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Please Refer To Attached MRI Report And Suggest. In August
Question: Please refer to attached MRI report and suggest. In August my period lasted for 20 days, Dr gave me regestrone for 2 weeks. Again when period started in September it lasted for a month, again Dr. gave me DUOLUTON L for 6 weeks, I didn't get period but spotting was there on and off for 6 weeks. My medicine got over on 6th Nov, my periods started 8th Nov, its heavy bleeding with clots.
Dr suggested surgery, need your advice.
MRI Report :
MRI - PELVIS
TECHNIQUE:
Diagnostics
Registered Date /Time: 09-09-2018 / 10:17AM
Sample Collection Date/ Time: 09-09-2018 / 10:47 AM
Print Date/ Time: 10-09-2018 / 06: 12 PM
MRI
T1-T2-IR Axials & Coronals, GRE Sagitals,Post contrast imaging
FINDINGS:
URINARY BLADDER is normal in contour. No filling defects noted. Wall thickness is normal. No calculi.
UTERUS is mild bulky in size measuring90mm x67mm x46mm.Multiple T1 Hypointense,T2predominantly
hypointense and STIR lsointense lesions noted in both subserosal and myometrial locations in both anterior
and posterior walls largest measuring 50mm x49mm in subserosal location and 34mmx26mm in posterior
myometrium. Endometrial thickness isincreased measuring 14mm.On postcontrast study minimal
enhancement noted with in the lesions.
Uterine cervix is normal in size, shape and signal morphology. Parametrium appears normal on both sides.
BOTH OVARIES appear normal in size, shape and signal morphology. No focal lesions noted.
Rectum is normal. Peri-rectal and peri-vesical fat planes appear normal.
No free fluid in the pelvis.
Iliac vessels appear normal.
No significant pelvic adenopathy noted.
Sacrum and both sacro-iliac joints appear normal.
Alignment of both hip joints appear normal.
Rest of the bones of the pelvis appear normal to the extent seen.
IMPRESSION:
Imaging features are suggestive of bulky uterus with multiple subserosal and myometrial fibroids.
Increased endometrial thickness.
Dr suggested surgery, need your advice.
MRI Report :
MRI - PELVIS
TECHNIQUE:
Diagnostics
Registered Date /Time: 09-09-2018 / 10:17AM
Sample Collection Date/ Time: 09-09-2018 / 10:47 AM
Print Date/ Time: 10-09-2018 / 06: 12 PM
MRI
T1-T2-IR Axials & Coronals, GRE Sagitals,Post contrast imaging
FINDINGS:
URINARY BLADDER is normal in contour. No filling defects noted. Wall thickness is normal. No calculi.
UTERUS is mild bulky in size measuring90mm x67mm x46mm.Multiple T1 Hypointense,T2predominantly
hypointense and STIR lsointense lesions noted in both subserosal and myometrial locations in both anterior
and posterior walls largest measuring 50mm x49mm in subserosal location and 34mmx26mm in posterior
myometrium. Endometrial thickness isincreased measuring 14mm.On postcontrast study minimal
enhancement noted with in the lesions.
Uterine cervix is normal in size, shape and signal morphology. Parametrium appears normal on both sides.
BOTH OVARIES appear normal in size, shape and signal morphology. No focal lesions noted.
Rectum is normal. Peri-rectal and peri-vesical fat planes appear normal.
No free fluid in the pelvis.
Iliac vessels appear normal.
No significant pelvic adenopathy noted.
Sacrum and both sacro-iliac joints appear normal.
Alignment of both hip joints appear normal.
Rest of the bones of the pelvis appear normal to the extent seen.
IMPRESSION:
Imaging features are suggestive of bulky uterus with multiple subserosal and myometrial fibroids.
Increased endometrial thickness.
Please refer to attached MRI report and suggest. In August my period lasted for 20 days, Dr gave me regestrone for 2 weeks. Again when period started in September it lasted for a month, again Dr. gave me DUOLUTON L for 6 weeks, I didn't get period but spotting was there on and off for 6 weeks. My medicine got over on 6th Nov, my periods started 8th Nov, its heavy bleeding with clots.
