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Postmenopause. Having Pain On Tailbone. Ultrasound Found Fibroids. Should I Go For Da Vinci Hysterectomy?

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Posted on Tue, 16 Apr 2013
Question: I am 52 post-menopause. no period in over two and half years. I have tailbone pain but also have had issues with many disc bulges and do have a small central disc bulge at L5-S-1.and a tear. I am having an epidural tuesday. I have had other epidurals last year for bulges in thoracic , theOBGYN did ultasound, external and vaginal..There is one fibroid measuring 6.1cm..My obgyn wants to proceed with divinci hysterectomy..trouble shooting to see if this will eliminate my pain...I have concerns. If my epidural injections helps as the others have, then why do i need Hysterctomy? And OB did not discuss if it is close to spine and that is a major concern should she do this surgery... this fibroid is on the posterior wall of uterus..I do take HRT's for past 2 years. My OB said since i am postmen. this fibroid will not grow..I am not in a rush to have hysterectomy just because she said it could be causing my tailbone pain and hysterc. may help 60% . to me that means she is 50/50 that is may help.. Could this pain be from tear/bulge. I am delaying hysterectomy . I am proceeding with epidural this Tuesday..I have no other symptoms with bleeding/ just tailbone pain pretty moderate . I would think I may want second opinion and possibly consult a neurosurgeon if a fibroid is close to spine!. concerns with this are of course MAJOR> Is my pain from bulge or pressure from fibroid..that is the question. I guess if epidural helps then it is from bulge/tear..and Hysterectomy not indicated.
doctor
Answered by Dr. Dr.Raju.A.T (2 hours later)
Hi,

Thanks for your query.

Yes, you are right in thinking that since the epidural is helping, the tail bone pain you have could be due to the disc bulge. I strongly believe the same. It is very rare for a fibroid to cause pressure on the spine and produce such pain in the tail bone site.

Also, I would not consider it safe to evict from the option of hysterectomy. Fibroid is an estrogen dependent tumor. Though in menopause, you are on HRT and this may cause the fibroid to grow. Also it may lead to complications like degeneration or malignant transformation if not removed. Hence, it would be advisable for you to go for the surgery irrespective of the tail bone pain.

Hope, I answered your query.

Please let me know if there are any other concerns.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr.Raju.A.T (3 hours later)
what if i stop taking the HRT, and do follow up ultrasound in 6 months to see if fibroid has changed is size..My mother never had her fibroid removed and she is in her 80's
my OBGYN said the fibroid would not grow since i am post menopause..and she said it would not become cancerous...
doctor
Answered by Dr. Dr.Raju.A.T (7 minutes later)
Hi,

Thanks for writing back.

The fact that the fibroids do not grow in post menopausal women is because the hormones needed for the fibroid to grow are deficient after menopause. But when you are taking Hence, those hormones from HRT can increase the size of the Fibroid.

Yes, stopping HRT and observing the fibroid would be a considerable option provided removing HRT may not affect you by aggravating the condition for which you were advised HRT.

Hope, I answered your query.

Wish you good health.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr.Raju.A.T (19 minutes later)
The only reason i started HRT's was because of the flashes, sleeplessness, and mood swings in addition wt gain....i have been on them for 2 years. The OBGYN wants to do procedure using Divinci robotics...i suppose this would break up the tumor and then she would remove uterus and ovaries vaginally. i have researched the robotics and am questioning this technique although it looks promising. Thanks for your thoughts. I am not ready to make a decision until I know all the pros and cons. etc etc. I am considering calling my pharmacist and discussing stopping HRT's at this time...since it has been over 2 years since last period , should i expect any side effects? I am also considering a second opinion with another OB.
Is it possible that the HRT's caused this Fibroid? or has it been there for a while? Also, is there any correlation or research that HRT's can cause issue with bulging disc in the spine? I have had a horrible time this past year..Have several in the cervical, and 2 in the thoracic, and as you know the lumbar...That is it for now. Should i be concerned if i proceed with hysterectomy and fibroid location..(posterior wall of uterus) 6.1 cm is this close to my spine?
that is all. good health to you XXXXXX .
doctor
Answered by Dr. Dr.Raju.A.T (17 hours later)
Hi again,

You can stop HRT to halt the growth or to prevent any complications due to fibroid.
The dosage has to be tapered over time to prevent withdrawal effects.

Yes, it is possible where the HRT itself can be the cause for fibroid development, also it can be considered that fibroid would have started much before but grown in size due to HRT only.

There is no relation between the spine problem with either the fibroid or the HRT.

Hope, I answered your query.

Wish you good health.

Regards,
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr.Raju.A.T

General & Family Physician

Practicing since :2008

Answered : 4889 Questions

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Postmenopause. Having Pain On Tailbone. Ultrasound Found Fibroids. Should I Go For Da Vinci Hysterectomy?

Hi,

Thanks for your query.

Yes, you are right in thinking that since the epidural is helping, the tail bone pain you have could be due to the disc bulge. I strongly believe the same. It is very rare for a fibroid to cause pressure on the spine and produce such pain in the tail bone site.

Also, I would not consider it safe to evict from the option of hysterectomy. Fibroid is an estrogen dependent tumor. Though in menopause, you are on HRT and this may cause the fibroid to grow. Also it may lead to complications like degeneration or malignant transformation if not removed. Hence, it would be advisable for you to go for the surgery irrespective of the tail bone pain.

Hope, I answered your query.

Please let me know if there are any other concerns.

Regards,