Keep the uterus, get rid of the fibroids

A myomectomy is another option for the treatment of leiomyomas (lie-o-my-o-mas), generally known as fibroids.  This too can be done via an abdominal incision, laparoscopically or via the vagina.  The location, size, number of fibroids and the desire to preserve future fertility are the four major factors that determine which route is used.

In general, this procedure is reserved for patients who want to keep their uterus for future childbearing. Incisions are made in the uterus itself and the fibroids are “shelled out”.  Because the uterus has such a vibrant blood supply and because the technique involves multiple cuts into the uterus, there can be a fair amount of bleeding.  Sometimes, 1/1000, the uterus cannot be saved because it has been completely ‘taken over’ by the fibroids and the patient will need a full hysterectomy.

With respect to having children, women are advised to get pregnant within six months to a year of having the surgery because fibroids do grow back!  Also, If you are planning pregnancy, it’s a good idea to consult with a fertility specialists before electing this procedure.  Scarring can occur around the fallopian tubes or ovaries after a myomectomy; this can damage the tubes and make it difficult to conceive.  Studies have shown, however, that when fibroids are the cause of infertility, this surgery can significantly improve your chances of having a baby.

There you have it!  Now spread the word!

4 Comments

  1. Linda

    June 9, 2009 at 9:14 pm

    I am a 33 year old woman who had been suffering with a fibroid uterus for a few years. A year ago, I sought the advice of my GYN for the problem because I felt they should be removed. It was in her opinion that I should wait because there was a possibility that they would shrink. I was given prescription for birth control (which I thought was to help in the shrinkage) and was told I should get another ultrasoumd in 6 months. After 6 months, I returned to my GYN and was sent for another ultrasound. The results found that the fibroids didn’t shrink but in fact grew another centimeter. At that point I asked what the birth control was actually doing to help the situation. The doctor stated that periods shouldn’t be as heavy because of it. I also asked what were my chances of conceiving with the fibriods and was told very rarely. I was told to come back in another 6 months. Needless to say I did return 6 months later complaining of bad cramping. At this time, I was seen by another doctor in the practice and when he looked at my file, he stated that the fibroids were extremely large and should have been removed a year ago. I was then sent for yet anothe ultrasound that found that my largest fibroid (I had several) had tripled in size since the ultrasound 6 months prior. I was then told that since I was slightly overweight I should try to lose weight first before getting a myomectomy because I ran the risk of having to get a full hysterectomy due to my size. At the time I was in extreme pain in my pelvic, with unbelievable pressure that made it unbarable to sit down and stand up. I was also losing control of my bladder. I was informed by the doctor that these symptomds were common due to the size of the tumors. I then asked was it common to miss a period as well. He replied nonchalantly, “yes or you’re pregnant”. A pregnancy was done and I was indeed with child. It was at that point I decided to seek a second opinion. That second opinion revealed that I was pregnant with triplets but also that my fibroid tumor had tripled in size in a 4 week time priod. The tumor was so large that it had bent my uterus in half leaving only limited size for the fetuses to develop. I was only 8 weeks pregnant but my uterus was so enlarged it was the zize as if I was in my 3rd trimester. The actually tried to go in manually which was extremely painful and straighten out my uterus. It didn’t work. After consulting with several OB-GYN surgeons, I then elected to have the tumor removed in order to try to save my pregnancy. Unfortunatly, my uterus was so damaged for that time, I ended up losing my babies and had to have a hysterectomy. My advice to everyone, is that you know your own body better than anyone. When you feel as though you’re not getting the right advice or treatment from your physician, seek a second opinion and do it early. Don’t wait like me. Follow your instincts.

  2. Marguerite

    April 19, 2010 at 9:15 am

    I am a 51 year old woman who bacame aware of having fibroids when I was 29 and having my first child. I was able to have two additional children without complications from the fibroids. Over the past 22 years the fibroids have not caused a problem and it is only now that it is recommended that some type of action be taken as one of them has grown considerably. My question is that I have a 19 year old daughter and I know that they say fibroids can be hereditary. What can she do starting now to help prevent this medical condition?

  3. admin

    April 28, 2010 at 4:34 am

    We don’t know what really causes fibroids. But it is believed that it is caused by several different things acting together. We encourage women to eat right, exercise, avoid cigarettes and alcohol and find healthy ways to control stress. In addition, there do seem to be a pattern of inheritance as well. Fibroids usually don’t surface until women are in their 30s, usually. Your daughter should make her Ob/Gyn aware of her concerns and get a pelvic exam each year.

    Dr. Nevins

  4. admin

    April 28, 2010 at 4:36 am

    Thank you Linda for sharing your story. It is a testament to the fact that even though fibroids rarely are cancerous, they cause lead to serious problems if left untreated.

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