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multiple intramural uterine fibroids

Discussion in 'All Categories' started by Dr arpana mishra - Nov 23rd, 2011 12:47 pm.
Dr arpana mishra	i am unmarried and have multiple uterine fibroid for 8 yrs,but it was of small size i was asymptomatic.since 2 yrs its increasing in size.i am on norethisterone 5 mg tds for 11 mths.still spot bleeding every day is there.after every 2 mth i have to do blood tranfusion.till now i have done 4 transfusion.latest usg report is-8.6cm6.5 cm the largest one ,second is 6.24.2cm ,third is 4.2*3.5 cm,ut is bulky.PA-ut is 14 wk size.kindly give your expert opinion.which lap surgeon in delhi should i consult???
re: multiple intramural uterine fibroids by Dr JS Chauhan - Nov 25th, 2011 12:20 am #1
Dr JS Chauhan	Dear Dr Arpana Mishra We are veery sorry that you have such a problem created by multiple uterine fibroid. In our opinion you should either opt between laparoscopic myomectomy or uterine artery embolization. Because the effect of uterine fibroid embolization on fertility is not fully understood, UFE is typically offered to women who no longer wish to become pregnant or who want or need to avoid having a hysterectomy, which is the operation to remove the uterus. Intramural fibroids are among the most typical types of uterine fibroids, present in 70% of women of childbearing age. Unlike subserosal fibroids, which develop on the exterior covering of the uterus, and submucosal fibroids, which develop just below the liner from the uterine cavity, intramural fibroids develop within the wall of the uterus. Intramural fibroids begin as small nodules within the muscular wall of the uterus. As time passes, intramural fibroids may expand inwards, causing distortion and elongation from the uterine cavity. Sometimes these fibroid tumors may grow for the endometrial cavity being submucosal fibroids or they may even grow for the outer surface of the uterus to become subserosal fibroids. Symptoms of Intramural Fibroids Intramural fibroids are usually asymptomatic, but in some women, they might cause problems such as: • Heavier menstrual bleeding • Pelvic pain • Pain in back and the back of the legs • Constipation and bloating • Constant urge to urinate • Lower-abdominal pressure or heaviness due to the weight of large intramural fibroids • Abnormally large abdomen • Pain or discomfort during intercourse, if the fibroids can be found within the cervix area • In some extreme cases, intramural fibroids may result in uterine hemorrhage Intramural Fibroids and Infertility Normally, intramural fibroids have no impact on fertility and pregnancy. However, within 3% of ladies, these uterine fibroids are linked with infertility. Ladies who have multiple intramural fibroids or large fibroids may find conceiving troublesome. Intramural fibroids can prevent sperm from entering the uterine cavity, specially when the fibroids can be found in the cervix. These fibroids can also enlarge the uterine cavity, thereby increasing the distance that sperm have to visit get to the fallopian tubes. Additionally, intramural fibroids may affect the uterus’s ability to contract, which has a direct impact upon sperm migration and ovum transport. Implantation of the embryo can also be inhibited by intramural fibroids as they distort the uterine cavity, impairing the circulation towards the endometrium and disturbing the endometrium structure. Even if implantation has occurred successfully, intramural fibroids may interfere with the introduction of the foetus. Uterine fibroids usually enlarge as the pregnancy proceeds. Due to this, there's a tussle for space between the growing baby and also the intramural fibroids. This struggle may either induce developmental defects in the unborn child or could cause a miscarriage. Management of Intramural Fibroids If intramural fibroids aren’t disturbing a woman’s capability to conceive and aren’t causing any pain, chances are they will be left untouched. However, when the intramural fibroids are large, treatment may be essential to reduce the symptoms produced by them. These uterine fibroids are generally treated by means of three kinds of surgical procedures: 1. Removal of one or more intramural fibroids by open abdominal surgery called abdominal myomectomy. 