Under the leadership of gynecologist and gynecological surgeon Omar Zwain, MD, AdventHealth for Women opened its new, multidisciplinary Comprehensive Fibroid Program at AdventHealth Winter Park in July 2024.
Bringing together board-certified, fellowship-trained gynecologic surgeons, interventional radiologists and hematologists along with laboratory, pharmacy and care coordination services in one location, the program was designed to enhance care for women suffering from uterine fibroids. It aims to facilitate early, accurate diagnosis and provide coordinated, individualized treatment plans to meet each patient’s needs with access to medical therapy, interventional radiological procedures and various surgical interventions, including minimally invasive and robotic surgery.
“Our goal with this new program is to enhance early diagnosis and take a whole-person approach to fibroid treatment, creating a personalized plan for each patient that meets their immediate needs, considers fertility and promotes their long-term health,” shares Dr. Zwain.
The Challenges and Impact of Uterine Fibroids
Benign tumors of the uterus, leiomyomas or myomas (fibroids) impact approximately 70% of white women and more than 80% of African American women during their lifetimes, with women between the ages of 30 and 40 experiencing the highest incidence. Some of the most common symptoms include:
- Heavy menstrual periods
- Irregular menstrual periods
- Pain, pressure, or a feeling of "fullness" in the pelvis
- Frequent urination
- Constipation
- Fertility issues
One study evaluating the impact of uterine fibroids found that women waited an average of 3.6 years before seeking treatment for their symptoms, and 41% saw two or more health care providers before their diagnosis.
“Lack of awareness about uterine fibroids and normal menstruation can cause delays in diagnosis and treatment,” explains Dr. Zwain. “This results in many women suffering unnecessarily from this chronic condition. We designed our program to address these challenges and decrease the patient burden.”
Taking a Team Approach to Improve Patient Care and Outcomes
Additional physician leaders of the AdventHealth Comprehensive Fibroid Program include AdventHealth Winter Park Chief of Gynecological Surgery Steven McCarus, MD; hematologist Rajesh Sehgal, MD; and interventional radiologist Alberto Mansilla, MD.
“Taking a multidisciplinary team approach to uterine fibroid care allows us to treat the entire patient, providing integrated, comprehensive care,” says Dr. Zwain. “With each physician focused on a different aspect of the patient’s health, we are more likely to identify areas of need and collaborate to manage those needs in an effective way that will improve patient outcomes.”
Evidence-based uterine fibroid treatment options available through the AdventHealth Comprehensive Fibroid Program include:
- Medical therapy
- Myomectomy (hysteroscopic, laparoscopic, robotic or abdominal)
- Fibroid ablation
- Fibroid embolization (uterine artery embolization or uterine fibroid embolization)
- Endometrial ablation
- Hysterectomy (vaginal, abdominal, laparoscopic or robotic)
“Our program offers the most advanced technologies in the treatment of fibroids, including minimally invasive surgical options and uterine-preserving procedures,” comments Dr. Zwain. “We believe that each patient has a unique situation, and during the evaluation, we discuss different management options and use a shared decision-making process to create an individualized plan tailored for that patient.”
Providing Care Coordination to Streamline and Enhance the Patient Experience
Ana Parada, BSN, RN serves as fibroid care coordinator for the new program. Along with providing clinical assistance to manage patient care, Parada acts as a patient’s personal advocate to help ensure the care they receive aligns with their specific goals and needs. She assists patients in several ways:
- Answering fibroid health questions
- Scheduling physician appointments
- Coordinating care amongst providers and facilities
- Providing pre- and postoperative counseling and education
“The fibroid program care coordinator makes the patient’s health care journey easier,” points out Dr. Zwain. “As an experienced registered nurse, she offers our patients expert guidance and support through every step of their journey with uterine fibroids, expediting and streamlining their care.”
Future Expansion
AdventHealth is piloting the Comprehensive Fibroid Program in Winter Park and hopes to eventually expand to additional office locations throughout Central Florida.