|Discussion in 'All Categories' started by sunita mehta - May 23rd, 2012 5:15 pm.|
|get heavy bleeding during periods which remains for 1 to 1 1/2 month with clots. Ultrasound report reveals large utrus of 12.9 * 9.5 *8.67cm with evidence of fibroids in the fundal and anterior wall of 2.2*1.8 cm and 1.07*1.0 cm in size.The endometrium is 12.0 mm in thichness.|
re: heavy bleeding during mensuration by Dr J S Chowhan - May 24th, 2012 2:02 pm
Dr J S Chowhan
|Dear Sunita Mehta
In our opinion you should go for myomectomy. You did not say which type of myoma you have. There are three type of myoma like: Subserous, Intramural and Submucous. As you have bleeding so it should be most commonly submucous myoma.
Fibroids bulging into the uterine cavity or inside the cavity (submucous fibroids) can occasionally cause heavy menstrual bleeding or infertility. Submucous fibroids can often be removed with a hysteroscope, a telescope placed with the cervix and into the uterus.
Research that combined is a result of many small studies found that submucous fibroids that alter the shape of the uterine cavity decreased pregnancy rates.
The reason submucous fibroids can lead to infertility is not clear, but current theories are that the fibroids change circulation to a developing embryo, or block passage of the embryo through the fallopian tube, or cause inflammation within the uterine lining, or produce proteins that hinder the embryo journey with the tube, its attachment towards the uterine lining or its development.
The way in which submucous fibroids cause heavy bleeding can also be unclear, but many studies show removing these fibroids cures heavy bleeding. One study of ladies with very heavy bleeding discovered that, after elimination of fibroids by hysteroscopy.
Hysteroscopic myomectomy is really a technique that can be performed only if fibroids are within or bulging into the uterine cavity (submucosal). This process is conducted as outpatient surgery without any incisions and without any postoperative discomfort. Anesthesia is required because the surgery might take one or two hours and would otherwise be uncomfortable.
A little telescope, the hysteroscope, is passed through the cervix and also the inside of the uterine cavity can be seen. A small camera is connected to the telescope and the view is projected on the video monitor. This magnifies the image and also allows the doctor to do the surgery while sitting in an appropriate position. Electricity passes through the thin wire attachment at the end of the hysteroscope, allowing the instrument to cut with the fibroid like a hot knife cutting through butter. Because the fibroid is shaved out, the heat in the instrument sears arteries and the blood loss is usually minimal. Women go back home the same day, and recovery is remarkably fast, with many patients capable of going normal again activity, work and use in a single or 2 days.
Hysteroscopic myomectomy has been a major advance within the treatment of women who have submucous fibroids.
If you have intramural fibroid then you have to go for laparoscopic myomectomy.
Myomectomy for intramural and submucous fibroid is not necessary always. Myomectomy should be performed only if appropriate indications exist. And since it is a technically difficult surgery, your physician should have the extra training and experience that it requires.
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