2. Destruction from the fibroids through uterine artery embolization by which polyvinyl alchol beads are injected in to the uterine artery with a catheter to bar the flow of blood towards the intramural fibroids 3. Hysterectomy which looks to get rid of the uterus At the present time, effective medicines that may permanently shrink these fibroids aren't available. Hence, surgery is a option readily available for treating intramural fibroids. However, there is a new non-surgical solution that has allowed a large number of women worldwide to ensure that you eliminate their fibroids pain and other related symptoms within 12 hours as well as their intramural fibroids permanently within 2 months. Uterine fibroid embolization (UFE) is really a minimally invasive treatment for fibroid tumors of the uterus. The process is also sometimes known as Uterine Artery Embolization (UAE), but this term is less specific and, as is going to be discussed below, UAE can be used for conditions apart from fibroids. Fibroid tumors, also called myomas, are benign tumors that arise in the muscular wall of the uterus. It is very rare for them to turn cancerous. More commonly, they cause heavy menstrual bleeding, pain in the pelvic region, and pressure around the bladder or bowel. Inside a UFE procedure, physicians make use of an x-ray camera called a fluoroscope to guide the delivery of small particles towards the uterus and fibroids. The small particles are injected through a thin, flexible tube called a catheter. These block the arteries that provide blood flow, causing the fibroids to contract. Nearly 90 % of ladies with fibroids experience relief of their symptoms. If you are interested we can perform laparoscopic or Robotic Myomectomy for you. We frequently find that the records are quite different than what your surgeon find on evaluation, and that my recommendations is to get your self examined at World Laparoscopy Hospital and seeing you is totally different than we would have made from reviewing records alone. With regards JS Chowhan
re: multiple intramural uterine fibroids by Dr JS Chauhan - Nov 25th, 2011 12:23 am #2
Dr JS Chauhan	Dear Dr Mishra If you are interested we can perform laparoscopic or Robotic Myomectomy for you. We frequently find that the records are quite different than what your surgeon find on evaluation, and that my recommendations is to get your self examined at World Laparoscopy Hospital and seeing you is totally different than we would have made from reviewing records alone. With regards JS Chowhan
re: multiple intramural uterine fibroids by Bulan - Aug 15th, 2012 9:57 pm #3
Bulan	Dear Sir, i am 49yrs. i had first U.S.G on july 2011 report was bulky uterus(12.0cm x6.4cmx6.2cm) with Fundal sub serous hypoechoic lesion(5.8cm x4.8cm) mensuration stopped during 3 (three) months before, U.S.G done rept.uterus ante-verted Size-L 10.2cm x5.9cm x6.6 cm with multiple varing sizes intramural S.O.L. S/O fibroid the largest one measure is 4.1 cmx 3.0 cm .endomerium not appriciated well. overies,P.O.D, U.B are normal. I have urging frequect urination,slite pain in pelvic area, no bleeding under this doctor adviced to go operation urgently what shall i do? operation may delay for few months....Anita Dear Anita Laparoscopic or robotic myomectomy is a good option for you, in which we or any of your surgeon accesses and removes fibroids via multiple, small abdominal incisions using specialized equipment. In some cases, this approach uses a surgical robot to perform the surgery. With regards M.K. Gupta
re: multiple intramural uterine fibroids by Hena mondal - Aug 30th, 2012 9:06 pm #4
Hena mondal	I am now 49 years, my uterus was anteverted & bulky 12.o cmx6.4cmx6.2cm, with fundal sub serous hypo echoic lesion measuring 5.8 cmx4.8 cm, P.O.D Collection was 2.7 cn x2. 1 cm., No adnexal mass was there. U.S.G done on 18.08.2011, Then I was suffering from abdominal pain with diarrhea, chink pericardium effusion, Pleural effusion, hypothyroidism etc. During this period my menstruation period was going on with some irregular, Hence my menstruation period has been stopped since after 11 th may 2012. then I had U.S.G., T V.S of lower abdomen, the size of uterus comes 10.2cn x 5.9 cm x6.6 cm with multiple varying sizes of intramural S.O.L ,S/O fibroids the largest one measure 4.1 cm x 3.0 cm. which are mild less in size than before. P.O.D No collection. Overies and cervix. appears normal At present I am feeling few frequent urination and pelvic pain only. Doctor Suggested Hysterectomy. What shall I do. Dear Hena Mondal At this age hysterectomy is required only