Re: Abdominal vs. hysteroscopic myomectomy for submucosal fibroids

[Guest guest]

I haven't had it yet but I'm scheduled for a laparotomy (abdominal)

myomecomty plus hysteroscopic resection in two weeks - and here's the

reasoning -

The hysteroscopic resection will remove the 2 cm fibroid that's

almost filling my uterine cavity and that's a really easy procedure

(relatively) and doesn't cut through my uterine wall.

But then I have two other subserosal fibroids, one of which is 6.5

cm - too big (according to my doctor) to remove with a laparascope

unless we shrink it first with Lupron which I decided I would rather

not do.

Now, although laparoscopy is easier to recover from, there is a

higher incidence of complications from it because it's harder to do

for the doctor. So I'm pretty comfortable with this decision.

I'm also going with a general anesthetic because I dread it less than

laying there for upwards of an hour or two while they cut me up.

I don't know how soon you are making this decision but I can let you

know how mine goes in a few weeks.

DeAnn

> Hello everyone. I am interested in hearing from people who have had

> abdominal or hysteroscopic myomectomies for submucosal fibroids.

>

[Guest guest]

I haven't had it yet but I'm scheduled for a laparotomy (abdominal)

myomecomty plus hysteroscopic resection in two weeks - and here's the

reasoning -

The hysteroscopic resection will remove the 2 cm fibroid that's

almost filling my uterine cavity and that's a really easy procedure

(relatively) and doesn't cut through my uterine wall.

But then I have two other subserosal fibroids, one of which is 6.5

cm - too big (according to my doctor) to remove with a laparascope

unless we shrink it first with Lupron which I decided I would rather

not do.

Now, although laparoscopy is easier to recover from, there is a

higher incidence of complications from it because it's harder to do

for the doctor. So I'm pretty comfortable with this decision.

I'm also going with a general anesthetic because I dread it less than

laying there for upwards of an hour or two while they cut me up.

I don't know how soon you are making this decision but I can let you

know how mine goes in a few weeks.

DeAnn

> Hello everyone. I am interested in hearing from people who have had

> abdominal or hysteroscopic myomectomies for submucosal fibroids.

>

[Guest guest]

Hi Therese,

My case is very similar to yours. I have the same-sized fibroid in

the same location. There was doubt as to whether it was totally

intramural or had some submucosal component. I had all the

ultrasounds and an MRI, but had to have hysteroscopy to determine the

exact nature. From this it was found to be intramural at the present

time. Did you not get this kind of information from the hysteroscopy

you've already had? An MRI might be useful in your case, before

having to go through the other proceudres.

In my case, as the fibroid was found to be intramural, the doctor

recommended me to carry on without intervention, as it was his

opinion that there was not enough evidence that the fibroid was

causing my problems so even if he did intervene the risks were not

worth the fact they might not be resolved. I have heavier & painful

periods, cramping at other times in the cycle and urinary discomfort.

What are your symptons? Are they severe enough for you to feel you

need intervention?

I was told if I wanted intervention in the future I would need to

have Lupron or a similar drug. I am very anti this. As has been

mentioned it can make the fibroids difficult to cut out successfully.

Also I had previously been on Synarel (like Lupron) for a few weeks

when I thought I might go through with an abdominal myomectomy

(before seeing the new doctor who told me the above). I felt dreadful

on it, but I didn't give it very long to see it things settled down.

Some women are fine. It can shrink the fibroids so I would argue that

as yours is quite small now it should be able to be removed as it is,

if you accept the increased blood loss risk.

Have you been given laparascopic myo. as an option? I would prefer

this over an abdominal myo. I think they can only be done for

fibroids around 10cm or less. Have you considered UAE at all? I would

be keen on this, if it weren't for the unknowns regarding future

fertility. Have you any fertility concerns?

Sorry I haven't been able to answer your questions about surgery

directly. I just wanted to share stories.

Nichola (UK).

> Hello everyone. I am interested in hearing from people who have had

> abdominal or hysteroscopic myomectomies for submucosal fibroids.

>

> I had a diagnostic hysteroscopy and D & C four weeks ago. My gyn

removed

> polyps and saw two fibroids in the uterine cavity which he didn't

remove

> because he doesn't do that type of surgery. He referred me to a

> reproductive endocrinologist to possibly remove the fibroids

through the

> hysteroscope.

>

> I had a consultation with the reproductive endocrinologist.

Unfortunately,

> my gyn's office did not fax my op reports to the reproductive

> endocrinologist's office in time for my appointment. This report

should

> have described the size of these fibroids, whether they were fully

in the

> uterine cavity, etc. The only thing the reproductive

endocrinologist had to

> evaluate me by was a two year old ultrasound report that I brought

in, and a

> physical exam of my abdomen, which confirmed that my uterus is the

size of a

> 12 to 14 week pregnancy.

>

> The ultrasound report describes an abdominal mass, just under 5 cm,

in the

> fundal area, primarily posterior. Based on this report the

reproductive

> endocrinologist thinks that this fibroid could be imbedded in the

wall. He

> recommended that I go on Lupron for three months, after which time

he would

> do a hysteroscopy and laparoscopy, and remove fibroids through the

> hysteroscope if he could. If the hysteroscopy or laparoscopy

revealed a

> fibroid imbedded in the wall, I would have to have an abdominal

myomectomy.

>

> I really have reservations about going on Lupron, and I mentioned my

> concerns to him. He said if I am worried about Lupron I don't have

to have

> it, but there is a greater risk of blood loss with the myomectomy.

