity and smoking. It typically affects women in their 40s and later but can occur in their 20s. Typically patients are told to do Kegel's or start using undergarment pad but not much else. This is NOT right. Women have many options depending on the issue at hand and having an experienced surgeon to help diagnose the problem (s) can help to find the right solution. Sometimes using biofeedback for mild incontinence or Pelvic Floor Muscle Therapy (PFMT) can work. In more severe forms, a pessary can be used to correct the prolapse. Surgical options are also available including colporrhaphy, apical suspension or
sacrocolpoplexy. Surgical options offer a longer lasting option to provide relief from prolapse. It may also involve use or need for hysterectomy. Some surgical options can be done vaginally or robotically but all minimally invasive. That offers less pain, quicker recovery and quicker return to your life.
No longer do women in Longview and East Texas have so suffer this alone. A little courage to speak up with your provider can help begin the path to recovery. Women of East Texas now have a resource that is not tied to the Metroplex in provider definitive and longer lasting relief of prolapse symptoms. Dr Quezada now brings these options to Longview and East Texas. Women now have an option to seek care for these issues.