Re: considering laparoscopic subtotal hysterectomy/question for Dr.

[Guest guest]

> > My uterus is the size of a 16 week pregnancy with multiple

> fibroids,

> > ranging in size from filbert nuts to the largest right posterior

> > lower segment at 9.5 x 10 x 7.3 cm, fundal subserous 5.7 x 4 x

> 2.5,

> > left fundal intramural 5 x 5 x 5, left calcified funda 3.5 cm.

> >

> > I have been living with the discomfort of these things (not to

> > mention the appearance of being pregnant) for several years and

> have

> > gotten to the point where I just want them out.

[Guest guest]

Sorry I am taking so long to respond to this e-mail - I am back to work

after the holidays, but the kids are still home for winter break. First, it

sounds like you should find a doctor who is skilled at myomectomy surgery -

nothing about your situation seems to preclude this option. Laparoscopic

myomectomy has been shown to cause fewer adhesions, but laparoscopy has some

limitations with regards to the size and number of fibroids that can be

removed in a reasonable time and with a safe loss of blood. In your

situation, it may be possible to remove the largest fibroids, but removing

them all may be time consuming and difficult. There is one study (not very

well done) that shows a slightly increased risk of heart disease following

hysterectomy (with preservation of the ovaries). However, physiologically it

seems reasonable to preserve organs unless cancer is present (almost never

the case with fibroids) or the uterus is irreparably damaged (also virtually

never the case). UAE sounds like it also may be a reasonable option for you.

I hope this is of some help.

Bill , MD

Re: considering laparoscopic subtotal

hysterectomy/question for Dr.

> > My uterus is the size of a 16 week pregnancy with multiple

> fibroids,

> > ranging in size from filbert nuts to the largest right posterior

> > lower segment at 9.5 x 10 x 7.3 cm, fundal subserous 5.7 x 4 x

> 2.5,

> > left fundal intramural 5 x 5 x 5, left calcified funda 3.5 cm.

> >

> > I have been living with the discomfort of these things (not to

> > mention the appearance of being pregnant) for several years and

> have

> > gotten to the point where I just want them out.

[Guest guest]

I just re-read my e-mail and added one word " laparoscopically " for

clarification. Abdominal myomectomy may be better in your situation if you

need or want all the fibroids removed.

Sorry I am taking so long to respond to this e-mail - I am back to work

after the holidays, but the kids are still home for winter break. First, it

sounds like you should find a doctor who is skilled at myomectomy surgery -

nothing about your situation seems to preclude this option. Laparoscopic

myomectomy has been shown to cause fewer adhesions, but laparoscopy has some

limitations with regards to the size and number of fibroids that can be

removed in a reasonable time and with a safe loss of blood. In your

situation, it may be possible to remove the largest fibroids, but removing

them all " laparoscopically " may be time consuming and difficult. There is

one study (not very well done) that shows a slightly increased risk of heart

disease following hysterectomy (with preservation of the ovaries). However,

physiologically it seems reasonable to preserve organs unless cancer is

present (almost never the case with fibroids) or the uterus is irreparably

damaged (also virtually never the case). UAE sounds like it also may be a

reasonable option for you.

I hope this is of some help.

Bill , MD

Re: considering laparoscopic subtotal

hysterectomy/question for Dr.

> > My uterus is the size of a 16 week pregnancy with multiple

> fibroids,

> > ranging in size from filbert nuts to the largest right posterior

> > lower segment at 9.5 x 10 x 7.3 cm, fundal subserous 5.7 x 4 x

> 2.5,

> > left fundal intramural 5 x 5 x 5, left calcified funda 3.5 cm.

> >

> > I have been living with the discomfort of these things (not to

> > mention the appearance of being pregnant) for several years and

> have

> > gotten to the point where I just want them out.