Dr suggested surgery, need your advice.
MRI Report :
MRI - PELVIS
TECHNIQUE:
Diagnostics
Registered Date /Time: 09-09-2018 / 10:17AM
Sample Collection Date/ Time: 09-09-2018 / 10:47 AM
Print Date/ Time: 10-09-2018 / 06: 12 PM
MRI
T1-T2-IR Axials & Coronals, GRE Sagitals,Post contrast imaging
FINDINGS:
URINARY BLADDER is normal in contour. No filling defects noted. Wall thickness is normal. No calculi.
UTERUS is mild bulky in size measuring90mm x67mm x46mm.Multiple T1 Hypointense,T2predominantly
hypointense and STIR lsointense lesions noted in both subserosal and myometrial locations in both anterior
and posterior walls largest measuring 50mm x49mm in subserosal location and 34mmx26mm in posterior
myometrium. Endometrial thickness isincreased measuring 14mm.On postcontrast study minimal
enhancement noted with in the lesions.
Uterine cervix is normal in size, shape and signal morphology. Parametrium appears normal on both sides.
BOTH OVARIES appear normal in size, shape and signal morphology. No focal lesions noted.
Rectum is normal. Peri-rectal and peri-vesical fat planes appear normal.
No free fluid in the pelvis.
Iliac vessels appear normal.
No significant pelvic adenopathy noted.
Sacrum and both sacro-iliac joints appear normal.
Alignment of both hip joints appear normal.
Rest of the bones of the pelvis appear normal to the extent seen.
IMPRESSION:
Imaging features are suggestive of bulky uterus with multiple subserosal and myometrial fibroids.
Increased endometrial thickness.
Dr suggested surgery, need your advice.
MRI Report :
MRI - PELVIS
TECHNIQUE:
Diagnostics
Registered Date /Time: 09-09-2018 / 10:17AM
Sample Collection Date/ Time: 09-09-2018 / 10:47 AM
Print Date/ Time: 10-09-2018 / 06: 12 PM
MRI
T1-T2-IR Axials & Coronals, GRE Sagitals,Post contrast imaging
FINDINGS:
URINARY BLADDER is normal in contour. No filling defects noted. Wall thickness is normal. No calculi.
UTERUS is mild bulky in size measuring90mm x67mm x46mm.Multiple T1 Hypointense,T2predominantly
hypointense and STIR lsointense lesions noted in both subserosal and myometrial locations in both anterior
and posterior walls largest measuring 50mm x49mm in subserosal location and 34mmx26mm in posterior
myometrium. Endometrial thickness isincreased measuring 14mm.On postcontrast study minimal
enhancement noted with in the lesions.
Uterine cervix is normal in size, shape and signal morphology. Parametrium appears normal on both sides.
BOTH OVARIES appear normal in size, shape and signal morphology. No focal lesions noted.
Rectum is normal. Peri-rectal and peri-vesical fat planes appear normal.
No free fluid in the pelvis.
Iliac vessels appear normal.
No significant pelvic adenopathy noted.
Sacrum and both sacro-iliac joints appear normal.
Alignment of both hip joints appear normal.
Rest of the bones of the pelvis appear normal to the extent seen.
IMPRESSION:
Imaging features are suggestive of bulky uterus with multiple subserosal and myometrial fibroids.
Increased endometrial thickness.
Brief Answer:
Detailed below.
Detailed Answer:
Hi,
Thanks for trusting us with your health concern.
I have gone through your query and would like to offer some suggestions. I have also gone through your reports and have noticed certain facts:
1. Your hemoglobin level is lower than normal, perhaps due to the persistent bleeding episodes.
2. Your alkaline phosphatase (ALP) levels are higher. In the current scenario, I would ask for a thorough evaluation of the liver function, thyroid profile, and estimation of the vitamin D levels. Lower vitamin D levels can elevate ALP and so is hyperthyroidism. Lowered bilirubin levels are not of concern.