It is my

> understanding that if I don't take the Lupron I will have to

undergo an

> abdominal myomectomy.

>

> I question the accuracy of ultrasound in pinpointing the location

and size

> of fibroids. Maybe the 5 cm mass seen on ultrasound is actually a

> combination of the two fibroids in my uterine cavity. Transvaginal

> ultrasound is supposed to be so much better than abdominal

ultrasound in

> finding submucosal fibroids. I had both procedures done at the

same time,

> and the transvaginal ultrasound was inconclusive.

>

> I would like to ask this doctor to perform a hysteroscopy and

laparoscopy

> without going on Lupron, to see if he can remove the fibroids

> hysteroscopically, before consenting to an abdominal myomectomy.

Is this a

> reasonable request? I am interested in hearing from people who

have had

> submucosal fibroids removed through abdominal myomectomy to find

out if the

> procedure was successful in reducing monthly bleeding. I would

like to hear

> from people who had hysteroscopic resections to find out how big

their

> tumors were, whether they went on Lupron to shrink them before

surgery, and

> whether their periods are now normal.

[Guest guest]

Hi Therese,

My case is very similar to yours. I have the same-sized fibroid in

the same location. There was doubt as to whether it was totally

intramural or had some submucosal component. I had all the

ultrasounds and an MRI, but had to have hysteroscopy to determine the

exact nature. From this it was found to be intramural at the present

time. Did you not get this kind of information from the hysteroscopy

you've already had? An MRI might be useful in your case, before

having to go through the other proceudres.

In my case, as the fibroid was found to be intramural, the doctor

recommended me to carry on without intervention, as it was his

opinion that there was not enough evidence that the fibroid was

causing my problems so even if he did intervene the risks were not

worth the fact they might not be resolved. I have heavier & painful

periods, cramping at other times in the cycle and urinary discomfort.

What are your symptons? Are they severe enough for you to feel you

need intervention?

I was told if I wanted intervention in the future I would need to

have Lupron or a similar drug. I am very anti this. As has been

mentioned it can make the fibroids difficult to cut out successfully.

Also I had previously been on Synarel (like Lupron) for a few weeks

when I thought I might go through with an abdominal myomectomy

(before seeing the new doctor who told me the above). I felt dreadful

on it, but I didn't give it very long to see it things settled down.

Some women are fine. It can shrink the fibroids so I would argue that

as yours is quite small now it should be able to be removed as it is,

if you accept the increased blood loss risk.

Have you been given laparascopic myo. as an option? I would prefer

this over an abdominal myo. I think they can only be done for

fibroids around 10cm or less. Have you considered UAE at all? I would

be keen on this, if it weren't for the unknowns regarding future

fertility. Have you any fertility concerns?

Sorry I haven't been able to answer your questions about surgery

directly. I just wanted to share stories.

Nichola (UK).

> Hello everyone. I am interested in hearing from people who have had

> abdominal or hysteroscopic myomectomies for submucosal fibroids.

>

> I had a diagnostic hysteroscopy and D & C four weeks ago. My gyn

removed

> polyps and saw two fibroids in the uterine cavity which he didn't

remove

> because he doesn't do that type of surgery. He referred me to a

> reproductive endocrinologist to possibly remove the fibroids

through the

> hysteroscope.

>

> I had a consultation with the reproductive endocrinologist.

Unfortunately,

> my gyn's office did not fax my op reports to the reproductive

> endocrinologist's office in time for my appointment. This report

should

> have described the size of these fibroids, whether they were fully

in the

> uterine cavity, etc. The only thing the reproductive

endocrinologist had to

> evaluate me by was a two year old ultrasound report that I brought

in, and a

> physical exam of my abdomen, which confirmed that my uterus is the

size of a

> 12 to 14 week pregnancy.

>

> The ultrasound report describes an abdominal mass, just under 5 cm,

in the

> fundal area, primarily posterior. Based on this report the

reproductive

> endocrinologist thinks that this fibroid could be imbedded in the

wall. He

> recommended that I go on Lupron for three months, after which time

he would

> do a hysteroscopy and laparoscopy, and remove fibroids through the

> hysteroscope if he could. If the hysteroscopy or laparoscopy

revealed a

> fibroid imbedded in the wall, I would have to have an abdominal

myomectomy.

>

> I really have reservations about going on Lupron, and I mentioned my

> concerns to him. He said if I am worried about Lupron I don't have

to have

> it, but there is a greater risk of blood loss with the myomectomy.

It is my

> understanding that if I don't take the Lupron I will have to

undergo an

> abdominal myomectomy.

>

> I question the accuracy of ultrasound in pinpointing the location

and size

> of fibroids. Maybe the 5 cm mass seen on ultrasound is actually a

> combination of the two fibroids in my uterine cavity. Transvaginal

> ultrasound is supposed to be so much better than abdominal

ultrasound in

> finding submucosal fibroids. I had both procedures done at the

same time,

> and the transvaginal ultrasound was inconclusive.

>

> I would like to ask this doctor to perform a hysteroscopy and

laparoscopy

> without going on Lupron, to see if he can remove the fibroids

> hysteroscopically, before consenting to an abdominal myomectomy.

Is this a

> reasonable request? I am interested in hearing from people who

have had

> submucosal fibroids removed through abdominal myomectomy to find

out if the

> procedure was successful in reducing monthly bleeding. I would

like to hear

> from people who had hysteroscopic resections to find out how big

their

> tumors were, whether they went on Lupron to shrink them before

surgery, and

> whether their periods are now normal.

