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Uterine Fibroids
Discussion in 'All Categories' started by Priyanka Bhardwaj - Nov 25th, 2011 2:33 pm.
Priyanka Bhardwaj
Priyanka Bhardwaj
i am 29 year old with one kid. i have fibrod of 3 cm in utrus, which is causing very heavy bleeding. i m taking medicine for 2 years but the problem is becoming big every month.


my ultra sound as in oct was as follow..
Uterus is anterverted and bulky in size.
measure 10.98*7.28*6.25 cm.
myometrium appears heterogenous.
heterogenously hypoechoic lesion of 3.95*3.57*2.06 cm is seen in sunmucosal location s/o submucosal fibroid.
another smal intramural fibroid in anterior wall of 2.16*1.78 cm
endometrium in midline and normal mesure 4.3mm

i am totally confused.. some doctor say to use only medicines.. some say to remove uterus, some laproscopy..
what should i do... should i continue with medicine or should go for surgery. plz sugest
re: Uterine Fibroids by Dr JS Chauhan - Nov 25th, 2011 7:18 pm
#1
Dr JS Chauhan
Dr JS Chauhan
Dear Priyanka Bhardwaj
Nearly all women with fibroids have no symptoms. For ladies that do have symptoms, you will find treatments that will help. Talk with your doctor about the easiest way to deal with your fibroids. They will consider a lot of things before helping you choose a treatment. Some of these things include:

Whether or not you are having symptoms from the fibroids
If you might want to conceive later on
The size of the fibroids
The location of the fibroids
Your age and just how near to menopause you might be

For those who have fibroids but don't have any symptoms, you may not need treatment. Your doctor will check during your regular exams to see if they have grown.

Medications

If you have fibroids and also have mild symptoms, your physician may suggest taking medication. Over-the-counter drugs for example ibuprofen or acetaminophen can be used for mild pain. If you have heavy bleeding on your period, taking an iron supplement will keep you against getting anemia or correct it should you are already anemic.

Several drugs commonly used for birth control can be prescribed to help control the signs of fibroids. Low-dose oral contraceptives don't make fibroids grow and can help control heavy bleeding. The same is true of progesterone-like injections (e.g., Depo-Provera®). An IUD (intrauterine device) called Mirena® includes a small amount of progesterone-like medication, which can be used to control heavy bleeding as well as for contraception.

Other drugs used to treat fibroids are "gonadotropin releasing hormone agonists" (GnRHa). The main one most often used is Lupron®. These drugs, given by injection, nasal spray, or implanted, can shrink your fibroids. Sometimes they are used before surgery to create fibroids simpler to remove. Side effects of GnRHas may include menopausal flashes, depression, not being able to sleep, decreased sex drive, and pain. Most women tolerate GnRHas very well. Most women don't get an occasion when taking GnRHas. This is often a big relief to ladies who have heavy bleeding. Additionally, it allows women with anemia to recuperate to a normal blood count. GnRHas can cause bone thinning, so their use is generally restricted to 6 months or less. These drugs are also very expensive, plus some insurance providers will cover only a few or none of the cost. GnRHas offer temporary relief from the symptoms of fibroids; once you stop taking the drugs, the fibroids often re-grow quickly.

Surgery

For those who have fibroids with moderate or severe symptoms, surgery could be the best way to deal with them.

Myomectomy- Surgery to get rid of fibroids if you don't take out the healthy tissue from the uterus. It's best for women who wish to have children after strategy to their fibroids or who wish to keep their uterus for other reasons. You can become pregnant after myomectomy. If your fibroids were imbedded deeply in the uterus, you might need a cesarean section to deliver. Myomectomy can be performed in many ways. It may be major surgery (involving cutting in to the abdomen) or performed with laparoscopy or hysteroscopy. The type of surgery that you can do depends on the kind, size, and location of the fibroids. After myomectomy new fibroids can grow and cause trouble later. All the possible risks of surgery are true for myomectomy. The risks depend on how extensive the surgical treatment is.

Hysterectomy - Surgery to remove the uterus. This surgery is the only real sure method to cure uterine fibroids. Fibroids would be the most typical reason why hysterectomy is conducted. This surgery is used when a woman's fibroids are large, if she's heavy bleeding, is either near or past menopause, or does not want children. When the fibroids are large, a woman may need a hysterectomy that involves cutting in to the abdomen to remove the uterus. If the fibroids are smaller, the doctor might be able to get to the uterus with the vagina, rather than creating a cut within the abdomen. In some instances hysterectomy can be performed with the laparoscope. Elimination of the ovaries and the cervix at the time of hysterectomy is usually optional. Women whose ovaries aren't removed don't get into menopause during the time of hysterectomy. Hysterectomy is a major surgery. Although hysterectomy is generally quite safe, it does carry a significant chance of complications. Recovery from hysterectomy usually takes several weeks.


Endometrial Ablation- The lining of the uterus is removed or destroyed to manage very heavy bleeding. This can be done with laser, wire loops, boiling water, electric energy, microwaves, freezing, and other methods. This procedure usually is considered minor surgery. It is possible on an outpatient basis or perhaps a doctor's office. Complications can happen, but are uncommon with most from the methods. Most people recover quickly. About 50 % of ladies who've this procedure don't have any more menstrual bleeding. About three in 10 women have much lighter bleeding. But, a lady cannot have children following this surgery.

Myolysis - A needle is inserted into the fibroids, usually guided by laparoscopy, and electric current or freezing can be used to eliminate the fibroids.

Uterine Fibroid Embolization (UFE), or Uterine Artery Embolization (UAE) - A thin tube is thread in to the blood vessels that supply blood to the fibroid. Then, tiny plastic or gel particles are injected into the blood vessels. This blocks the circulation to the fibroid, causing it to contract. UFE can be an outpatient or inpatient procedure. Complications, including early menopause, are uncommon but could occur. Studies suggest fibroids will not re-grow after UFE, but more long-term research is needed. Not all fibroids may be treatable with UFE. The best candidates for UFE are women who hve fibroids which are causing heavy bleeding or fibroids that are causing pain or pressing around the bladder or rectum or even the ladies who should not have a hysterectomy or if do not want to have children in the future

MRI-guided ultrasound surgery shrinks fibroids using a high-intensity ultrasound beam. The MRI scanner helps the doctor locate the fibroid, and also the ultrasound sends out hot sound waves to eliminate the fibroid. The ExAblate® 2000 Product is a medical device that uses this method to eliminate uterine fibroids. Some health care providers use lasers to remove a fibroid in order to cut off the blood supply to the fibroid, making it shrink. Mifepristone®, and other anti-hormonal drugs being developed, could provide symptom relief without bone-thinning negative effects. They are promising treatments, but none are yet available or FDA approved.

In your case we have to examine all your investigation and after seeing and examining you we can draw the conclusion that which treatment option will be better for you. We will request you to vist us some day so that we can give you the best choice.

With regards

J S Chauhan.
re: Uterine Fibroids by Djallal - Feb 10th, 2012 12:02 am
#2
Djallal
Djallal
Good cnnoett and simple to understand description. How can I go about getting permission to share part of the article in my future publication?
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