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Very large fibroid

Hello Dr. Parker,

I get directed to your site every time I search for information on fibroids. I live in India, but I was hoping to get an opinion from you about the possibility of removal of my very large subserosal fibroid. On MRI it measures 12.3cm x 13cm. There are two small intramural fibroids (3 cm each).

I would be very obliged if you could give me some advice if the fibroids can be removed laparoscopically. I want to retain fertility and I am 32 years of age (unmarried).

Thanks,

A

A,

Yes, this fibroid can be removed laparoscopically by an experienced laparoscopic surgeon.  One other fibroid is subserosal and could also be removed. Also see:http://www.fibroidsecondopinion.com/laparoscopic-myomectomy/

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.

19 Comments

  1. carol thorne
    Posted September 3, 2010 at 2:14 pm | Permalink

    I am 53rs old with 2 grown up children. I have not had a period now for 7months and have menopausal symptoms. The last period I had was very heavy and prolonged. (12days) I had a laparoscopy and hysteroscopy which showed two fibroids, one on the posterior wall of my uterus which is causing low back pain. My gynaecologist has suggested a total abdominal hysterectomy and removal of my ovaries because of my age, apparently I don’t need them! I really don’t want major surgery but want rid of the pain. What are my alternatives? My gynaecologist didn’t offer any!

    Carol,

    You have a number of alternatives. Uterine artery embolization shrinks fibroids about 40%. Myomectomy, which may be able to be performed laparoscopically by a skilled laparoscopic surgeon, will just remove the fibroid. If you chose to have a hysterectomy, it too may be able to be performed laparoscopically. You can certainly keep your ovaries since, for women who do not have a family history of ovarian cancer, there may be benefit to your heart and bones from the hormones the ovaries make until very late in life.

    You should consider getting a second opinion to get these other alternatives explained to you.

    Bill Parker, MD

  2. Susan Cooney
    Posted September 7, 2010 at 1:13 pm | Permalink

    I also have a very large fibroid, which has seen a recent growth spurt, according to my last sonogram in July when compared to the previous one 6 months earlier. My tumor is now 10 x 14 cm, up from 9.3 cm in January, and before that, 8.2 x 9.8 cm in Aug ’09.

    I live in a small Maine town, and the only option that three different doctors have given is hysterectomy due to the large size of the fibroid. I have had a sonogram on my ureters which were fine in January. My symptoms are starting to become difficult as the pressure in my abdomen is getting greater, the abdominal swelling is much larger, and bleeding is worse but manageable.

    Do you have any suggestions for someone that does not have any doctor nearby that can offer myomectomy?

    Thank you for your very informative site.

    S.
    You should strongly consider getting a second opinion from a gynecologist outside of your town. You might call the nearest medical center and ask for an appointment with someone who does myomectomy surgeries. A good laparoscopic surgeon should even be able to remove this fibroid laparoscopically. Do not be constrained by your local gynecologists.

    I hope this is helpful,

    Bill Parker, MD

  3. Posted September 9, 2010 at 6:55 pm | Permalink

    Erin,

    You might consider uterine artery embolization – this is not surgery and can shrink fibroids about 40%. Most major hospitals have someone trained to do this.

    Bill Parker, MD

  4. Ana
    Posted September 11, 2010 at 11:09 pm | Permalink

    Dr. Parker,
    i have a few fibroids, but i would like to keep my ovaries and cervix which are quite healthy and remove only my uterus with fibroids . my OBGYN suggests that i should remove all the organs along with uterus. need advice.
    thanks
    Ana

  5. Posted September 12, 2010 at 6:26 pm | Permalink

    Ana,

    First, you should consider just having a myomectomy with preservation of your uterus. In many cases, depending on the sizes of the fibroids, an experienced laparoscopic surgeon can do this laparoscopically as an outpatient.

    If you wish to have a hysterectomy, you should strongly consider keeping your ovaries and probably your cervix. The ovaries continue to make hormones until very late in life and these hormones protect against heart disease, osteoporosis and possibly lung cancer.

    For some women, the cervix is an important part of sexual pleasure and removal changes this.

    I hope this is of some help.

    Bill Parker, MD

  6. Sara
    Posted September 22, 2010 at 2:29 pm | Permalink

    I have been just diagnosed with very large fibroids (25cm) – the sonographer said it looked like my whole uterus has been replaced by fibroid tissue. I’m assuming hysterectomy is my only option, but would like your opinion as to whether in this situation less drastic solutions are possible. I am getting a lot of pressure symptoms, including lower back aches, bladder and bowel irritability.

    When fibroids grow, they push away the normal muscle – they do not destroy it. So, when the fibroids are carefully removed, all the normal remains. See patient C on the photo page – I removed 150 fibroids and the uterus is now normal size. http://www.fibroidsecondopinion.com/fibroid-photos/ You should consider getting a second opinion from someone who frequently performs myomectomies.