[Guest guest]

Hi Therese,

My case is very similar to yours. I have the same-sized fibroid in

the same location. There was doubt as to whether it was totally

intramural or had some submucosal component. I had all the

ultrasounds and an MRI, but had to have hysteroscopy to determine the

exact nature. From this it was found to be intramural at the present

time. Did you not get this kind of information from the hysteroscopy

you've already had? An MRI might be useful in your case, before

having to go through the other proceudres.

In my case, as the fibroid was found to be intramural, the doctor

recommended me to carry on without intervention, as it was his

opinion that there was not enough evidence that the fibroid was

causing my problems so even if he did intervene the risks were not

worth the fact they might not be resolved. I have heavier & painful

periods, cramping at other times in the cycle and urinary discomfort.

What are your symptons? Are they severe enough for you to feel you

need intervention?

I was told if I wanted intervention in the future I would need to

have Lupron or a similar drug. I am very anti this. As has been

mentioned it can make the fibroids difficult to cut out successfully.

Also I had previously been on Synarel (like Lupron) for a few weeks

when I thought I might go through with an abdominal myomectomy

(before seeing the new doctor who told me the above). I felt dreadful

on it, but I didn't give it very long to see it things settled down.

Some women are fine. It can shrink the fibroids so I would argue that

as yours is quite small now it should be able to be removed as it is,

if you accept the increased blood loss risk.

Have you been given laparascopic myo. as an option? I would prefer

this over an abdominal myo. I think they can only be done for

fibroids around 10cm or less. Have you considered UAE at all? I would

be keen on this, if it weren't for the unknowns regarding future

fertility. Have you any fertility concerns?

Sorry I haven't been able to answer your questions about surgery

directly. I just wanted to share stories.

Nichola (UK).

> Hello everyone. I am interested in hearing from people who have had

> abdominal or hysteroscopic myomectomies for submucosal fibroids.

>

> I had a diagnostic hysteroscopy and D & C four weeks ago. My gyn

removed

> polyps and saw two fibroids in the uterine cavity which he didn't

remove

> because he doesn't do that type of surgery. He referred me to a

> reproductive endocrinologist to possibly remove the fibroids

through the

> hysteroscope.

>

> I had a consultation with the reproductive endocrinologist.

Unfortunately,

> my gyn's office did not fax my op reports to the reproductive

> endocrinologist's office in time for my appointment. This report

should

> have described the size of these fibroids, whether they were fully

in the

> uterine cavity, etc. The only thing the reproductive

endocrinologist had to

> evaluate me by was a two year old ultrasound report that I brought

in, and a

> physical exam of my abdomen, which confirmed that my uterus is the

size of a

> 12 to 14 week pregnancy.

>

> The ultrasound report describes an abdominal mass, just under 5 cm,

in the

> fundal area, primarily posterior. Based on this report the

reproductive

> endocrinologist thinks that this fibroid could be imbedded in the

wall. He

> recommended that I go on Lupron for three months, after which time

he would

> do a hysteroscopy and laparoscopy, and remove fibroids through the

> hysteroscope if he could. If the hysteroscopy or laparoscopy

revealed a

> fibroid imbedded in the wall, I would have to have an abdominal

myomectomy.

>

> I really have reservations about going on Lupron, and I mentioned my

> concerns to him. He said if I am worried about Lupron I don't have

to have

> it, but there is a greater risk of blood loss with the myomectomy.

It is my

> understanding that if I don't take the Lupron I will have to

undergo an

> abdominal myomectomy.

>

> I question the accuracy of ultrasound in pinpointing the location

and size

> of fibroids. Maybe the 5 cm mass seen on ultrasound is actually a

> combination of the two fibroids in my uterine cavity. Transvaginal

> ultrasound is supposed to be so much better than abdominal

ultrasound in

> finding submucosal fibroids. I had both procedures done at the

same time,

> and the transvaginal ultrasound was inconclusive.

>

> I would like to ask this doctor to perform a hysteroscopy and

laparoscopy

> without going on Lupron, to see if he can remove the fibroids

> hysteroscopically, before consenting to an abdominal myomectomy.

Is this a

> reasonable request? I am interested in hearing from people who

have had

> submucosal fibroids removed through abdominal myomectomy to find

out if the

> procedure was successful in reducing monthly bleeding. I would

like to hear

> from people who had hysteroscopic resections to find out how big

their

> tumors were, whether they went on Lupron to shrink them before

surgery, and

> whether their periods are now normal.

[Guest guest]

Therese (and also Mimi):

I'll tell you both my experience and maybe that will be another input point

to help you guys make both your decisions. Three years ago, I was

diagnosed with a 2 cm fibroid (submucosal) that was causing terrible

bleeding. My doctor removed it hysteroscopically. After removing it, she

saw another one--bigger (on the ultrasound, it looked like 1 fibroid) and

also tried to remove it. However, I was experiencing a complication (rare)

where my body was absorbing too much of the saline so they had to stop the

procedure before she could get the second one out. Anyway, my periods

after this procedure were improved for about a year, until that remaining

one got bigger (3.5 cm). I spent the last 3 years knowing that eventually

I will have to do something again, I researched UAE, talked to many doctors

and read everything I could get my hands on.

I am now scheduled to repeat this procedure in April. I must share first

that I found the procedure to be very easy on me. I only had cramps in the

recovery room, but felt fine the next day. One week later, my doctor did a

follow-up exam and allowed me to resume exercising, etc. (I only took one

day off from work). There is comfort that I know what to expect this

time. I have decided to take the Lupron, because, in my case, it is

advantageous to decrease the surgery time as much as possible. I really

want to make sure they have time to get EVERYTHING out this time so my

decision to go on Lupron was based on my prior surgical experience. I will

be on it for 3 months before surgery we hope to have about 40% reduction in

the size before the surgery.

