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What Does This Ultrasound Report Indicate?

Posted on Thu, 1 Dec 2016

Question: I am 51 years old. I had an endometrial ablation performed in April due to heavy , prolonged uterine bleeding for the past 3 years. This has stopped the bleeding although I still get some period type pain occasionally but has been a success rom bleeding point of view). I have a pendunculated subserosal fibroid which extends the length of the uterus and appears to be two masses stuck together - the lower part sits on my bladder (explaining the bladder symptoms I have). On ultrasound today it measures about 7 x 6 cm. (it was 6 x 5cm in XXXXXXX 16 and 3 x 4 in XXXXXXX 2014). My left ovary was ok and my right one couldn't be seen (it has previously should some cysts). The gynae gave me 3 options: watch and wait, referral for embolization, hysterectomy (as it is too big or removal of fibroid alone). I have some abdo pain on the right side - sharp and pinching fairly regularly, and central low squeezing pain/pressure pain. Otherwise am well have mildly elevated ESR and plasma C with not explanation. I would like some advice as to the best course of action. Am tempted by hysterectomy but is this over kill?

Answered by Dr. Dr. Rakhi Tayal (1 hour later)

Brief Answer:
Wait and watch is best of the three.

Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
You have a large fibroid that is increasing in size but is not causing you much symptoms. It is normal to feel heaviness and bladder symptoms with a fibroid of this size.
Embolization is needed only if you are having an active bleeding. Since you are in a perimenopausal age group this fibroid is likely to regress on its own after menopause.
Going for a major surgery like hysterectomy for almost no symptoms is not advisable. There is no harm in wait and watch and is the safest way of all the three. It is best to avoid a major surgery as far as you can.
Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Rakhi Tayal (43 minutes later)

Thank you, this is very helpful. I am menopausal, and having flushes x30 a day plus joint pain, basically lots of menopausal symptoms. I do want to have HRT as I need to hold down a job and with all the symptoms this is unsustainable . Will HRT cause the fibroid to grow more ? If yes, then should I perhaps consider removal of the fibroid Ahead of having HRT? I am not at all keen to have major surgery but will do if it resolves the problems. Bladder pressure does affect me every day, need to pass urine every 30 mins in day and can't risk any jumping, walking quickly and certainly no jogging for fear of leakage. Good to know that watch and wait approach is safe though.

Answered by Dr. Dr. Rakhi Tayal (28 minutes later)

Brief Answer:
Surgery should be considered before HRT.

Detailed Answer:
Hello.
Thanks for writing again.
Taking HRT can cause an increase in growth of fibroid. In that case its removal should be considered. If the bladder symptoms are distressing even then you should get the surgery done.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
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