if the symptom is due to fibroid because after menopause fibroid will start srinking. Uterine fibroid tumors or leiomyomas are estrogen dependent - they enjoy estrogen. Actually, uterine fibroid tumors never develop prior to the start of menstruation when the female body begins producing estrogen. While pregnant, fibroid tumors often grow extremely fast due the additional estrogen produced by your body while pregnant. Most women who've fibroid tumors and who are able to wait until after menopause discover their uterine fibroid tumors shrink and disappear once estrogen production stops in your body. Because of estrogen’s affect, both women who actually have fibroid tumors and people who've had uterine fibroids previously need to pay particular attention to the potential negative effects of estrogen-containing medications. So in our opinion you should give more attention more on your thyroid problem rather than on your fibroid. With regards M.K. Gupta
re: multiple intramural uterine fibroids by Hena mondal - Sep 2nd, 2012 10:01 am #5
Hena mondal	Sir, Many thanks for your valuable advice in response Q No-4.The doctor is emphasizing on Abdominal Hysterectomy as the fibroids became intramural and multiple as per TVS report if though it was single in hole abdomen U.S.G report which was done just one year before.Under this circumstances which advice will more preferable and safety? if Abdominal Hysterectomy necessity who can done safely plan Gyno/ Gyno M.S? plz. Plz.advice further once. Dear Mondal The choice is depend upon skill of gynecologists and the instrument available to perform the surgery. In case of multiple intramural myoma sometime we prefer da Vinci robotic surgery. With regards Dr J S Chowhan
re: multiple intramural uterine fibroids by ann - Jan 15th, 2013 3:34 am #6
ann	I have two intramural uterine fibroids, one 7cm and the other 2cm. I am 40yrs unmarried. I have frequent urination and pelvic pressure, discomfort and constipation. Pl suggest, what type of laparoscopy surgery is required to remove it? can it be dissolved with medicines? Dear Ann Laparoscopic surgery is a good option for your fibroid to get removed. Some GNRH can work to srink the myoma but it again regrow once you will stop the treatment. With regards Sadhana
re: multiple intramural uterine fibroids by tracy - Jan 27th, 2013 7:26 am #7
tracy	omg i am so worryed i have just read my letter it says i have a bulky uterus im on to my 4 misscaridge so does this mean i will never have kids r worse whats going to happen to me Dear Tracy It is not necessary that bulky uterus will not have capacity to become pregnent. Please consult your gynecologist and get some more investigation done to rule out the causes of infirtility. With regards Sadhana
re: multiple intramural uterine fibroids by Bisbabe - Jan 29th, 2013 5:25 am #8
Bisbabe	I am married,in 2009 i had surgery for fibroid which does not affect my uterus. since then i have been trying to be pregnant and i have done series of hormonal test, pelvic scan, blood test etc and everyting was ok. last year december precisely 20th, i did another pelvic scan the result details are- THE UTERUS IS NON-GRAVID ANTEVERTED, OF NOMAL WITH NON-UNIFORM MYOMETRIAL ECHO-PATTERN. IT MEASURES ABOUT 50MM IN AP DIAMETER. THE ENDOMETRIAL WALL MEASURES ABOUT 8MM IN THICKNESS. THE RIGHT OVARY MEASURES ABOUT 36MM27MM IN SIZE. THE LEFT OVARY MEASURES ABOUT 40MM31MM IN SIZE. THERE ARE INTRAL MURAL FIBROIDS NOTED IN THE ANTERIOR AND POSTERIOR UTERINE WALLS. THE ANTERIOR ONES MEASURE ABOUT 15MM14MM AND 15MM15MM. THE POSTERIOR ONE MEASURE ABOUT 12MM*13MM IN SIZE. BOTH ADNEXAE ARE FEE BILATERIALLY, THE POUCH OF DOUGLAS IS FREE, THE GENERAL UTERINE OUTLINE IS INCONSISTENT.Pls i need your medical and economical solution to this problem because i want to have kids and i'm 40yrs plus. pls..........i want to be pregnant for God's sake! Dear Bosbabe After seeing your ultrasound report we want to advice you that fibroid is not creation problem to you. Most fibroids do not produce any symptoms. During a routine pelvic exam, in millions of women the first signs of fibroids can be detected. There are several tests that may show more information about fibroids but without any problem With regards Dr J S Chowhan
re: multiple intramural uterine fibroids by hadiza habia Haruna - Mar 27th, 2013 7:54 am #9
hadiza habia Haruna	I have a Multiple intramural fibroid What is the treatment. 2. Can we a sex with my husband.