I've only been on Lupron for 3 weeks so I can't really report fairly on

this experience. I have had no real side effects. The shot stopped my now

constant bleeding within 24 hours. However yesterday I bled a bit, it

seems to have stopped today--we'll see what happens in this regard. I

haven't had the hot flashes or any of the other possible side-effects yet.

Mimi, with regard to your Lupron questions: Some of the pro's are that it

might make the surgery easier on the doctor if the fibroids are shrunk a

bit first, reducing surgery time also decreases the risk. The con's are

that some people have bad side-effects from Lupron. You should read the

patient insert before deciding whether to go on it. Also, if you also have

small fibroids, these may completely shrink and be missed during the

surgery and could potentially cause problems down the road. As I said I

haven't had any side-effects yet but I still have 2 more months to go! I

was also on Depo Provera, which helped control bleeding for a period of

time but then stopped working for me.

I can't comment on myomectomy--my fibroids are totally within the uterine

cavity so can be reached throught hysteroscope.

Good luck to you both. If either of you want more details that I may have

glossed over, feel free to email me directly.

Sydney

At 09:41 AM 2/28/01 -0500, you wrote:

>Hello everyone. I am interested in hearing from people who have had

>abdominal or hysteroscopic myomectomies for submucosal fibroids.

>

>I had a diagnostic hysteroscopy and D & C four weeks ago. My gyn removed

>polyps and saw two fibroids in the uterine cavity which he didn't remove

>because he doesn't do that type of surgery. He referred me to a

>reproductive endocrinologist to possibly remove the fibroids through the

>hysteroscope.

>

>I had a consultation with the reproductive endocrinologist. Unfortunately,

>my gyn's office did not fax my op reports to the reproductive

>endocrinologist's office in time for my appointment. This report should

>have described the size of these fibroids, whether they were fully in the

>uterine cavity, etc. The only thing the reproductive endocrinologist had to

>evaluate me by was a two year old ultrasound report that I brought in, and a

>physical exam of my abdomen, which confirmed that my uterus is the size of a

>12 to 14 week pregnancy.

>

>The ultrasound report describes an abdominal mass, just under 5 cm, in the

>fundal area, primarily posterior. Based on this report the reproductive

>endocrinologist thinks that this fibroid could be imbedded in the wall. He

>recommended that I go on Lupron for three months, after which time he would

>do a hysteroscopy and laparoscopy, and remove fibroids through the

>hysteroscope if he could. If the hysteroscopy or laparoscopy revealed a

>fibroid imbedded in the wall, I would have to have an abdominal myomectomy.

>

>I really have reservations about going on Lupron, and I mentioned my

>concerns to him. He said if I am worried about Lupron I don't have to have

>it, but there is a greater risk of blood loss with the myomectomy. It is my

>understanding that if I don't take the Lupron I will have to undergo an

>abdominal myomectomy.

>

>I question the accuracy of ultrasound in pinpointing the location and size

>of fibroids. Maybe the 5 cm mass seen on ultrasound is actually a

>combination of the two fibroids in my uterine cavity. Transvaginal

>ultrasound is supposed to be so much better than abdominal ultrasound in

>finding submucosal fibroids. I had both procedures done at the same time,

>and the transvaginal ultrasound was inconclusive.

>

>I would like to ask this doctor to perform a hysteroscopy and laparoscopy

>without going on Lupron, to see if he can remove the fibroids

>hysteroscopically, before consenting to an abdominal myomectomy. Is this a

>reasonable request? I am interested in hearing from people who have had

>submucosal fibroids removed through abdominal myomectomy to find out if the

>procedure was successful in reducing monthly bleeding. I would like to hear

>from people who had hysteroscopic resections to find out how big their

>tumors were, whether they went on Lupron to shrink them before surgery, and

>whether their periods are now normal.

>

>

>

[Guest guest]

Therese (and also Mimi):

I'll tell you both my experience and maybe that will be another input point

to help you guys make both your decisions. Three years ago, I was

diagnosed with a 2 cm fibroid (submucosal) that was causing terrible

bleeding. My doctor removed it hysteroscopically. After removing it, she

saw another one--bigger (on the ultrasound, it looked like 1 fibroid) and

also tried to remove it. However, I was experiencing a complication (rare)

where my body was absorbing too much of the saline so they had to stop the

procedure before she could get the second one out. Anyway, my periods

after this procedure were improved for about a year, until that remaining

one got bigger (3.5 cm). I spent the last 3 years knowing that eventually

I will have to do something again, I researched UAE, talked to many doctors

and read everything I could get my hands on.

I am now scheduled to repeat this procedure in April. I must share first

that I found the procedure to be very easy on me. I only had cramps in the

recovery room, but felt fine the next day. One week later, my doctor did a

follow-up exam and allowed me to resume exercising, etc. (I only took one

day off from work). There is comfort that I know what to expect this

time. I have decided to take the Lupron, because, in my case, it is

advantageous to decrease the surgery time as much as possible. I really

want to make sure they have time to get EVERYTHING out this time so my

decision to go on Lupron was based on my prior surgical experience. I will

be on it for 3 months before surgery we hope to have about 40% reduction in

the size before the surgery.

