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Dr. Phil, MD
Dr. Phil, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 55465
Experience:  GP in the United States
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There, I have recently turned 35 and a recent ultrasound

Customer Question

Hi there, I have recently turned 35 and a recent ultrasound scan showed an enlarged uterus measuring 16 cm at its maximum dimension with 10 cm fibroid in the posterior myometrium which was deviating the endometrium anteriorly that was last april, for the last three months I have been on esmya and had an mri last week which showed it has only reduced slightly, I am wondering what my options are as I definitely still want kids, but think my fibroid is quite large an would interfere without getting any treatment? I live in the UK and was thinking myomectomy or embolization might be the best option, but I think the quicker treatment option might be good for me? Im also worried if I go for a myomectomy that it might turn into a hysterectomy, what are the chances of that happening? Also what is a hysterectomy, what would be the opportunities to have your own children if a hysterectomy happened, surrogacy? Is there any other options? Should you preserve your eggs? How do you know that you have got a good surgen? How would you go about finding a reputable gynaecologist privately in UK? Are there any websites or advice lines in the UK that could give you accurate up to date information on fibroid tumours? Can you give wriiten notice that whatever happens during surgery that you do NOT consent to a hysterectomy happening, as I was told you have to sign consent saying that a hysterectomy could happen during surgery if there were complications, which is something I definelty wouldn't want? So really just to find out what options are available to me and what would you recommend would be the most suitable and effective? Also do you think its better to go on the NHS or privately, and how much roughly do you think treatment would cost if you were to go privately?
Thanks Leanna
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Phil, MD replied 1 year ago.
Thanks for this questionAny other medical issues?
Customer: replied 1 year ago.
PTSD mental health, fibroids were causing heavy mensual cycle was on traxanemic acid, pressure feeling, abdomen pain sometimes, sore back occasionally, that's all.
Expert:  Dr. Phil, MD replied 1 year ago.
Thanks for this question.I think you are going to need this surgically removedThis is quite a large fibroid and may interfere with a pregnancyThere are many surgical optionsMost private UK GYNs can handle this. It shouldn't be hard to find one
Dr. Phil, MD and 2 other Medical Specialists are ready to help you
Customer: replied 1 year ago.
What surgical options would be suitable fr my case do you think?
Expert:  Dr. Phil, MD replied 1 year ago.
endometrial ablation or myomectomyhere is an article on bothhttps://www.nichd.nih.gov/health/topics/uterine/conditioninfo/treatments/Pages/surgical-treatments.aspx
Customer: replied 1 year ago.
Yeah that's what I was thinking, do you think that the myomectomy could be done lapriascoprically? what the largest size of fibroid that could be done that way? Or would it nee to be done through open insiscion?
Expert:  Dr. Phil, MD replied 1 year ago.
without seeing the actual ultrasound I can't comment on that.my guess is that it should be able to be done non invasively
Customer: replied 1 year ago.
non invasively what is that called?
Expert:  Dr. Phil, MD replied 1 year ago.
that means laparoscopicallyor transvaginally
Customer: replied 1 year ago.
really the gyncologist im currently seeing has suggested open surgery through an insision through the abdomen, Im trying to find the most non invasive procedure as possible?
Customer: replied 1 year ago.
Also Im worried that if I get a myomectomy that it could go wrong and I would need a hysterectomy, do you know what percentages chances of that happening are? Also am a bit concerened that you have to sign a consent form at the start saying that you accept that a hysterectomy might have to happen if there are complications? Is there any way you could NOT give them consent to do a hysterectomy if something went wrong?
Expert:  Dr. Phil, MD replied 1 year ago.
No, there is no way to get around thatThe risk is low.ABout 1-2% but it does happen
Customer: replied 1 year ago.
if that did ever happen would they leave the ovaries in place still? Would you be able to have kids through sarragocy? which procedure is less dangerous lapriscopically or open surgery myomectomy?
Expert:  Dr. Phil, MD replied 1 year ago.
yes, they would leave them inyes surrogacy would be an optionlaparoscopic is less dangerous
Customer: replied 1 year ago.
do you think laparoscopic would be ok for 10cm fibroid?
Expert:  Dr. Phil, MD replied 1 year ago.
maybe you will need to have the surgeon look at the ultrasound to be sure
Customer: replied 1 year ago.
also was puton the drug esmya 5 mg for three months but it doesn't seem to have ben very effective, why doyou think that would be?
Expert:  Dr. Phil, MD replied 1 year ago.
the fibroid is just too big probably
Customer: replied 1 year ago.
will the fibroid keep growing and at what rate? Is it best to get treated sooner rather than later?
Customer: replied 1 year ago.
would scarring and adhesions cause problems getting pregnant or with pregnancy?
Customer: replied 1 year ago.
do you know if robotic surgery is safe enough?
Customer: replied 1 year ago.
are you still there?
Expert:  Dr. Phil, MD replied 1 year ago.
Can you ask one question at a time?
Customer: replied 1 year ago.
will the fibroid keep growing and is it better to get it treated sooner rather than later?
Expert:  Dr. Phil, MD replied 1 year ago.
There is no way to predict but most likely it will keep growing
Customer: replied 1 year ago.
would scarring and adhesions cause problems getting pregnant or problems during pregnancy?
Expert:  Dr. Phil, MD replied 1 year ago.
possibly. yes
Customer: replied 1 year ago.
is there anything could do to help reduce it?
Expert:  Dr. Phil, MD replied 1 year ago.
not really. no