re: multiple intramural uterine fibroids by Annalakshmi - Mar 30th, 2013 5:44 am #10
Annalakshmi	AUM SRI SAIRAM TRANS ABDOMINAL SONOGRAPHY in June 2006 Uterus appeared bulky Uterus measured 8.88 x 3.5 cms Nebothian cyst in anterior wall Left ovary appeared normal Left ovary measured 2.6 x 2.0 cms Right ovary appeared normal Right ovary measured 3.4 x 1.8 cms Right kidney appread normal Right kidney measured 9.4 x 3.6 cms Left kidney appeared normal Left kidney measured 9.4 x 4.7 cms IMPRESSION: BULKY UTERUS; NEBOTHIAN CYST IN ANTERIOR WALL; NORMAL OVARIES & KIDNEYS FEB 2011 ULTRASOUND OF UTERUS: Bulky uterus identified Two fibroids measuring 15/16 mm and 20/19 mm were observed along the anterior wall Myometrium appeared to be slightly mottled Endometrium measured 12 mm
re: multiple intramural uterine fibroids by Mrs. Ametepey - May 14th, 2013 7:47 am #11
Mrs. Ametepey	I am 39 years diagnosed of intramural fibroid nodules and the centimetres are 2.9 x 2.4 x 2.4 cm and am afraid that with this I would get pregnant because i need a child badly. do I have the chance Dear Ametepey Generally Small fibroids are not a cause of pregnancy and hopefully nothing should stop you to getting pregnant. With regard J S Chowhan
re: multiple intramural uterine fibroids by ada - Aug 15th, 2013 4:29 pm #12
ada	I have multiple itramular fibrod what drugs do i use for it. Dear Ada You did not write your age and do you have baby or not. Most of the fibroid does not harm if your family is complete and if you don't have any symptom. With regard Sadhana
re: multiple intramural uterine fibroids by megha - Sep 16th, 2013 9:14 pm #13
megha	a small hypo echoic fibroid size 8*5 mm in anterior myometrium treatment Dear Megha There will not be any consequence most of the time due to that much small fibroid.
re: multiple intramural uterine fibroids by Dosunmu Oluwakemi - Oct 4th, 2013 9:23 pm #14
Dosunmu Oluwakemi	Dear Doc Chowhan, How much does the UAE cost? Laparoscopic Cholecystectomy fee also depends upon the type of room you opt.
re: multiple intramural uterine fibroids by xxxxx - Mar 22nd, 2014 12:49 am #15
xxxxx	the gall bladder is of normal shape and size. it shows normal wall thickness. NO calculus is detected in it.Two small echogenic foci are seen along the wall-polyps. what is the treatment for this? ??? the age of my mom is 43 years Dear Harmanjot The treatment for polyps in the gall bladder is Laparoscopic cholecystectomy.Before the surgery preanasthetic investigations and check up is done. Thanks With Regards Dr J S Chowhan World Laparoscopy Hospital Cyber City, DLF Phase II, Gurgaon, NCR Delhi, 122 002, India PHONES: For Training: +91(0)9540993399, 9999677788 For Treatment: +91(0)9540994499 For General Enquiry: +91(0)124 - 2351555 Email: contact@laparoscopyhospital.com
re: multiple intramural uterine fibroids by Babington Mary - Apr 11th, 2014 2:45 pm #16
Babington Mary	Kindly advise us on what to do as we married for 5 years.A pelvic scan test shows bulky uterus with AP diameter of 12.0cm.The echo pattern is heterogenous.The Myomtrium is expanded by intramural solid tissue masses with mixed echo textures and AP diametre of (1)5.3 cm in the mid Anterior wall (2)3.9cm in the fundal wall (3)5.8cm in the upper posterior will.No cyst,No pelvic collection.No cyesisor retained products of conception sighted. Dear Babington Mary The Laparoscopic Myomectomy is the treatment of choice for the intramural fibroids.please send scanned copy of ultrasound and MRI to advice further. Thanks With Regards Dr J S Chowhan World Laparoscopy Hospital Cyber City, DLF Phase II, Gurgaon, NCR Delhi, 122 002, India PHONES: For Training: +91(0)9540993399, 9999677788 For Treatment: +91(0)9540994499 For General Enquiry: +91(0)124 - 2351555 Email: contact@laparoscopyhospital.com
re: multiple intramural uterine fibroids by Mrs. Stella - Aug 21st, 2014 2:57 am #17
