Treating Troubling Fibroids Without Surgery

NY Times ^ | November 23, 2004 | LAWRENCE K. ALTMAN

[neverdem]

[billorites]

First, take nine white raisins. They have to be white...

[Recall]

I was watching the baby channel last week. A woman with fibroids had a C-Section. When they cut her open the doctor pointed out a fibroid, it was as big as a BASEBALL. BUT he didn't remove it. I couldn't believe he left it in her!

I know they say fibroids are suppose to shrink on their own but it seems to me if you have the patient open and you can see these large tumours you should cut them out.

[VeritatisSplendor]

maybe right after delivery is not a good time to excise a large area - the uterus is thinned out and has a huge number of blood vessels at the surface to nourish the baby - the linear cut of a c-section is one thing, but a whole area? you want to sew it up and get the muscles contracting as fast as you can, to stop the bleeding.

Mrs VS

[Felis_irritable]

"Most patients also experience intense pain for several hours afterward and stay overnight in the hospital. For some patients, the pain persists for several days, or even two weeks...Additional complications from the embolization procedure can include abscesses and other infections; heavy uterine bleeding; early menopause from the pellets damaging the ovaries; or destruction of the uterus, requiring emergency surgery...Although the procedure is safe, "there are still significant uncertainties about the procedure, especially in terms of future fertility and long-term outcomes,"

I'm glad they slipped in "although the procedure is safe..." because I was beginning to wonder.

[Swede Girl]

I think some doctors are not sure what to do about fibroids. There are only a few doctors nationwide who are experts....real experts. I have had friends who have had all kinds of experiences with fibroids and surgery, good and bad. It has been traditionally easier for doctors to just go in and do a quick hysterectomy rather than addressing and spending time on the problem at hand.

The main thing women should know is that a hysterectomy is NEVER necessary unless there is cancer and should never be performed for simple fibroids. If your doctor recommends a hysterectomy for benign fibroids you need to change doctors fast and search until you find one trained and educated properly enough to know this.

[neverdem]

I'm not an OB/GYN, but maybe the nature of the cutting required for a complete excision of the fibroid would make any future pregnancy problematic with respect to uterine integrity, i.e. spontaneous rupture and emergency C-section.

[mewzilla]

The main thing women should know is that a hysterectomy is NEVER necessary unless there is cancer and should never be performed for simple fibroids.

I wouldn't say never :)

[neverdem]

FReepmail me if you want on or off my health and science ping list.

[LibertyLight]

Thanks for this article.
I had surgery for fibroids (1 grapefruit size and 3 or 4 smaller ones) in 1997 and felt much better afterwards --- but now I have some back again -
one is 12cm x 10cm and some smaller ones.
No wonder I feel distended...!
I do not want surgery again and hubby and I are still trying for a baby after some miscarriages. I pray every day.

[Ladysmith]

Me neither! Getting rid of that cotton-picker was a blessing and a half!

[mewzilla]

Multiples run in our family. Big ones, too.

[Recall]

Thanks for posting this. I'm learning a lot.

[Ladysmith]

Ouch! Is that so? I'll keep that in mind for my relation.

[mewzilla]

We've had myomectomies and hysterectomies, tried different meds. Don't know anyone who's had the procedure that Dr. Rice just had. Glad there's another option for women. I'm just curious about where those little pellets go, if there's any chance they can get back into the bloodstream.

[Yaelle]

Good luck to you! They spotted a small one in my uterus while I was pregnant last time. The next time they scanned me, post-baby, it was gone.

[Texas Songwriter]

No they are not complex to remove. They mostly "shell out" of the wall of the uterus. But they can bleed and especially vigorously in a gravid uterus.

[Texas Songwriter]

NEVER? Not so. If the uterine fibroids have degenerated and cause intractible pain....if the fibroid tumors cause bleeding. In some patients with cancer you should not perform surgery. You may need to irradicate certain uterine carcinomas with intrauterine radiation implants. You have not given your freeper good information, except in that you infer second opinions.

[Polybius]

I was watching the baby channel last week. A woman with fibroids had a C-Section. ...When they cut her open the doctor pointed out a fibroid, it was as big as a BASEBALL. BUT he didn't remove it. I couldn't believe he left it in her! I know they say fibroids are suppose to shrink on their own but it seems to me if you have the patient open and you can see these large tumours you should cut them out.

Unless the fibroid is pedunculated (on a stalk) the excision of a large fibroid will result in a gaping raw wound in the muscle of a uterus that is already more vascular because of the pregnancy. The medical literature therefore discourages a fibroidectomy at C-Section because of the increased risk of hemorrhage.

"First, do no harm."

[neverdem]

They spotted a small one in my uterus while I was pregnant last time. The next time they scanned me, post-baby, it was gone.

Was it seen on repeated sonograms(ultrasounds), or was it just seen in one image, i.e. could it have been an artifact?