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Hysterectomy, or other options

I am 39 and I have a 5 inch fibroid in my uterus plus others and lesions along with multiple cysts on my ovaries. I am considering a partial hysterectomy….keeping my ovaries. Is it necessary or will the fibroid just go away? I do urinate frequently and I am just starting to experience bleeding abnormalities. I do not plan on having children and I have all HPV viruses that cause cancer that I monitor frequently…so I am wondering if this is the right thing to do? I am worried that it will only keep getting bigger and im also worried if I have the surgery I will lose my sexual drive or pleasures. Then the other part of me says I will no longer have to worry about the HPV problems or about the fibroid if I have the surgery done… Please advise.

Thank you, Wendy

Wendy,

Unfortunately, fibroids don’t shrink until menopause, at an average age of 52.  So, it sounds like waiting for menopause will take too long.  We are not able to predict the growth rate of fibroids, but some do not grow over time while others do grow.  If you chose to have a hysterectomy, the procedure will relieve the symptoms of urinary frequency and bleeding related to the fibroid.  But, there are other options.

Myomectomy, which could be performed laparoscopically by a skilled laparoscopic surgeon, removes the fibroid and should relieve your symptoms.  For more about this see: http://www.fibroidsecondopinion.com/laparoscopic-myomectomy/

UAE (embolization ) shrinks the fibroid and is likely to work as well. See this page: http://www.fibroidsecondopinion.com/uterine-artery-embolization/

If you choose not to have a hysterectomy, the HPV virus can be easily monitored with viral tests of the cervix. Often the virus goes away by itself, but if the cervical cells start to become abnormal the cervix can be easily treated in the doctor’s office years before cancer develops.
For more about this see: http://www.gynsecondopinion.com/pap.htm

If you have uterine contractions or pleasurable cervical sensation during intercourse, hysterectomy will eliminate these sensations. Neither myomectomy nor UAE are likely to interfere with your sexuality. However, sometimes just removing the fibroid, either with myomectomy or hysterectomy or shrinking it with UAE makes intercourse more comfortable. More about this can be found here: www.fibroidsecondopinion.com/hysterectomy-for-fibroids/

I hope this is helpful,
Bill Parker, MD

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Disclaimer: The ideas, procedures and suggestions contained on this web site are not intended as a substitute for consulting with your physician. All matters regarding your health require medical supervision.

4 Comments

  1. Suzanna
    Posted November 30, 2009 at 6:29 pm | Permalink

    I am 45 and have a 4cm x 3.9cm submucosal fibroid. Its the primary cause of my anemia. I have expressed to my family doctor and the gynecologist she referred me to that I am against having a hysterectomy. I am waiting to be referred to another gynecologist for a 2nd opinion but am already forewarned that all gynecologists will recommend a hysterectomy because its far easier to do than a myomectomy (more bleeding, more complex, it will grow back anyways, etc.). I’d rather address the fibroid than perform a major surgery that’s irreversible. What I am stupefied is the cavalier manner which something as major as a hysterectomy is frequently recommended over other options like a myomectomy. Please advise if a hysterectomy is the best option and are there any merits in why they seem unwilling to do a myomectomy?

  2. Posted December 1, 2009 at 11:00 pm | Permalink

    Suzanna,

    It is ridiculous for gynecologists to suggest hysterectomy as your only option. The fibroid is small (4 cm)and since it is submucosal, it can be reached with the hysteroscope and removed. Hysteroscopic myomectomy is an outpatient procedure with virtually no postoperative discomfort and a 1-2 day recovery. If you do not desire to become pregnant in the future, you can have an endometrial ablation done at the same time, and the success rates are 90%.

    You should get a second opinion from a gynecologist skilled at these procedures. For more information about this see:
    http://www.fibroidsecondopinion.com/hysteroscopic-myomectomy/

    Bill Parker, MD

  3. Posted March 2, 2011 at 11:17 pm | Permalink

    I have an enlarged uterus on all sides and it has grown several large fibroids. I have the worste pain of my life and also have reoccuraing cycst on my ovary. I talked to my obgyn and he greatly agrees taking my uterus out is the best option along with taking the cycst out as well. how long is recovery time on this kind of surgery?

  4. Posted March 4, 2011 at 8:33 pm | Permalink

    Recovery will depend on the type of hysterectomy you chose to have. Recovery after laparoscopic hysterectomy is usually about 2 weeks and after abdominal hysterectomy it is about 6 weeks. Some surgeons are skilled at removing a large uterus with vaginal hysterectomy and recovery is about 2-3 weeks.

    Bill Parker, MD

Fibroid Doctor William H. Parker

Dr. William H. Parker is a board-certified Fellow in the American College of Obstetricians and Gynecologists. Dr. Parker is an internationally recognized expert in fibroid surgery and research. Based in San Diego, California, he is considered one of the best fibroid surgeons for abdominal and laparoscopic myomectomy in the United States and abroad. He has been chosen for Best Doctors in America and Top Doctors every year beginning in the late 90's.

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