I've only been on Lupron for 3 weeks so I can't really report fairly on

this experience. I have had no real side effects. The shot stopped my now

constant bleeding within 24 hours. However yesterday I bled a bit, it

seems to have stopped today--we'll see what happens in this regard. I

haven't had the hot flashes or any of the other possible side-effects yet.

Mimi, with regard to your Lupron questions: Some of the pro's are that it

might make the surgery easier on the doctor if the fibroids are shrunk a

bit first, reducing surgery time also decreases the risk. The con's are

that some people have bad side-effects from Lupron. You should read the

patient insert before deciding whether to go on it. Also, if you also have

small fibroids, these may completely shrink and be missed during the

surgery and could potentially cause problems down the road. As I said I

haven't had any side-effects yet but I still have 2 more months to go! I

was also on Depo Provera, which helped control bleeding for a period of

time but then stopped working for me.

I can't comment on myomectomy--my fibroids are totally within the uterine

cavity so can be reached throught hysteroscope.

Good luck to you both. If either of you want more details that I may have

glossed over, feel free to email me directly.

Sydney

At 09:41 AM 2/28/01 -0500, you wrote:

>Hello everyone. I am interested in hearing from people who have had

>abdominal or hysteroscopic myomectomies for submucosal fibroids.

>

>I had a diagnostic hysteroscopy and D & C four weeks ago. My gyn removed

>polyps and saw two fibroids in the uterine cavity which he didn't remove

>because he doesn't do that type of surgery. He referred me to a

>reproductive endocrinologist to possibly remove the fibroids through the

>hysteroscope.

>

>I had a consultation with the reproductive endocrinologist. Unfortunately,

>my gyn's office did not fax my op reports to the reproductive

>endocrinologist's office in time for my appointment. This report should

>have described the size of these fibroids, whether they were fully in the

>uterine cavity, etc. The only thing the reproductive endocrinologist had to

>evaluate me by was a two year old ultrasound report that I brought in, and a

>physical exam of my abdomen, which confirmed that my uterus is the size of a

>12 to 14 week pregnancy.

>

>The ultrasound report describes an abdominal mass, just under 5 cm, in the

>fundal area, primarily posterior. Based on this report the reproductive

>endocrinologist thinks that this fibroid could be imbedded in the wall. He

>recommended that I go on Lupron for three months, after which time he would

>do a hysteroscopy and laparoscopy, and remove fibroids through the

>hysteroscope if he could. If the hysteroscopy or laparoscopy revealed a

>fibroid imbedded in the wall, I would have to have an abdominal myomectomy.

>

>I really have reservations about going on Lupron, and I mentioned my

>concerns to him. He said if I am worried about Lupron I don't have to have

>it, but there is a greater risk of blood loss with the myomectomy. It is my

>understanding that if I don't take the Lupron I will have to undergo an

>abdominal myomectomy.

>

>I question the accuracy of ultrasound in pinpointing the location and size

>of fibroids. Maybe the 5 cm mass seen on ultrasound is actually a

>combination of the two fibroids in my uterine cavity. Transvaginal

>ultrasound is supposed to be so much better than abdominal ultrasound in

>finding submucosal fibroids. I had both procedures done at the same time,

>and the transvaginal ultrasound was inconclusive.

>

>I would like to ask this doctor to perform a hysteroscopy and laparoscopy

>without going on Lupron, to see if he can remove the fibroids

>hysteroscopically, before consenting to an abdominal myomectomy. Is this a

>reasonable request? I am interested in hearing from people who have had

>submucosal fibroids removed through abdominal myomectomy to find out if the

>procedure was successful in reducing monthly bleeding. I would like to hear

>from people who had hysteroscopic resections to find out how big their

>tumors were, whether they went on Lupron to shrink them before surgery, and

>whether their periods are now normal.

>

>

>

[Guest guest]

Therese (and also Mimi):

I'll tell you both my experience and maybe that will be another input point

to help you guys make both your decisions. Three years ago, I was

diagnosed with a 2 cm fibroid (submucosal) that was causing terrible

bleeding. My doctor removed it hysteroscopically. After removing it, she

saw another one--bigger (on the ultrasound, it looked like 1 fibroid) and

also tried to remove it. However, I was experiencing a complication (rare)

where my body was absorbing too much of the saline so they had to stop the

procedure before she could get the second one out. Anyway, my periods

after this procedure were improved for about a year, until that remaining

one got bigger (3.5 cm). I spent the last 3 years knowing that eventually

I will have to do something again, I researched UAE, talked to many doctors

and read everything I could get my hands on.

I am now scheduled to repeat this procedure in April. I must share first

that I found the procedure to be very easy on me. I only had cramps in the

recovery room, but felt fine the next day. One week later, my doctor did a

follow-up exam and allowed me to resume exercising, etc. (I only took one

day off from work). There is comfort that I know what to expect this

time. I have decided to take the Lupron, because, in my case, it is

advantageous to decrease the surgery time as much as possible. I really

want to make sure they have time to get EVERYTHING out this time so my

decision to go on Lupron was based on my prior surgical experience. I will

be on it for 3 months before surgery we hope to have about 40% reduction in

the size before the surgery.

I've only been on Lupron for 3 weeks so I can't really report fairly on

this experience. I have had no real side effects. The shot stopped my now

constant bleeding within 24 hours. However yesterday I bled a bit, it

seems to have stopped today--we'll see what happens in this regard. I

haven't had the hot flashes or any of the other possible side-effects yet.