Mrs. Stella	I recently underwent a Examination at a Diagnostic Imaging Center in Mumbai/Bombay (India) and I am 55 years of Age and my periods has stopped 3 years back and do not have any bleeding. My Recent Abdomen & Pelvic Sonography Report reads as under : Liver is of normal size & echo texture. No evidence of focal lesion in Liver. Portal vein appear normal (10MM) No dilated I.H.B.R. No evidence of pleural effusion. Gall Bladder is well distended. Tiny echogenic foci seen adherent to gall bladder wall suggestive of gall bladder polyps. No evidence of cholelithiasis. No evidence of pericholecystic collection. No thickening of gall bladder wall. C.B.D appears normal (2mm) and no evidence of calculi in it. Pancreas shows normal echogenicity. No sign of acute or chronic Pancreatitis. Spleen shows normal echogenicity and it is of normal size (8.5cms) No evidence of Paraaortic Lymphadenopathy or Ascities. Right kidney measures 9.0 with parenchymal thickness 1.7cms Left Kidney measures 10.5cms with parenchymal thickness 1.9cms No evidence of renal calculi or Hydronephrosis. Mild fullness in both Kidney appear physiological . Cortical echogenicity on either side appear normal. Bladder shows smoth margin and there is no evidene of vesicle calculi. Pre viod bladder volume is 605 cc. Post void residue of 27 cc. " Uterus is normal in size and Retroverted in position, It measures 2.6cm in Transverse, 3.2 cm in AP and 7.7 cm in longitudinal axis. There is evidence of multiple intramural uterine fibroids, in the left Postero-lateral wall measring 4.2 x 3.5 cms, anterior wall measuring 0.7 x 0.5 cms and left lateral wall measuring 1.9 x 1.5cms. Endometrical canal is seen in the centre of the uterine cavity. Endometrial thickness measures 3mm. Cervical canal shows no abnormality Both the ovaries are of normal size. Right ovary measure 1.9 x 1.0 cms. Left ovary measure 1.0 x 1.5 cms. No evidence of adnexal mass. No evidence of fluid in posterior cul-de-sac is seen Sonography examination of umbilical region was done using high frequency proble. There is abdominal wall defect measureing 1.9 cms with protrusion of omental fat on coughing suggestive of umbilical hernia. REMARK: TINY GALL BLADDER POLYPS RETROVERTTED UTERUS WITH MULTIPLE UTERINE FIBROIDS (4.2 X 3.5 CMS) UMBILICAL HERNIA. Report Signed by Doctor Please let me know if this is uterus cancer and what special treatment is required from my side. I am shortly going for an " Umbilical Hernia " operation and Can I simultaneously get my self operated for my " RETROVERTED UTERUS WITH MULTIPLE UTERINE FIBROIDS (4.2 X 3.5 CMS) found as per the examination Report . Thanks for your reply. MRS. STELLA. K Dear Madam before deciding the treatment plan we want to know that your family is complete or not and what are the symptom you have at present. If your family is already complete you dont need to worry about these fibroids. After menopause the fibroid will shrink its own. For polyp of gallbladder and umbilical hernia, both of them can be operated at same session and laparoscopic surgery would be the best option for this. We can perform your surgery at World Laparoscopy Hospital or you can chose any good laparoscopic surgeon nearby. Before surgery you need thorough evaluation by a gynecologist and a general surgeon. Please let us know if you want any further help. With regards Dr. R.K. Mishra
re: multiple intramural uterine fibroids by Rama - Sep 18th, 2014 4:02 pm #18
Rama	Age 50 yrs. unmarried. Periods irregular and very heavy. Doctor advised USG which showed multiple fibroids. Your advice. Dear Rama You are nearing the menopausal age with multiple fibroids and heavy bleeding. First line of treatment will be medical management with hormones etc. if it is not effective then surgery and Hystrectomy is recommended. Thanks With Regards Dr J S chowhan
re: multiple intramural uterine fibroids by Nehal Dalal - Dec 13th, 2014 10:43 pm #19
Nehal Dalal	Utdrus appears bulky 48X62X85mm and shown 14X18mm hypoechoic lesionin post. myometrium p/o fibroid cervis appears normal et-12mm (Pl suggest that Removal of Uterus is necessary in this condition let me know on urgent basis please. also let me know the bleeding is there since back 40 days can not stop back days Dear Neha Your USG shows uterus to be of normal size with a small fibroid. This fibroid looks innocent and for AUB i.e.(Altered uterine Bleeeding) you must consult a gynaecologist. Thanks With Regards Dr J S Chowhan
re: multiple intramural uterine fibroids by Dr S K Panda - Mar 22nd, 2015 1:16 am #20
Dr S K Panda	My pt 28years old p2l2 having bilateral ovarian teratoma of 9 cm Each ; what is the right treatment. Laparoscopic Ovarian cystectomy is the correct treatment for ovarian teratoma.