    Bill Parker, MD

  7. Debby
    Posted October 15, 2010 at 8:11 am | Permalink

    I live in the uk I have been diagnosed as having fibroids..I am 48 unfortunately overweight. I visited a Gynaecologist for the first time yesterday.
    They have suggested The Mirena coil..this only prevents them from growing I have been diagnosed as having a grossly enlarged uterus..
    This is very painful ..very uncomfortable and looks like I am 9 months pregnant.. what alteratives are there please..I wish for the fibroids to be romoved or shrunk or have a hysterectomy..
    I also find sex painful
    can you help advise me please
    Thank You

    Myomectomy is always an option: http://www.fibroidsecondopinion.com/abdominal-myomectomy/
    Uterine artery embolization may also be an option: http://www.fibroidsecondopinion.com/uterine-artery-embolization/
    Hysterectomy is an option if you wish this procedure: http://www.fibroidsecondopinion.com/hysterectomy-for-fibroids/

    I hope these web-pages are helpful,

    Bill Parker, MD

  8. anita
    Posted October 16, 2010 at 12:50 pm | Permalink

    Can i get pregnant and conceive my first child with my 10*8*5 broad ligament subserosal fibroid? I do not want surgery as i have no symptoms. Will the fibroid cause any complications? my husband thinks unless i remove the fibroid(through surgery only) he will not have a child with me..However i want us to try for baby immediately as i am already in my early thirties..Please advise.

    Thanks
    Anita

  9. Anna Lipcsey
    Posted November 1, 2010 at 10:12 am | Permalink

    Dear Dr. Parker,

    Let me applaud you on your extensive research on uterine fibroids. I share your view on taking the least damaging action when dealing with fibroid tumors. I have multiple solid and complex fibroids and my uterus measures 22x16x11 cm. Other than pressure, I don’t have any uncomfortable symptoms. I live in Toronto, Canada and my doctor, who is a specialist at Toronto’s Princess Margaret Hospital talks only about hysterectomy from the time I met her and she never gave me any information or choices, just a threat about my fibroids possibly be cancerous or could develop into cancerous tumors. I am 35 years old, I do have two kids, but I am not ready to give up my uterus and getting tired of advocating for my body alone against this specialist. I know I have to get another opinion, wondering if you know of any doctors in the Toronto area you have had any dealings with in your professional contacts. Or advise on how to find the right specialist.

  10. Karoline
    Posted November 28, 2010 at 7:18 pm | Permalink

    I’ve had an UFE done in 2009 and it seems like my problems with these fibroids only got worse that procedure did not help at all.I was told by my gynecologist that the fibroids were too large to and that I needed to have a complete hysterectomy done. I really don’t want to take away all of my woman hood,but if it comes to my health I don’t have a problem with that. I just need a second opinion please help me!

    A myomectomy can always be done and a hysterectomy should not be necessary. How many fibroids do you have and how big are they?

    Bill Parker, MD

  11. Chery Fall
    Posted December 4, 2010 at 7:01 pm | Permalink

    Thank you so much Dr. Parker for being so generous with your knowledge and expertise. I do not know how many times I have visited your website since I was diagnosed with uterine fibroids. I followed your advice about second opinions and saw two doctors. I have 4 fibroids, the largest is 4cm and a polyp. Ultrasound showed that there is a fibroid and a polyp inside the uterine cavity. Both doctors said they need to come out for me to be able to have children. One doctor wants to do an hysteroscopy and a laparoscopy on the same day. He will use a morcellator and prescribed misoprostol to be taken at the hospital before surgery. The second one said he would use a resectoscope and performs only a hysteroscopy. He also ordered MRI to map the fibroids. Please help me make the best decision possible. Both said they perform these surgeries on a very regular basis. I am very grateful for the wealth of information you offered me. THANK YOU!
    Chery

  12. Posted December 9, 2010 at 6:20 pm | Permalink

    Chery,

    The only fibroids that clearly interfere with fertility are those that bulge into the uterine cavity. These submucous fibroids can often be removed with the hysteroscope, as an outpatient, with a 1 or 2 day recovery. If the other fibroids are not causing you symptoms, you should ask doctor #1 for a very good reason to remove them. An MRI is the best way to map the fibroids, so the information and best procedure will likely be clearer after this is done. The MRI images should be seen by the gynecologists and then you should ask their opinions about what they recommend. Good luck with whatever you choose to do.
    Bill Parker, MD