Your MRI report shows several fibroids in the uterus, and a couple of them are of significant size. If the bleeding is not heavy, hormone treatment can be tried for six months along with correction of all hormone errors. Medical hysterectomy can be tried through drugs if surgery is not wished for or contemplated.
If you have completed your reproductive function, that is, have had children and are sterilized, you can go for hysterectomy. The other commonly used methods are uterine artery embolization/selective myomectomy, especially when the reproductive function is to be preserved.
I think, in your case, further management can be planned once other hormone causes are excluded as a reason for the prolonged bleeding apart from the fibroids. If only and only fibroids have been detected as the cause, surgical treatment is likely to give better results since the tumors are many.
Please maintain proper nutrition and try to maintain a healthy BMI.
Hope your query has been clarified. Please feel free to contact for further information. I will be happy to help.
regards,
Shanti.V.
Detailed below.
Detailed Answer:
Hi,
Thanks for trusting us with your health concern.
I have gone through your query and would like to offer some suggestions. I have also gone through your reports and have noticed certain facts:
1. Your hemoglobin level is lower than normal, perhaps due to the persistent bleeding episodes.
2. Your alkaline phosphatase (ALP) levels are higher. In the current scenario, I would ask for a thorough evaluation of the liver function, thyroid profile, and estimation of the vitamin D levels. Lower vitamin D levels can elevate ALP and so is hyperthyroidism. Lowered bilirubin levels are not of concern.
Your MRI report shows several fibroids in the uterus, and a couple of them are of significant size. If the bleeding is not heavy, hormone treatment can be tried for six months along with correction of all hormone errors. Medical hysterectomy can be tried through drugs if surgery is not wished for or contemplated.
If you have completed your reproductive function, that is, have had children and are sterilized, you can go for hysterectomy. The other commonly used methods are uterine artery embolization/selective myomectomy, especially when the reproductive function is to be preserved.
I think, in your case, further management can be planned once other hormone causes are excluded as a reason for the prolonged bleeding apart from the fibroids. If only and only fibroids have been detected as the cause, surgical treatment is likely to give better results since the tumors are many.
Please maintain proper nutrition and try to maintain a healthy BMI.
Hope your query has been clarified. Please feel free to contact for further information. I will be happy to help.
regards,
Shanti.V.
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
Detailed below.
Detailed Answer:
Hi,
Thanks for trusting us with your health concern.
I have gone through your query and would like to offer some suggestions. I have also gone through your reports and have noticed certain facts:
1. Your hemoglobin level is lower than normal, perhaps due to the persistent bleeding episodes.
2. Your alkaline phosphatase (ALP) levels are higher. In the current scenario, I would ask for a thorough evaluation of the liver function, thyroid profile, and estimation of the vitamin D levels. Lower vitamin D levels can elevate ALP and so is hyperthyroidism. Lowered bilirubin levels are not of concern.
Your MRI report shows several fibroids in the uterus, and a couple of them are of significant size. If the bleeding is not heavy, hormone treatment can be tried for six months along with correction of all hormone errors. Medical hysterectomy can be tried through drugs if surgery is not wished for or contemplated.
If you have completed your reproductive function, that is, have had children and are sterilized, you can go for hysterectomy. The other commonly used methods are uterine artery embolization/selective myomectomy, especially when the reproductive function is to be preserved.
I think, in your case, further management can be planned once other hormone causes are excluded as a reason for the prolonged bleeding apart from the fibroids. If only and only fibroids have been detected as the cause, surgical treatment is likely to give better results since the tumors are many.
Please maintain proper nutrition and try to maintain a healthy BMI.
Hope your query has been clarified. Please feel free to contact for further information. I will be happy to help.
regards,
Shanti.V.
Detailed below.
Detailed Answer:
Hi,
Thanks for trusting us with your health concern.
I have gone through your query and would like to offer some suggestions. I have also gone through your reports and have noticed certain facts:
1. Your hemoglobin level is lower than normal, perhaps due to the persistent bleeding episodes.
2. Your alkaline phosphatase (ALP) levels are higher. In the current scenario, I would ask for a thorough evaluation of the liver function, thyroid profile, and estimation of the vitamin D levels. Lower vitamin D levels can elevate ALP and so is hyperthyroidism. Lowered bilirubin levels are not of concern.