re: multiple intramural uterine fibroids by Amarilis Diaz - Apr 23rd, 2015 11:40 am #21
Amarilis Diaz	Hi Dr. I will appreciate your response for my health problem. I am 43 years old. I do not want to have a baby. Recently I had an endovaginal sonogram which reflected that I have multiple foliples were the bigger 1.7cm.Also this study revealed that I also have 2.4*2.0 Fibroid. I would like to know your opinion. I do not have long menstrual period, I used to have back pain but I do not have blood in urine. I can tell you that I do have pressure in pelvic area. But it is not complicate but I do not want a surgery. Which recomendation can you provide me? Thank you! Dear Amarilis, Your fibroid is small and you are already reaching to menopause stage so any surgery is not required. After menopause you fibroid will automatically shrink in size. with regards Nidhi
re: multiple intramural uterine fibroids by suzana - Oct 17th, 2015 8:13 pm #22
suzana	I have small intramural fibroid 12 mm, I've just turned 50. My period is late for two months. Is this have to do with the fibroid, and how dangerous is it? Dear Suzana You have late period because you are getting menopause. You should not worry about these things because your fibroid is innocent and it is not creating any disease and that much small fibroid has nothing to do with your late period. With regard Dr R K Mishra
re: multiple intramural uterine fibroids by Hani khan - Nov 11th, 2015 8:47 pm #23
Hani khan	My mom is having bulky uterus with focal adenomyosis of 41×32 mm and subserous fibroid of 33×26 mm please suggest your opinion and her age is 44 years. Dear Mr Khan, If there is no symptom due to this fibroid to your mother nothing is required to do otherwise she has to get laparoscopic myomectomy done. Generally that much small myoma does not do any problem and after menopause it will start shrinking its own. With regard Dr R K Mishra
re: multiple intramural uterine fibroids by vasanth - Nov 14th, 2015 9:07 pm #24
vasanth	Respected madam i am having mild diffuse grade 1 fatty liver as well as symentanious problem of two intra mural fibroids largest in the right lateral wall of the body, anteriorly, indenting the endometria; linging, streaky endometrium and streaky ovaries are seen i need u r guidenes. Dear Madam You did not tell your age and size of fibroid. If fibroids are small it has nothing to do with your problem. Please send your detail history then only we will be able to give you some useful advice. With regard Nidhi
re: multiple intramural uterine fibroids by alidina - Jan 21st, 2016 8:43 pm #25
alidina	My ultra sound result can suggest what to do bulky uterus with multiple fibroids and intramural cystic leisons cervical nabothian cysts. Dear Alidina You did not write the size of fibroid and what are your symptom. It is estimated that at least 50% of fibroids are asymptomatic, but this figure is likely to be an underestimate as it is based on women in whom fibroids are found incidentally during another procedure (e.g. cervical screening), and there is little, if any, data from population studies on the true incidence of fibroids. If a prevalence of 50% by 50 years of age is accepted, a large number of women have asymptomatic fibroids. Working on the cliché, 'if it ain't broken, don't fix it', it may seem surprising that there should be a chapter dedicated to the issue of asymptomatic fibroids, since the simplistic approach might be to leave the asymptomatic fibroids well alone. However, asymptomatic fibroids may become symptomatic in the future, so it may be wiser to treat fibroids before they grow to a size when they become symptomatic, or treatment becomes more challenging, especially in young women who may desire fertility at a later stage, and in view of the fact that many women are starting their families in their mid-thirties when they have a 30% chance of having a fibroid(s). Despite their common occurrence, fibroids are still poorly understood. It is not known why they form in the first place, what determines their number and ultimate size, the best treatment approaches, or the factors that determine which women develop symptoms. Even when women present with disorders such as infertility, pelvic pain and abnormal bleeding, it is not always possible to be certain that a given myoma is not simply an innocent bystander rather than the cause of the symptom. This chapter addresses the challenging issue of what to do when fibroids are diagnosed incidentally. Firstly, there is the need to ascertain that the pelvic mass palpated is indeed a fibroid, and not an early, more sinister tumour, especially if conservative management is adopted. In addition, there is the issue of size, position and potential for becoming symptomatic at a later date. With the availability of uterine-preserving and largely non-invasive treatment modalities, should more asymptomatic, younger women be offered treatment if it is deemed that their fibroids may cause problems as they grow? Where treatment is not offered, is it necessary to follow-up such women.
