I have a large fibroid, about the size of a grapefruit. I am in my late forties. I haven’t been to see my gynecologist in well over a year. He has recommended a hysterectomy. I wouldn’t be too bothered by this but have had 2 c-sections in the past and dread the thought of additional scarring. However, I have a lot of discomfort such as stinging pains like pin pricks, and an enlarged uterus. Should I toughen up and just get the surgery or go for a pap smear and try to hold off for menopause. Any help you could offer would be appreciated. Also, I wish in the future that more research could be done for a medication for fibroids to help other women. Thank You.

T.

T,

The fibroid will shrink about 50% once you get to menopause (average age is 52).  A skilled laparoscopic surgeon should be able to remove either the fibroid (laparoscopic myomectomy) or the uterus (laparoscopic hysterectomy) if that is what you want. Either of these procedures involves a 0-1 night hospital stay and a 2 week recovery to normal activity. If your symptoms are bothersome, you should consider getting a second opinion.  I agree – a lot more research is needed in every aspect of taking care of women with fibroids.

Bill Parker, MD

“I am just so pleased with the live telesurgery demonstration,” said the Conference Program Chair C.Y. Liu, MD.  “Dr. Parker did such a wonderful job – he mesmerized the entire audience with his fluid and skillful live demonstration of how the laparoscopic myomectomy could be used and should be done. I am thankful for his willingness to share his expert surgical technique with us.”

During the procedure, Dr. Parker explained what he was doing as he operated, and he answered questions from the audience as well as for the doctors watching over the Internet around the world. This surgery was the first time the American Association of Gynecologic Laparoscopists had used the Internet to transmit a live surgery. A short, edited video of the procedure may be viewed at http://www.fibroidsecondopinion.com/laparoscopic-myomectomy/.

www.youtube.com/watch?v=Fvw3dUesfdI

“Minimally invasive fibroid surgery offers the benefit of outpatient surgery with minimal discomfort and seven to 10 days to full recovery,” Dr. Parker said about the procedure. “Women really benefit from these advantages and they appreciate a quick return to their daily lives.”

Hello Dr. Parker,

I was doing some research online and came across your website and looking at Laparoscopic and Robotic Myomectomy. But I have few questions for you, hope you would be able to answer it for me.

I am 27 years old and found out about the Fibroid when I just turned 26. The nurse, doctors, radiologist, everyone were surprised that for a young person like me has Fibroids.  And I do not have a family history of Fibroids either. Since, then I have been doing Ultrasound and regular checkup every 6 month with my doctor.  I have 2 big fibroids, one on the top of the Uterus and another behind or on the wall of the Uterus.  Since I am so young, there are so many complications, I have to think before choosing the Option.

Last week, my doctor told me, both fibroid have grown to the size of not quite as Soft ball but larger than BaseBall. And recommended I have the Laporoscopy Myomectomy done, as soon as I can.  Since, the bigger, it gets, harder and complicate for surgery.   This week, I went for second opinion and the doctor recommended/told me da Vinci myomectomy. I read a lot about it online too. But I am really confused now and scared too because I have never had any surgery before. Both has its advantage and disadvantages, I was wondering if you have suggestion for me. I called my regular doctor and told about da Vinci Myomectomy, she told me I am not the candidate for that since my fibroids are big. I have the surgery date scheduled in few weeks, I am getting more and more scared and worried, as to what I should do. What would be the good decision for me, since I plan on getting pregnant in the next few years when I am married?

I appreciate your time and opinion. Hope to get a reply from you.
Thanks,
A.

A,

Is the first doctor recommending a laparoscopic myomectomy (telescope through the navel) or an abdominal myomectomy (bikini incision)?   Laparoscopic myomectomy and robotic myomectomy are very similar and both have a faster recovery than abdominal myomectomy. It sounds like your doctor does not perform either laparoscopic or robotic myomectomy and is nervous about the size of the fibroids. The important thing with either of these procedures is to find a gynecologist who has a lot of experience and skill doing the procedure.

Bill Parker, MD

Thank you for the reply.   My regular doctor does the laparoscopic myomectomy. Because my fibroids are big, she can’t do the laparoscopic myomectomy. She said she has done many myomectomies, however I should ask more questions.

The procedure she will be performing on me is “myomectomy per Laparotomy” which is the abdominal myomectomy. I think I am going to do more research. And also waiting to find out, how often my doctor performs this procedures and complication, successes etc. I think she already has given answers to a part of these questions.

Thanks,  A.

A.

You should also ask the other doctor how many da Vinci (robotic) myomectomies they have done, how many for women with fibroids the size of yours, how many have gotten pregnant, how many complications they have had.  This is a relatively new procedure and some doctors are just learning.  You do not want them practicing on you!

Bill Parker, MD

For more information about laparoscopic and robotic myomectomy please see:

http://www.fibroidsecondopinion.com/laparoscopic-myomectomy/