Your MRI report shows several fibroids in the uterus, and a couple of them are of significant size. If the bleeding is not heavy, hormone treatment can be tried for six months along with correction of all hormone errors. Medical hysterectomy can be tried through drugs if surgery is not wished for or contemplated.
If you have completed your reproductive function, that is, have had children and are sterilized, you can go for hysterectomy. The other commonly used methods are uterine artery embolization/selective myomectomy, especially when the reproductive function is to be preserved.
I think, in your case, further management can be planned once other hormone causes are excluded as a reason for the prolonged bleeding apart from the fibroids. If only and only fibroids have been detected as the cause, surgical treatment is likely to give better results since the tumors are many.
Please maintain proper nutrition and try to maintain a healthy BMI.
Hope your query has been clarified. Please feel free to contact for further information. I will be happy to help.
regards,
Shanti.V.
Above answer was peer-reviewed by :
Dr. Kampana
Thanks Dr for the detailed analysis and comprehensive explanation. I really appreciate.
My T3, T4 are normal but TSH is 7.54. I'm taking thyronorm 50 mg for past 3 months, prior to that I was taking 25 mg.
THYROID STIMULATING HORMONE (TSH) C.L.I.A 7.54 μIU/ml 0.3-5.5
My bleeding is always heavy with large clots.
I would need further understanding on :
1) When you say multiple fibroids : is their locations, number and size alarming? Based on locations are they harmful, because one Dr told me that location decides the severity of fibroids. You mentioned tumors are many so, are these tumors or fibroids? what's the difference between 2 and which one I have?
2) As mentioned I have been given Regestrone, PauseX, Duluton L but bleeding is controlled only till the period I m taking these medicines, as and when I stop it's heavy bleeding with severe pain.
3) How effective would be correction through medicine Vs. surgery to get fibroids removed?
Thanks for taking time to answer my query.
My T3, T4 are normal but TSH is 7.54. I'm taking thyronorm 50 mg for past 3 months, prior to that I was taking 25 mg.
THYROID STIMULATING HORMONE (TSH) C.L.I.A 7.54 μIU/ml 0.3-5.5
My bleeding is always heavy with large clots.
I would need further understanding on :
1) When you say multiple fibroids : is their locations, number and size alarming? Based on locations are they harmful, because one Dr told me that location decides the severity of fibroids. You mentioned tumors are many so, are these tumors or fibroids? what's the difference between 2 and which one I have?
2) As mentioned I have been given Regestrone, PauseX, Duluton L but bleeding is controlled only till the period I m taking these medicines, as and when I stop it's heavy bleeding with severe pain.
3) How effective would be correction through medicine Vs. surgery to get fibroids removed?
Thanks for taking time to answer my query.
Thanks Dr for the detailed analysis and comprehensive explanation. I really appreciate.
My T3, T4 are normal but TSH is 7.54. I'm taking thyronorm 50 mg for past 3 months, prior to that I was taking 25 mg.
THYROID STIMULATING HORMONE (TSH) C.L.I.A 7.54 μIU/ml 0.3-5.5
My bleeding is always heavy with large clots.
I would need further understanding on :
1) When you say multiple fibroids : is their locations, number and size alarming? Based on locations are they harmful, because one Dr told me that location decides the severity of fibroids. You mentioned tumors are many so, are these tumors or fibroids? what's the difference between 2 and which one I have?
2) As mentioned I have been given Regestrone, PauseX, Duluton L but bleeding is controlled only till the period I m taking these medicines, as and when I stop it's heavy bleeding with severe pain.
3) How effective would be correction through medicine Vs. surgery to get fibroids removed?
Thanks for taking time to answer my query.
My T3, T4 are normal but TSH is 7.54. I'm taking thyronorm 50 mg for past 3 months, prior to that I was taking 25 mg.