  13. Posted December 19, 2010 at 6:00 pm | Permalink

    Anita,

    The only fibroids that clearly decrease fertility are submucous fibroids (bulging into the uterine cavity). Subserosal fibroids do not decrease fertility. Fibroids only very, very rarely cause problems during pregnancy and they do not harm the baby. One issue is that broad ligament fibroid might get in the way of the birth canal and make a Cesarean section necessary. More about these issues here:http://www.fibroidsecondopinion.com/fibroids-and-pregnancy/

    I hope this is helpful,

    Bill Parker, MD

  14. Leslie
    Posted December 28, 2010 at 9:22 am | Permalink

    Hello I have 3 large fibroids and 7 small ones. I will be having surgery to remove the fiborids in May 11. I have been to two doctors for my fiborids and the one that is doing the surgery said she is will remvoe the fiborids so i will be able to have kids since i am only 31. I had a mri done in december 2010 and the mri said that i had 3 large ones and 7 small ones also my uterus is the size of a 16 weeks pregnancy. I am wondering by her removing the fiborids will she be able to repair my ututerus where i will be able to have kids. I don’t wont a hysterecomy. Please help. or how large does your uterus has to be before they can’t repair it anymore.

  15. Posted December 28, 2010 at 9:43 pm | Permalink

    Leslie,

    In the hands of a gynecologist with good training and a lot of experience doing myomectomies on large fibroids, any size uterus should be able to be repaired and a hysterectomy should not be necessary. Consider asking your doctor the questions on this page: http://www.fibroidsecondopinion.com/questions-everyone-should-ask-their-doctor-before-surgery/

    I hope this is helpful,

    Bill Parker, MD

  16. Sheree
    Posted February 20, 2011 at 11:19 pm | Permalink

    Hi, I had a baby last May and my fibroid got so big it still looks like I’m pregnant. My ob/gyn said I have to wait until this May at least for a myomectomy but I want to know if UAE is safe and the usual recovery time. I started a new job but I have 2 periods and spotting every month, a lot of bleeding and pain, and urinary incontinence which is embarassing. My mother had endometriosis and fibroids and she ended up getting a hysterectomy in the OR because it couldn’t be saved from multiple fibroids. My last sono revealed largest was 10x12cm. I want one more child- I’m 32. Thanks!

  17. Fortoh Raissa
    Posted February 27, 2011 at 6:45 pm | Permalink

    Scan show that i have a large fibriod about the size of eight months pregnant woman and other smaller one i don’t know what to do i want to have children

  18. Posted March 4, 2011 at 8:40 pm | Permalink

    I usually recommend that women only need to wait 3 months after delivery to have a myomectomy. UAE is safe, but there is a very small chance that it can cause the ovaries to stop working earlier than normal menopause. Myomectomy is always possible and hysterectomy is not necessary if the surgeon is an expert in myomectomy surgery.

    Bill Parker, MD

  19. Maryam
    Posted September 12, 2011 at 12:42 pm | Permalink

    Dr. Parker,

    Thanks so much for your very informative website. I am 35 years old, and really want to have children soon. I have been diagnosed with 4 intramural fibroids – 8 x 7, 6 x 7, 6 x 5 and 3 cm roughly.

    I bleed a lot on the 1st couple of days of my period, but my haemoglobin level never drops below 11 (I check every few months). The most uncomfortable symptom for me is the bulging abdomen especially around my period which has people asking if I’m pregnant. I use a corset to try to keep it flat.

    My gynecologist would have liked me to try for a pregnancy first before a myomectomy, but that is not a possibility just now, so as he now recommends a myomectomy as he is concerned about the size (they grew about an inch a piece in the past year)leading to more complications in the future. From your website, it looks like laparoscopic surgery may not be a good option for me, given my desire to have children and the size of the fibroids.

    Another worry I have is about adhesions occuring with an abdominal myomectomy. My doctor knows about the adhesion barriers, but doesnt use them. He explained to me that barriers only reduce but do not eliminate adhesions, and that there is a risk that the flexibility of the fallopian tubes could be reduced as an unwanted result of the surgery. Because he understands my concerns, he suggests that I consider India which probably has better technology than we have for minimizing adhesions, but warns me that barriers do not entirely eliminate adhesions. This is a concern for me, because for faith reasons, IVF is not a possibility I can consider. I would be very grateful if you could offer some advice.

    Thank you!

    The only way to know whether laparoscopic surgery is feasible is to get a pelvic MRI to see if the uterine wall can be reconstructed properly – and you would need an expert laparoscopic surgeon to remove 4 fibroids the sizes you have. Fibroids that bulge into the uterine cavity decrease fertility, so the MRI would also tell you whether this is an issue or not. If not, then attempting pregnancy without surgery may be reasonable.

    Your doctor is right about adhesion barriers – they do not eliminate adhesions, but can decrease them by about 50%.

    I hope this information is helpful,

    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 Los Angeles, 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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