Mimi, with regard to your Lupron questions: Some of the pro's are that it

might make the surgery easier on the doctor if the fibroids are shrunk a

bit first, reducing surgery time also decreases the risk. The con's are

that some people have bad side-effects from Lupron. You should read the

patient insert before deciding whether to go on it. Also, if you also have

small fibroids, these may completely shrink and be missed during the

surgery and could potentially cause problems down the road. As I said I

haven't had any side-effects yet but I still have 2 more months to go! I

was also on Depo Provera, which helped control bleeding for a period of

time but then stopped working for me.

I can't comment on myomectomy--my fibroids are totally within the uterine

cavity so can be reached throught hysteroscope.

Good luck to you both. If either of you want more details that I may have

glossed over, feel free to email me directly.

Sydney

At 09:41 AM 2/28/01 -0500, you wrote:

>Hello everyone. I am interested in hearing from people who have had

>abdominal or hysteroscopic myomectomies for submucosal fibroids.

>

>I had a diagnostic hysteroscopy and D & C four weeks ago. My gyn removed

>polyps and saw two fibroids in the uterine cavity which he didn't remove

>because he doesn't do that type of surgery. He referred me to a

>reproductive endocrinologist to possibly remove the fibroids through the

>hysteroscope.

>

>I had a consultation with the reproductive endocrinologist. Unfortunately,

>my gyn's office did not fax my op reports to the reproductive

>endocrinologist's office in time for my appointment. This report should

>have described the size of these fibroids, whether they were fully in the

>uterine cavity, etc. The only thing the reproductive endocrinologist had to

>evaluate me by was a two year old ultrasound report that I brought in, and a

>physical exam of my abdomen, which confirmed that my uterus is the size of a

>12 to 14 week pregnancy.

>

>The ultrasound report describes an abdominal mass, just under 5 cm, in the

>fundal area, primarily posterior. Based on this report the reproductive

>endocrinologist thinks that this fibroid could be imbedded in the wall. He

>recommended that I go on Lupron for three months, after which time he would

>do a hysteroscopy and laparoscopy, and remove fibroids through the

>hysteroscope if he could. If the hysteroscopy or laparoscopy revealed a

>fibroid imbedded in the wall, I would have to have an abdominal myomectomy.

>

>I really have reservations about going on Lupron, and I mentioned my

>concerns to him. He said if I am worried about Lupron I don't have to have

>it, but there is a greater risk of blood loss with the myomectomy. It is my

>understanding that if I don't take the Lupron I will have to undergo an

>abdominal myomectomy.

>

>I question the accuracy of ultrasound in pinpointing the location and size

>of fibroids. Maybe the 5 cm mass seen on ultrasound is actually a

>combination of the two fibroids in my uterine cavity. Transvaginal

>ultrasound is supposed to be so much better than abdominal ultrasound in

>finding submucosal fibroids. I had both procedures done at the same time,

>and the transvaginal ultrasound was inconclusive.

>

>I would like to ask this doctor to perform a hysteroscopy and laparoscopy

>without going on Lupron, to see if he can remove the fibroids

>hysteroscopically, before consenting to an abdominal myomectomy. Is this a

>reasonable request? I am interested in hearing from people who have had

>submucosal fibroids removed through abdominal myomectomy to find out if the

>procedure was successful in reducing monthly bleeding. I would like to hear

>from people who had hysteroscopic resections to find out how big their

>tumors were, whether they went on Lupron to shrink them before surgery, and

>whether their periods are now normal.

>

>

>

[Guest guest]

Hi, I have had neither procedure but I have spent the

past five months on Lupron. I have heard about more

severe side effects than I experienced. My symptoms

included some mild mental confusion such that you know

what you are trying to say but the actual words come

out less organized than you intend. Further, the hot

flashes are unbelievable! I also had a lot of joint

pain and body aches which resulted in an additional

prescription for indomithican for pain. The Lupron

stopped my period in about three weeks from the date

of the first injection. However, much to my great

dismay after five months of hot flashes etc. it did

not shrink my fibroids an appreciable amount. There

may have been a 10% reduction and that is a generous

estimate.

Celeste

--- Sydney Lagier wrote:

> Therese (and also Mimi):

>

> I'll tell you both my experience and maybe that will

> be another input point

> to help you guys make both your decisions. Three

> years ago, I was

> diagnosed with a 2 cm fibroid (submucosal) that was

> causing terrible

> bleeding. My doctor removed it hysteroscopically.

> After removing it, she

> saw another one--bigger (on the ultrasound, it

> looked like 1 fibroid) and

> also tried to remove it. However, I was

> experiencing a complication (rare)

> where my body was absorbing too much of the saline

> so they had to stop the

> procedure before she could get the second one out.

> Anyway, my periods

> after this procedure were improved for about a year,

> until that remaining

> one got bigger (3.5 cm). I spent the last 3 years

> knowing that eventually

> I will have to do something again, I researched UAE,

> talked to many doctors

> and read everything I could get my hands on.

>

> I am now scheduled to repeat this procedure in

> April. I must share first

> that I found the procedure to be very easy on me. I

> only had cramps in the

> recovery room, but felt fine the next day. One week

> later, my doctor did a

> follow-up exam and allowed me to resume exercising,

> etc. (I only took one

> day off from work). There is comfort that I know

> what to expect this

> time. I have decided to take the Lupron, because,

> in my case, it is

> advantageous to decrease the surgery time as much as

> possible. I really

> want to make sure they have time to get EVERYTHING

> out this time so my

> decision to go on Lupron was based on my prior

> surgical experience. I will

> be on it for 3 months before surgery we hope to have

> about 40% reduction in

> the size before the surgery.