THYROID STIMULATING HORMONE (TSH) C.L.I.A 7.54 μIU/ml 0.3-5.5
My bleeding is always heavy with large clots.
I would need further understanding on :
1) When you say multiple fibroids : is their locations, number and size alarming? Based on locations are they harmful, because one Dr told me that location decides the severity of fibroids. You mentioned tumors are many so, are these tumors or fibroids? what's the difference between 2 and which one I have?
2) As mentioned I have been given Regestrone, PauseX, Duluton L but bleeding is controlled only till the period I m taking these medicines, as and when I stop it's heavy bleeding with severe pain.
3) How effective would be correction through medicine Vs. surgery to get fibroids removed?
Thanks for taking time to answer my query.
Brief Answer:
Surgery appears to be the better option.
Detailed Answer:
Hello,
Thanks for writing back.
If your TSH levels get back to normal levels with the dose prescribed, you should continue the same as maintenance.
Here are your answers:
1. Fibroids occur essentially in the myometrium or the muscle layer of the uterus. They can lie under the superficial or serosal layer, beneath the endometrium or the inner lining of the uterus or stay in the myometrium. In the first case, they do not cause much bleeding, but can grow and become pedunculated causing torsion and rupture at times. In the second case, heavier bleeding and abnormal bleeding is noticed. In the last case, polyp formations are seen along with spotting/bleeding episodes. Also, the intensity of the symptoms is dependent on the size.
Fibroids are referred to as tumors. They are so called because they are abnormal growths seen in normal tissue.
You have several fibroids as per the MRI report. They are of different sizes, but not of alarming proportions. A couple of them are of considerable suze to recommend surgical removal.
2. Since you have already been through several hormone courses with no permanent respite, surgery seems to be the better option. Medical management may not be much effective.
Hope I have answered your queries. Please get back if you need anything else. I will be ready to help.
regards,
Shanti.V.
Surgery appears to be the better option.
Detailed Answer:
Hello,
Thanks for writing back.
If your TSH levels get back to normal levels with the dose prescribed, you should continue the same as maintenance.
Here are your answers:
1. Fibroids occur essentially in the myometrium or the muscle layer of the uterus. They can lie under the superficial or serosal layer, beneath the endometrium or the inner lining of the uterus or stay in the myometrium. In the first case, they do not cause much bleeding, but can grow and become pedunculated causing torsion and rupture at times. In the second case, heavier bleeding and abnormal bleeding is noticed. In the last case, polyp formations are seen along with spotting/bleeding episodes. Also, the intensity of the symptoms is dependent on the size.
Fibroids are referred to as tumors. They are so called because they are abnormal growths seen in normal tissue.
You have several fibroids as per the MRI report. They are of different sizes, but not of alarming proportions. A couple of them are of considerable suze to recommend surgical removal.
2. Since you have already been through several hormone courses with no permanent respite, surgery seems to be the better option. Medical management may not be much effective.
Hope I have answered your queries. Please get back if you need anything else. I will be ready to help.
regards,
Shanti.V.
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
Surgery appears to be the better option.
Detailed Answer:
Hello,
Thanks for writing back.
If your TSH levels get back to normal levels with the dose prescribed, you should continue the same as maintenance.
Here are your answers:
1. Fibroids occur essentially in the myometrium or the muscle layer of the uterus. They can lie under the superficial or serosal layer, beneath the endometrium or the inner lining of the uterus or stay in the myometrium. In the first case, they do not cause much bleeding, but can grow and become pedunculated causing torsion and rupture at times. In the second case, heavier bleeding and abnormal bleeding is noticed. In the last case, polyp formations are seen along with spotting/bleeding episodes. Also, the intensity of the symptoms is dependent on the size.
Fibroids are referred to as tumors. They are so called because they are abnormal growths seen in normal tissue.
You have several fibroids as per the MRI report. They are of different sizes, but not of alarming proportions. A couple of them are of considerable suze to recommend surgical removal.
2. Since you have already been through several hormone courses with no permanent respite, surgery seems to be the better option. Medical management may not be much effective.