re: multiple intramural uterine fibroids by purnima chhetri - Feb 2nd, 2016 12:31 pm #26
purnima chhetri	sir, my latest usg report shows I have intramural myoma of 12mm sized in posterior myometrium,my age is 47, please suggest what kind of treatment is needed. Dear Purnima, If you want experience pain due to fibroid then you should go for Laparoscopic Myomectomy done to remove the fibroid. But if you don't experience and pain then you dont need to do anything about it right now. With regards Nidhi
re: multiple intramural uterine fibroids by Nirmaljit kaur - Mar 17th, 2016 8:24 am #27
Nirmaljit kaur	Sir, I am 48 year old and I have hypoechoic lesion in the post wall of uterus abtting the endometrium that is 16mmx15mm, which is causing I faced heavy bleeding in periods and pain in uterus. I was taking medicine from 2 month but the problem is becoming increase every month and also size of hypoechoic lesion in uterus. Kindly suggest me tht what should I do for the same, should go for surgery ? If yes, Would the surgery for same be safe for me ? Dear Nirmaljit, If there is no symptoms then no surgery is required for this small myoma. But if you experience any pain then Laparoscopic Myomectomy is required. With regards Nidhi
re: multiple intramural uterine fibroids by Sharmila Sinha - Mar 22nd, 2016 7:46 pm #28
Sharmila Sinha	Dear Sir/Madam, Myself 52 years, my weight is 48 kg and my period stopped after 49 years but again it started few months before with pain in the back pelvic region and feeling weakness.So did the USG-ABDOMEN-LOWER (FEMALE) TA/TV test by which the report is here thereby; Ultrasound Report as follows, 1. Uterus:size is (66 X 37 X 47 mm). It shows a Hypoechoic lession of size (12 X 11 mm). Endometrial thickness is 0.27 cm.Peri endometrial halo is normal. 2. Adenexae: Right ovary is 23 X 18 mm and Left ovary is 26 X 22. Both ovaries show normal configuration. No mass seen.No collection seen. 3.Urinary bladder:Shows anechoic lumen with normal mucosa 4.Impression:Fibroid Uterus Therefore Sir/Madam you are requested to give me advice for the same as early as possible. Waiting for your advice. Thank You, Regards, Sharmila Sinha Dear Mrs Sinha That much small fibroid in post menopausal state is not of any importance. You should get pap-smear examination done and in our opinion just conservative management will be OK and next month probably menses will not come. You should consult a gynecologist for checkup. With regard Dr. Nidhi
re: multiple intramural uterine fibroids by Kavya - Apr 11th, 2016 9:06 pm #29
Kavya	I am 39 years old. I have utrus bulky size and diffuse altered echotexture focal hypoechoic lesion seen upper right lateral wall of 51 x 43 mm size Endo -11mm ... Can I have chance to get pregnancy. Dear Kavya If the lateral wall Myoma is not creating any symptom then there is no need to do anything about that. But, if you have pain and excessive blood loss during menses then surgery is required. However, You should try to get pregnant as soon as possible otherwise this myoma will grow in size and then it will create problem in conception. The relationship between leiomyomas and infertility remains a subject of debate. The question is: do myomas influence fertility? We are obliged to conclude that the question remains. The absence of an answer to this crucial question is probably due to the fact that we have not yet conducted the appropriate prospective studies required to obtain any clear results. With regard Dr Nidhi
re: multiple intramural uterine fibroids by carla yehia - May 23rd, 2016 9:28 am #30
carla yehia	Hi I am a women I am a28 years old when I was preganant with twins I was diagonised with left anterior lateral multiple fibroid measuring 6.7×6.5×6.3 cm but I didnot complain from any thing when I was a pregnant and I was deliverlied with out problem now after a 4 years of delivery I want to conceive again is this possible or shouid I remove it first they are measured now 6.7×6.3×6.5 and I not complain from any thing.my fiboid is intramural
