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Discussion in 'All Categories' started by suresh - Sep 21st, 2012 8:32 am.
uterus is markedly enlarged,antiflexed and anteverted, it measures 14.1x12.3x9.53 cms, hyperechoic mass is seen superimposed over endometrium, another 33.4 mm hypoechoic mass is seen in posterior myometrium,no evidence of fluid is seen in endometrial cavity,outline,size,shape and echotexture of cervix normal.patient is overweighted. total weight 107 kg.
re: fibroid by Sadhana - Sep 23rd, 2012 8:04 am
Dear Suresh

Just 33.4 mm intramural fibroid is not going to create any problem for the patient. One other hyperechoic mass which is seen superimposed over endometrium is in our opinion you are talking about submucous myoma.

Submucosal myomas are associated with infertility, and may be treated by hysteroscopic resection.

Fibroid of the uterus are the most common solid pelvic tumours in women, and are present in ~20 to 25% of women aged ≥35 years. Fibroid which is also called as Leiomyomas are associated with infertility, the causal relationship in this regard appearing to be more evident for submucosal myomas. Indeed, leiomyomas represent an increasing medical problem in women attempting to conceive at a more advanced age, when the rate of development of these lesions is also increased.

When patients have bleeding or pain associated with infertility, the hysteroscopic procedure provides a safe and efficient treatment modality, and may be beneficial for all symptoms.

With regards

re: fibroid by Krishna - Oct 6th, 2012 9:56 am
My wife has multiple fibroid. Her MRI report read as "Uterus is enlarged in size and retroverted in shape. Large intramural fibroid measuring approx 57 x38 x39 mm (AP x Trans x CC) appearing hypointense on all pulse sequences seen in the left lateral wall. The fibroid is closely abutting the endometrium with its displacement to right side. A subserosal fibroid measuring 24 x 31mm in size seen arising from the fundus region. Another small intramural fibroid of
size 11x9 mm seen in the right lateral wall. Approx 20 x 13mm size submucosal fibroid projecting into endometrial canal seen arising from the left lateral wall. Nabothian cysts are seen in the cervix."
She is 38 yrs of age and we have no kids yet. Myomectomy is suggested to her but she is very scared of surgery. Her few concerns are :
1.Whether all her fibroids could be removed by robotic surgery?
2 What are the chances of resurfacing of fibroids?
3 What are the chances of conceiving and what difficulties may arise? many robotic myomectomies has been performed at your center? What is the success rate and what difficulties/problems arised during and post surgery?
re: fibroid by Dr M K Gupta - Oct 6th, 2012 9:59 am
Dr M K Gupta
Dr M K Gupta
All the intramural fibroid and most of the sub serous myoma is not responsible for infertility. The submucosal fibroid projecting into endometrial cavity is essential to remove. da Vinci robotic surgery can be used to treat subserous and intramural myoma but for submucous myoma you should go for hysteroscopic resection. study is performed to evaluate the factors associated with the recurrence of myoma after Myomectomy. Identifying the factors of myoma recurrence will assist the patient and her gynecologist in deciding the most appropriate method of treatment according to her specific social, medical and emotional needs.

Multiple logistic regression is used to
determine the factors affecting the recurrence. Some of the factors are given below:

1. Age of Surgery,
2. Tumor Size
3. Pelvic Pain

Interaction between the Age of Surgery and Tumor Size are significant in the final model.

The 5 year cumulative recurrence rate is 24.32% and the 10 year cumulative recurrence rate is 32.57%.

If the patient get pregnant then chances of recurrence decreases.

With regards
M K Gupta
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