Hope I have answered your queries. Please get back if you need anything else. I will be ready to help.
regards,
Shanti.V.
Surgery appears to be the better option.
Detailed Answer:
Hello,
Thanks for writing back.
If your TSH levels get back to normal levels with the dose prescribed, you should continue the same as maintenance.
Here are your answers:
1. Fibroids occur essentially in the myometrium or the muscle layer of the uterus. They can lie under the superficial or serosal layer, beneath the endometrium or the inner lining of the uterus or stay in the myometrium. In the first case, they do not cause much bleeding, but can grow and become pedunculated causing torsion and rupture at times. In the second case, heavier bleeding and abnormal bleeding is noticed. In the last case, polyp formations are seen along with spotting/bleeding episodes. Also, the intensity of the symptoms is dependent on the size.
Fibroids are referred to as tumors. They are so called because they are abnormal growths seen in normal tissue.
You have several fibroids as per the MRI report. They are of different sizes, but not of alarming proportions. A couple of them are of considerable suze to recommend surgical removal.
2. Since you have already been through several hormone courses with no permanent respite, surgery seems to be the better option. Medical management may not be much effective.
Hope I have answered your queries. Please get back if you need anything else. I will be ready to help.
regards,
Shanti.V.
Above answer was peer-reviewed by :
Dr. Kampana
Thank You so, much Dr for detailed explanations, this is very helpful. As you recommended that surgery would be best option, could you suggest what are different kind of surgery and which would be best in my case. I still plan to continue with reproductive stage.
Also, would surgery have any implication on conceiving in future?
Also, would surgery have any implication on conceiving in future?
Thank You so, much Dr for detailed explanations, this is very helpful. As you recommended that surgery would be best option, could you suggest what are different kind of surgery and which would be best in my case. I still plan to continue with reproductive stage.
Also, would surgery have any implication on conceiving in future?
Also, would surgery have any implication on conceiving in future?
Brief Answer:
Detailed below.
Detailed Answer:
Hi,
Thanks for writing again.
As you wish to retain your reproductive state, the surgical options available for you are-
1. Myomectomy- laparoscopic or robotic, hysteroscopic and abdominal. Laparoscopic myomectomy can be attempted when the fibroids are fewer in number, which is not so in your case. Hysteroscopic myomectomy can be contemplated if the fibroids are beneath the endometrium. This again, doesn't seem feasible in your case as most of them are sub-serosal and myometrial.
So, abdominal myomectomy is the possible option as it can deal with multiple fibroids.
2. Uterine artery embolization. In this technique, blood supply to the fibroids is interfered causing them to shrink and provide relief from their symptoms. However, this procedure needs an expert, as errors can lead to diminished blood supply to the ovaries and other organs resulting in serious side effects.
3. Myolysis is a laparoscopic procedure that uses radiofrequency energy, laser or electric current to destroy fibroids and make the blood vessels shrink. Freezing the fibroids is another way and is called cryomyolysis.
4. FUS or focused-ultrasound surgery guided by MRI is a newer technique wherein ultrasound is used to treat through heating and destroying small areas of fibroid tissue.
Furthermore, evaluation is needed to assess the fertility state before proceeding for surgery. Several complications like abortions, preterm births etc., can happen when pregnancy occurs post-surgery. Infertility can be another possible development secondary to wound healing.
In the current scenario, I would ask you to see a specialist for a proper appraisal of the situation and plan further management. Hope this helps.
Wish you good health.
regards,
Shanti.V.
Detailed below.
Detailed Answer:
Hi,
Thanks for writing again.
As you wish to retain your reproductive state, the surgical options available for you are-
1. Myomectomy- laparoscopic or robotic, hysteroscopic and abdominal. Laparoscopic myomectomy can be attempted when the fibroids are fewer in number, which is not so in your case. Hysteroscopic myomectomy can be contemplated if the fibroids are beneath the endometrium. This again, doesn't seem feasible in your case as most of them are sub-serosal and myometrial.
So, abdominal myomectomy is the possible option as it can deal with multiple fibroids.