>

> I've only been on Lupron for 3 weeks so I can't

> really report fairly on

> this experience. I have had no real side effects.

> The shot stopped my now

> constant bleeding within 24 hours. However

> yesterday I bled a bit, it

> seems to have stopped today--we'll see what happens

> in this regard. I

> haven't had the hot flashes or any of the other

> possible side-effects yet.

>

> Mimi, with regard to your Lupron questions: Some of

> the pro's are that it

> might make the surgery easier on the doctor if the

> fibroids are shrunk a

> bit first, reducing surgery time also decreases the

> risk. The con's are

> that some people have bad side-effects from Lupron.

> You should read the

> patient insert before deciding whether to go on it.

> Also, if you also have

> small fibroids, these may completely shrink and be

> missed during the

> surgery and could potentially cause problems down

> the road. As I said I

> haven't had any side-effects yet but I still have 2

> more months to go! I

> was also on Depo Provera, which helped control

> bleeding for a period of

> time but then stopped working for me.

>

> I can't comment on myomectomy--my fibroids are

> totally within the uterine

> cavity so can be reached throught hysteroscope.

>

> Good luck to you both. If either of you want more

> details that I may have

> glossed over, feel free to email me directly.

>

> Sydney

>

> At 09:41 AM 2/28/01 -0500, you wrote:

> >Hello everyone. I am interested in hearing from

> people who have had

> >abdominal or hysteroscopic myomectomies for

> submucosal fibroids.

> >

> >I had a diagnostic hysteroscopy and D & C four

> weeks ago. My gyn removed

> >polyps and saw two fibroids in the uterine cavity

> which he didn't remove

> >because he doesn't do that type of surgery. He

> referred me to a

> >reproductive endocrinologist to possibly remove the

> fibroids through the

> >hysteroscope.

> >

> >I had a consultation with the reproductive

> endocrinologist. Unfortunately,

> >my gyn's office did not fax my op reports to the

> reproductive

> >endocrinologist's office in time for my

> appointment. This report should

> >have described the size of these fibroids, whether

> they were fully in the

> >uterine cavity, etc. The only thing the

> reproductive endocrinologist had to

> >evaluate me by was a two year old ultrasound report

> that I brought in, and a

> >physical exam of my abdomen, which confirmed that

> my uterus is the size of a

> >12 to 14 week pregnancy.

> >

> >The ultrasound report describes an abdominal mass,

> just under 5 cm, in the

> >fundal area, primarily posterior. Based on this

> report the reproductive

> >endocrinologist thinks that this fibroid could be

> imbedded in the wall. He

> >recommended that I go on Lupron for three months,

> after which time he would

> >do a hysteroscopy and laparoscopy, and remove

> fibroids through the

> >hysteroscope if he could. If the hysteroscopy or

> laparoscopy revealed a

> >fibroid imbedded in the wall, I would have to have

> an abdominal myomectomy.

> >

> >I really have reservations about going on Lupron,

> and I mentioned my

> >concerns to him. He said if I am worried about

> Lupron I don't have to have

> >it, but there is a greater risk of blood loss with

> the myomectomy. It is my

> >understanding that if I don't take the Lupron I

> will have to undergo an

> >abdominal myomectomy.

> >

> >I question the accuracy of ultrasound in

> pinpointing the location and size

> >of fibroids. Maybe the 5 cm mass seen on

> ultrasound is actually a

> >combination of the two fibroids in my uterine

> cavity. Transvaginal

> >ultrasound is supposed to be so much better than

> abdominal ultrasound in

> >finding submucosal fibroids. I had both procedures

> done at the same time,

> >and the transvaginal ultrasound was inconclusive.

> >

> >I would like to ask this doctor to perform a

> hysteroscopy and laparoscopy

> >without going on Lupron, to see if he can remove

> the fibroids

> >hysteroscopically, before consenting to an

> abdominal myomectomy. Is this a

> >reasonable request? I am interested in hearing

> from people who have had

> >submucosal fibroids removed through abdominal

> myomectomy to find out if the

> >procedure was successful in reducing monthly

> bleeding. I would like to hear

> >from people who had hysteroscopic resections to

> find out how big their

> >tumors were, whether they went on Lupron to shrink

> them before surgery, and

> >whether their periods are now normal.

> >

> >

> >

[Guest guest]

Hi, I have had neither procedure but I have spent the

past five months on Lupron. I have heard about more

severe side effects than I experienced. My symptoms

included some mild mental confusion such that you know

what you are trying to say but the actual words come

out less organized than you intend. Further, the hot

flashes are unbelievable! I also had a lot of joint

pain and body aches which resulted in an additional

prescription for indomithican for pain. The Lupron

stopped my period in about three weeks from the date

of the first injection. However, much to my great

dismay after five months of hot flashes etc. it did

not shrink my fibroids an appreciable amount. There

may have been a 10% reduction and that is a generous

estimate.

Celeste

--- Sydney Lagier wrote:

> Therese (and also Mimi):

>

> I'll tell you both my experience and maybe that will

> be another input point

> to help you guys make both your decisions. Three

> years ago, I was

> diagnosed with a 2 cm fibroid (submucosal) that was

> causing terrible

> bleeding. My doctor removed it hysteroscopically.

> After removing it, she

> saw another one--bigger (on the ultrasound, it

> looked like 1 fibroid) and

> also tried to remove it. However, I was

> experiencing a complication (rare)

> where my body was absorbing too much of the saline

> so they had to stop the

> procedure before she could get the second one out.