re: multiple intramural uterine fibroids by Sonali Mali - Nov 1st, 2016 2:02 pm #31
Sonali Mali	Hello Sir/Madam, My name is Sonali, 29 years old and unmarried. As per sonography reports, my uterus is bulky and shows 2 fibroids. One on anterior wall measuring 2.4 cms and one is on posterior wall measuring 2.2 cms. Soon I will be getting married. I am worried if I this affect in conceiving baby after marriage. Please suggest the best way to cure. Does these fibroids dissolve by medicines or I need to go through surgery? Also some mobile molecules found in the gall bladder and it is with distended smooth wall. Please do guide me on the same. Dear Sonali It seems that you are having multiple fibroid problem. As you have stated that you are unmarried fertility is most important concern for you. The fibroid can't be dissolve with the help of the medicine you need to go for the surgery for this. Laparoscopic myomectomy can be done if the fibroid is intramural and hysteroscopy myomectomy can be done if the fibroid is sub mucosal. The myomectomy procedure helps to preserve the reproductive potential. Please send us your full report regarding your gall bladder problem. With regards Dr Rahul
re: multiple intramural uterine fibroids by Anita singh - Nov 7th, 2016 8:11 pm #32
Anita singh	Age-48 No need of children. Clinical result is as under Uterus is bulky approx. 11.16.45.9 cms, normal in shape and outline. A subserosal fibroid measuring approx 50*39mm is seen posteriorly in lower uterine. Multiple small anterior and posterior wall intramural fibroids are also seen. Endometrial echo is central and measures 5.1mm in thickness, ovaries are normal. No associated adnexal mass is seen. No free fluids is seen in the pelvis. Please suggest what we should do? Regards Anita Dear Anita Thank you for providing your all details. It seems that you have multiple fibroid in your uterus. as you have mention that your age is 48 and you dont need children so you can go for the removal of the uterus. Total laparoscopic Hysterectomy can be done. It is a laparoscopic procedure of removing uterus unlike the previous open surgery where whole abdomen used to be opened. In this the small incision are made through that whole instrument and camera are inserted and the procedure is carried out. With Regards Dr Rahul
re: multiple intramural uterine fibroids by Hemi - Nov 13th, 2016 5:44 pm #33
Hemi	Respected Sir, My Name is Hemi Shah, I m 45 Years old, unmarried. After heavy bleeding In my current periods I visit to dr. she gives the report that: - Impression :- Bulky adenomyotic uterus with multiple intramural myomas & nomal ovaries.. what should I do now ? Regards, Hemi Shah. Dear Hemi We need to know the size of the myomas. Laparoscopic Myomectomy can be done for the removal of the fibroid. It will help you to protect your reproductive potential. You can contact a good gynecologist or can come to world laparoscopic hospital.
re: multiple intramural uterine fibroids by Viji - Dec 15th, 2016 1:33 pm #34
Viji	I m suffering intermolar fibroid . I married 1 year back and I conceive after 6 month but 3 months I did dnc due to heart beat not come my child. May I know if Intermolar fibroid also reason for heart beat issue. Please suggest me to. Get healthy baby again. Dear Viji You havr not mentioned about the size of your fibroid uterus. Large intramural fibroid may be the cause of pregnancy loss. Please get laparoscopic myomectomy done. With regard Dr Rahul
re: multiple intramural uterine fibroids by JeromeMarivsob - Jul 2nd, 2020 4:53 am #35
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