2. Uterine artery embolization. In this technique, blood supply to the fibroids is interfered causing them to shrink and provide relief from their symptoms. However, this procedure needs an expert, as errors can lead to diminished blood supply to the ovaries and other organs resulting in serious side effects.
3. Myolysis is a laparoscopic procedure that uses radiofrequency energy, laser or electric current to destroy fibroids and make the blood vessels shrink. Freezing the fibroids is another way and is called cryomyolysis.
4. FUS or focused-ultrasound surgery guided by MRI is a newer technique wherein ultrasound is used to treat through heating and destroying small areas of fibroid tissue.
Furthermore, evaluation is needed to assess the fertility state before proceeding for surgery. Several complications like abortions, preterm births etc., can happen when pregnancy occurs post-surgery. Infertility can be another possible development secondary to wound healing.
In the current scenario, I would ask you to see a specialist for a proper appraisal of the situation and plan further management. Hope this helps.
Wish you good health.
regards,
Shanti.V.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Detailed below.
Detailed Answer:
Hi,
Thanks for writing again.
As you wish to retain your reproductive state, the surgical options available for you are-
1. Myomectomy- laparoscopic or robotic, hysteroscopic and abdominal. Laparoscopic myomectomy can be attempted when the fibroids are fewer in number, which is not so in your case. Hysteroscopic myomectomy can be contemplated if the fibroids are beneath the endometrium. This again, doesn't seem feasible in your case as most of them are sub-serosal and myometrial.
So, abdominal myomectomy is the possible option as it can deal with multiple fibroids.
2. Uterine artery embolization. In this technique, blood supply to the fibroids is interfered causing them to shrink and provide relief from their symptoms. However, this procedure needs an expert, as errors can lead to diminished blood supply to the ovaries and other organs resulting in serious side effects.
3. Myolysis is a laparoscopic procedure that uses radiofrequency energy, laser or electric current to destroy fibroids and make the blood vessels shrink. Freezing the fibroids is another way and is called cryomyolysis.
4. FUS or focused-ultrasound surgery guided by MRI is a newer technique wherein ultrasound is used to treat through heating and destroying small areas of fibroid tissue.
Furthermore, evaluation is needed to assess the fertility state before proceeding for surgery. Several complications like abortions, preterm births etc., can happen when pregnancy occurs post-surgery. Infertility can be another possible development secondary to wound healing.
In the current scenario, I would ask you to see a specialist for a proper appraisal of the situation and plan further management. Hope this helps.
Wish you good health.
regards,
Shanti.V.
Detailed below.
Detailed Answer:
Hi,
Thanks for writing again.
As you wish to retain your reproductive state, the surgical options available for you are-
1. Myomectomy- laparoscopic or robotic, hysteroscopic and abdominal. Laparoscopic myomectomy can be attempted when the fibroids are fewer in number, which is not so in your case. Hysteroscopic myomectomy can be contemplated if the fibroids are beneath the endometrium. This again, doesn't seem feasible in your case as most of them are sub-serosal and myometrial.
So, abdominal myomectomy is the possible option as it can deal with multiple fibroids.
2. Uterine artery embolization. In this technique, blood supply to the fibroids is interfered causing them to shrink and provide relief from their symptoms. However, this procedure needs an expert, as errors can lead to diminished blood supply to the ovaries and other organs resulting in serious side effects.
3. Myolysis is a laparoscopic procedure that uses radiofrequency energy, laser or electric current to destroy fibroids and make the blood vessels shrink. Freezing the fibroids is another way and is called cryomyolysis.
4. FUS or focused-ultrasound surgery guided by MRI is a newer technique wherein ultrasound is used to treat through heating and destroying small areas of fibroid tissue.
Furthermore, evaluation is needed to assess the fertility state before proceeding for surgery. Several complications like abortions, preterm births etc., can happen when pregnancy occurs post-surgery. Infertility can be another possible development secondary to wound healing.
In the current scenario, I would ask you to see a specialist for a proper appraisal of the situation and plan further management. Hope this helps.
Wish you good health.
regards,
Shanti.V.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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