Myomas, more commonly known as fibroids, are the most frequent non-cancerous (benign) tumors of the female reproductive system. It is estimated that they affect between 20% and 50% of women of reproductive age.

It is a mass of muscular tissue that develops in or on the wall of the uterus. A fibroid can be single or multiple, and its size varies from a few millimeters to several centimeters.

There are three main types depending on their location:

• Submucosal : inside the uterine cavity (often causing bleeding).

• Intramural : within the muscle of the uterus.

• Subserosal : on the outer wall of the uterus (potentially compressing nearby organs).

While many fibroids are asymptomatic and discovered during a routine ultrasound, they can sometimes become debilitating:

• Very heavy or prolonged periods (menorrhagia).

• Bleeding between periods (metrorrhagia).

• Pelvic pain or heaviness.

• Frequent urges to urinate (if the fibroid is pressing on the bladder).

• Discomfort during sexual intercourse.

• Infertility or recurrent miscarriages.

Treatment for fibroids is not always necessary: it depends on the discomfort experienced and your desire to become pregnant. Dr. Choffel always prioritizes the most conservative and least invasive approach.

1. Diagnosis : A clinical examination combined with a pelvic ultrasound (sometimes supplemented by an MRI or diagnostic hysteroscopy) allows for precise mapping of the fibroids.

2. Surgical Treatment of Excellence : When medical treatment is no longer sufficient, Dr. Choffel offers cutting-edge surgical solutions:

• Operative Hysteroscopy : For fibroids located inside the uterus (submucosal). The procedure is performed vaginally, without any incisions, often on an outpatient basis.

• Laparoscopic Myomectomy : To remove fibroids while preserving the uterus. This minimally invasive technique uses small incisions, allowing for aesthetic healing and rapid recovery.

• Da Vinci Robotic Surgery : For complex, numerous, or large fibroids. The robot allows Dr. Choffel exceptional suturing precision to perfectly reconstruct the uterine wall, a major advantage for patients wishing to have a future pregnancy.

• Laparotomy (Traditional Open Surgery)

Although Dr. Choffel favors minimally invasive techniques, laparotomy may be necessary in certain specific situations (for example, in the presence of very large multiple fibroids or contraindications to laparoscopy).

The procedure: The surgery is performed through a horizontal incision above the pubic bone (similar to a cesarean section scar in most cases).

Why this choice? It offers the surgeon direct and maximum exposure to treat large or complex pathologies that could not be safely removed through small incisions.

Patient Support: Even during laparotomy, Dr. Choffel implements enhanced recovery protocols (ERAS) to optimize your comfort and recovery.

A uterine polyp is a small growth that develops from the lining of the uterus (the endometrium). Imagine a small “tag” of flesh, usually the size of a grain of rice or a cherry, growing inside the uterine cavity.

In the vast majority of cases, polyps are benign (non-cancerous) tumors. However, their presence can disrupt the normal functioning of the uterus and cause uncomfortable symptoms.

Some polyps are completely asymptomatic, but they often manifest as:

• Bleeding between periods (spotting).

• Particularly heavy or prolonged periods.

• Bleeding after menopause (which should always prompt a consultation).

• Difficulty conceiving, as the polyp can prevent implantation of the embryo.

The diagnosis is usually made during a pelvic ultrasound or a diagnostic hysteroscopy (a quick examination performed in the office using a miniature camera, without anesthesia).

The treatment: Operative Hysteroscopy When a polyp is causing symptoms or interfering with fertility, Dr. Choffel removes it via operative hysteroscopy. This is a standard procedure that prioritizes your comfort:

• No scarring : The procedure is performed through the natural openings. There are no incisions on the abdomen.

• Extreme precision : Under video guidance, Dr. Choffel removes the polyp with millimeter precision, while perfectly preserving the rest of the uterine lining.

• Rapid recovery : The procedure is most often performed on an outpatient basis (admission and discharge on the same day). Post-operative pain is minimal, allowing you to resume your activities the very next day.

Systematic analysis Each polyp removed by Dr. Choffel is sent for histological analysis (under a microscope) to confirm its benign nature and ensure the patient’s complete safety.