> Anyway, my periods

> after this procedure were improved for about a year,

> until that remaining

> one got bigger (3.5 cm). I spent the last 3 years

> knowing that eventually

> I will have to do something again, I researched UAE,

> talked to many doctors

> and read everything I could get my hands on.

>

> I am now scheduled to repeat this procedure in

> April. I must share first

> that I found the procedure to be very easy on me. I

> only had cramps in the

> recovery room, but felt fine the next day. One week

> later, my doctor did a

> follow-up exam and allowed me to resume exercising,

> etc. (I only took one

> day off from work). There is comfort that I know

> what to expect this

> time. I have decided to take the Lupron, because,

> in my case, it is

> advantageous to decrease the surgery time as much as

> possible. I really

> want to make sure they have time to get EVERYTHING

> out this time so my

> decision to go on Lupron was based on my prior

> surgical experience. I will

> be on it for 3 months before surgery we hope to have

> about 40% reduction in

> the size before the surgery.

>

> I've only been on Lupron for 3 weeks so I can't

> really report fairly on

> this experience. I have had no real side effects.

> The shot stopped my now

> constant bleeding within 24 hours. However

> yesterday I bled a bit, it

> seems to have stopped today--we'll see what happens

> in this regard. I

> haven't had the hot flashes or any of the other

> possible side-effects yet.

>

> Mimi, with regard to your Lupron questions: Some of

> the pro's are that it

> might make the surgery easier on the doctor if the

> fibroids are shrunk a

> bit first, reducing surgery time also decreases the

> risk. The con's are

> that some people have bad side-effects from Lupron.

> You should read the

> patient insert before deciding whether to go on it.

> Also, if you also have

> small fibroids, these may completely shrink and be

> missed during the

> surgery and could potentially cause problems down

> the road. As I said I

> haven't had any side-effects yet but I still have 2

> more months to go! I

> was also on Depo Provera, which helped control

> bleeding for a period of

> time but then stopped working for me.

>

> I can't comment on myomectomy--my fibroids are

> totally within the uterine

> cavity so can be reached throught hysteroscope.

>

> Good luck to you both. If either of you want more

> details that I may have

> glossed over, feel free to email me directly.

>

> Sydney

>

> At 09:41 AM 2/28/01 -0500, you wrote:

> >Hello everyone. I am interested in hearing from

> people who have had

> >abdominal or hysteroscopic myomectomies for

> submucosal fibroids.

> >

> >I had a diagnostic hysteroscopy and D & C four

> weeks ago. My gyn removed

> >polyps and saw two fibroids in the uterine cavity

> which he didn't remove

> >because he doesn't do that type of surgery. He

> referred me to a

> >reproductive endocrinologist to possibly remove the

> fibroids through the

> >hysteroscope.

> >

> >I had a consultation with the reproductive

> endocrinologist. Unfortunately,

> >my gyn's office did not fax my op reports to the

> reproductive

> >endocrinologist's office in time for my

> appointment. This report should

> >have described the size of these fibroids, whether

> they were fully in the

> >uterine cavity, etc. The only thing the

> reproductive endocrinologist had to

> >evaluate me by was a two year old ultrasound report

> that I brought in, and a

> >physical exam of my abdomen, which confirmed that

> my uterus is the size of a

> >12 to 14 week pregnancy.

> >

> >The ultrasound report describes an abdominal mass,

> just under 5 cm, in the

> >fundal area, primarily posterior. Based on this

> report the reproductive

> >endocrinologist thinks that this fibroid could be

> imbedded in the wall. He

> >recommended that I go on Lupron for three months,

> after which time he would

> >do a hysteroscopy and laparoscopy, and remove

> fibroids through the

> >hysteroscope if he could. If the hysteroscopy or

> laparoscopy revealed a

> >fibroid imbedded in the wall, I would have to have

> an abdominal myomectomy.

> >

> >I really have reservations about going on Lupron,

> and I mentioned my

> >concerns to him. He said if I am worried about

> Lupron I don't have to have

> >it, but there is a greater risk of blood loss with

> the myomectomy. It is my

> >understanding that if I don't take the Lupron I

> will have to undergo an

> >abdominal myomectomy.

> >

> >I question the accuracy of ultrasound in

> pinpointing the location and size

> >of fibroids. Maybe the 5 cm mass seen on

> ultrasound is actually a

> >combination of the two fibroids in my uterine

> cavity. Transvaginal

> >ultrasound is supposed to be so much better than

> abdominal ultrasound in

> >finding submucosal fibroids. I had both procedures

> done at the same time,

> >and the transvaginal ultrasound was inconclusive.

> >

> >I would like to ask this doctor to perform a

> hysteroscopy and laparoscopy

> >without going on Lupron, to see if he can remove

> the fibroids

> >hysteroscopically, before consenting to an

> abdominal myomectomy. Is this a

> >reasonable request? I am interested in hearing

> from people who have had

> >submucosal fibroids removed through abdominal

> myomectomy to find out if the

> >procedure was successful in reducing monthly

> bleeding. I would like to hear

> >from people who had hysteroscopic resections to

> find out how big their

> >tumors were, whether they went on Lupron to shrink

> them before surgery, and

> >whether their periods are now normal.

> >

> >

> >

[Guest guest]

That's totally discouraging!

At 10:32 AM 2/28/01 -0800, you wrote:

>However, much to my great

>dismay after five months of hot flashes etc. it did

>not shrink my fibroids an appreciable amount. There

>may have been a 10% reduction and that is a generous

>estimate.