Gynecologic Surgery: Joyce's Story

Taking Control: After Sophisticated Surgery for Large Fibroids, Joyce Neal Gets Back to Work Quickly and Becomes a Mom

Joyce Neal knows a thing or two about making dreams come true. The 44-year-old gynecologist and obstetrician from Leonardtown, Md., helps women become happy, healthy moms. But before she started her own family, she overcame an issue that more than 1 in 5 women face: uterine fibroids.

Four years ago, massive fibroids were causing Joyce excruciating pain and affecting her mobility at work. "As the fibroids grew, the nerve compression worsened," she says. "I wanted to have the fibroids removed through minimally invasive surgery so I could get back to work - caring for my own patients - as quickly as possible."

Know Your Options

"The latest minimally invasive treatments allow women with fibroids - and even women like Joyce who have large fibroids - to avoid traditional surgery or a hysterectomy," says Paul MacKoul, MD, gynecologic oncologist and medical director of minimally invasive gynecologic surgery, Holy Cross Hospital.

Dr. MacKoul performed laparoscopy-assisted myomectomy on Joyce to remove the fibroids. In this minimally invasive surgery, small incisions are made to give surgical instruments and a tiny video camera access to the area being treated. The camera shows the surgical site on a video screen, which the surgeon monitors while performing the procedure.

"New techniques requiring advanced physician skills now allow larger fibroids - up to 7 to 10 pounds - to be removed laparoscopically," Dr. MacKoul says. "Very special techniques are used to control bleeding during the surgery, and after the fibroids are removed, the uterine muscle is securely closed through only a two-inch incision in the abdomen."

As a result, patients experience less pain, shorter hospital stays, shorter recovery times and smaller abdominal scars than with traditional surgery.

"I went home the day after my surgery and was able to go back to work a few days later," Joyce says.

Preserving Hope for Fertility

At the time of her surgery in 2006, Joyce was not yet focused on having a baby.

"For women who want to have children, a myomectomy is one of the treatment options available because it can preserve fertility," Dr. MacKoul says. "But for women with larger fibroids, we must be especially careful during the surgery to minimize the risk of scar tissue in the uterus, which can hinder pregnancy in the future."

Within a year of her surgery, Joyce became pregnant. She has had no recurrence of fibroids and now enjoys spending time with her 2-year-old daughter, Jada Willow.

What are Uterine Fibroids?

It is not clear what causes fibroids, which are growths that develop from the muscle tissue of the uterus. More than one in five women may have fibroids during their childbearing years.

Fibroids can range in size, from smaller than a pea to larger than a grapefruit. Some women may have fibroids and never even know it; others may experience moderate to severe problems.

Common symptoms caused by fibroids include:

• Abnormal bleeding, possibly leading to anemia and other problems
• Pain, especially with large fibroids
• Bladder or bowel problems
• Infertility

Unmatched Expertise 

Holy Cross Hospital offers the most advanced laparoscopic surgeries available today to women with complex gynecologic conditions. Our board-certified gynecologic oncologists are specially trained to care for women with conditions such as endometriosis, pelvic pain, excessive bleeding, fibroids and cancer.

In fact, physicians at Holy Cross Hospital perform more inpatient gynecologic surgeries than any other hospital in Maryland or the District of Columbia.

For the past 16 years, Holy Cross Hospital's highly advanced surgeons have been training surgeons from hospitals all over the country in advanced gynecologic procedures through our GATE Institute, a specialized minimally invasive surgery training center.