|Discussion in 'All Categories' started by Dale - Dec 26th, 2011 7:50 am.|
I would like to have your opinion on possible treatment for my wife, age 34, who is otherwise healthy, except occasional small brownish vaginal discharge. Tests on her liver, kidney, thyroid functions, chest x-ray and upper abdominal ultrasound are all normal.
Since she could not get pregnant after six months of our marriage, on transvaginal ultrasound she is found to have multiple (at least three) uterine fibroids, with the largest being approximately 3cm x 4cm. MRI shows similar findings, plus possible chocolate cysts on both ovaries.
Based on these information, I would like to know:
1. What is the best treatment approach for her now? Our goal is to have a child.
2. Would she be benefited if a laparoscopic myomectomy is performed to remove the fibroids?
3. If she is found to have endometriosis during laparoscopic myomectomy, should it be operated on at the same time?
4. Can you give me an estimate on medically related costs (doctors fees, tests, surgery, anesthesiologist, etc) for a laparoscopic myomectomy without insurance coverage?
Thank you very much for your help.
re: Fibroids and Endometriosis by Dr JS Chauhan - Dec 27th, 2011 12:26 am
Dr JS Chauhan
You did not mention which type of fibroid it is:
Uterine Fibroids are classified based on their whereabouts inside the uterus. There are three primary kinds of fibroid tumors:
Subserosal fibroids develop in the outer portion of the uterus and continue to grow outward. These fibroids typically do not affect a ladies menstrual flow, or cause excessive menstrual bleeding, but could cause pain due to their size and the added pressure on other organs.
Intramural fibroid tumors are the most typical and develop in the uterine wall and expand. These fibroids may cause the uterus to appear larger in size which can be mistaken for putting on weight or pregnancy. Associated symptoms include heavy menstrual bleeding, pelvic and lower back pain, frequent urination and pressure.
The other kind of fibroid tumor is submucosal, the least common of the three. These fibroids develop inside the uterine cavity and may cause excessive menstrual bleeding along with prolonged menstrual cycles.
A woman may have one or all of these types of fibroids. It is common for a lady to have multiple fibroid tumors also it may be difficult to understand which fibroid is causing your symptoms. Because fibroid tumors are a diffuse disease of the uterus, you will find usually more fibroids present than could be detected due to their small size. A woman who has only one visible fibroid needs to think that you will find multiple uterine fibroids present when discussing therapy. Uterine fibroids can also be referred to as myoma, leiomyoma, leiomyomata, and fibromyoma.
The fibroid which is outside the uterine cavity is not the cause of infertility.
Endometriosis is the real cause of infirtility for your wife. Many theories have been proposed to describe why it's tougher for women with endometriosis to conceive. However, up to now, none have been proven. It's possible there are several causes and that different causes are relevant in different women. Some of the theories include:
pelvic adhesions inhibit the movement from the egg on the fallopian tube. eggs are of poor quality
chemicals made by the endometriosis inhibit the movement of the egg down the fallopian tube
inflammation within the pelvis caused by endometriosis energizes the manufacture of cells that attack the sperm and shorten their life time eggs aren't released from the ovaries each month (also called anovulation, which may also exist in women without endometriosis).
We can perform both the surgery for your wife but you should first come with all the report and consult with us to find out the way we should treat your wife.
re: Fibroids and Endometriosis by sad - Apr 20th, 2012 7:31 pm
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