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Is an abdominal hysterectomy absolutely necessary for uterine fibroid tumor?

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Practicing since : 1999
Answered : 1586 Questions
I have a uterine fibroid tumor that is 16.7 cm – transverse – I am 52 yrs old- good health history –but have had anemia for several years. Is an abdominal hysterectomy absolutely necessary? I am allergic to sulfa and penicillin and wonder why they wouldn’t offer Lupron to reduce the size of the tumor to do it laparoscopically, and reduce the risk of infection? XXXXXXX Crockard
Posted Tue, 21 Jan 2014 in Women's Health
Answered by Dr. Timothy Raichle 46 minutes later
Brief Answer: Hello, I would be happy to help you... Detailed Answer: First of all, there are three reasons that you need this surgery: 1. Given your age, any abnormal bleeding from your uterus is going to be very difficult to assess given the size of the uterus itself - in terms of ruling out cancerous changes 2. It is causing health problems - anemia 3. It will become more difficult to remove as it gets bigger Second, with regard to some of your questions: 1. Lupron will shrink the size of this fibroid slightly, but it will not be significant in terms of making the surgery easier 2. The main benefit of Lupron would be to stop you from bleeding while your body replenishes blood cells 3. A uterus of that size in a transverse dimension is unsafe to approach laparoscopically The best option for someone like you would be an abdominal approach (i.e. through an incision). While this is becoming a less common approach these days, in your case, it is the safest way to remove your uterus. Anyone claiming that they can get this out laparoscopically is not being entirely honest about the inherent increased risks associated with that approach. Is this what they are recommending?
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Follow-up: Is an abdominal hysterectomy absolutely necessary for uterine fibroid tumor? 16 minutes later
They suggested full abdominal but were going to discuss laparoscopic and maybe try. the birth control has stopped the bleeding-so I think my anemia is better. I was hoping to go through menopause and that would help reduce the size. From your response, I am guessing that the Lupron option would have been a good one had it been offered earlier. Actually, my Dr. has know about this for over 15 yrs and I think we have missed other alternatives in the meantime, namely the procedure that restricts blood flow. she couldn't remove it before bc it was in the uterine wall and now of course it's in the cavity as well.
Answered by Dr. Timothy Raichle 18 minutes later
Brief Answer: Thank you for the followup Detailed Answer: Again, even though I am not able to offer you an opinion based on an actual patient encounter, I would suggest that the laparoscopic approach to a uterus this size is extremely difficult and likely to be associated with a greater chance of complications versus an abdominal hysterectomy. Good luck and please ask if you have any additional questions.
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Follow-up: Is an abdominal hysterectomy absolutely necessary for uterine fibroid tumor? 3 minutes later
Ok thank you and I appreciate your help and will not question the abdominal procedure anymore. I would like to keep an ovary though. Thanks again for answering this so late. You are generous with your time and answers. My best XXXXXXX
Answered by Dr. Timothy Raichle 1 hour later
Brief Answer: Thank you again Detailed Answer: Please remember to provide the highest possible rating and visit again - you can start your future questions with "this is for Dr. Raichle".
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