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Ultrasound showed fibroid. What treatment is required? Should I go for surgery?

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OBGYN, Maternal and Fetal Medicine
Practicing since : 1979
Answered : 79 Questions
Hello Doctor@HCM,

I am XXXXXXX, from bangalore, and this regarding the reports of wife when she had a normal health check-up with ultrasound.
And in the reports it was found that she has a fibroid (report attached).
Kindly check and give me a suggestion for the treatment, whether to go for a surgery (if required) or any other treatment without any side-effects.
And for your information, we are planning for kids.
Also let me know a specialist available to cure fibroid in Bangalore.
Her age is: 30, and period cycles are normal no bleeding, but has pelvic pain some times.
If possible, can you able to guess through reports, from when these fibroid grown.
I am posting this again for the second time, as, i didn't get desired answer through this channel. Please forward to the concerned specialty if this questions is not related with you.
Thanks once again in advance.
Regards, XXXXXXX
Posted Sun, 18 Nov 2012 in Women's Health
Answered by Dr. Nirja Chawla 2 hours later
i've read through your wife's ultrasound report. Let me explain this report in simple language: there is a reasonably large fibroid ~ 5 cms. A fibroid can be taken to be a 'knot' of tissue, which is generally benign = not cancer. Its very common among women and in most situations, do not require any treatment.

Lets look at when fibroids may require treatment:
1. When the fibroid causes symptoms which are essentially of 3 types - pain, pressure, heavy bleeding.
2. When there are no symptoms and fibroid has been diagnosed on routine check but the uterus with the fibroid has been found to be more than 12 cms in size on ultrasound.
3. In infertile patients, when no other cause for their inability to conceive is found other than a fibroid, one may consider removal of the fibroid.

Now, lets look at your wife's situation:
The fibroid is good sized but it is NOT touching the lining of the uterus (=endometrium) which is reported on ultrasound as 4 mm only and the patient does NOT have heavy periods.
Other than occasional pelvic pain, she has no symptoms and its possible that this pain may not be caused by this fibroid.
The size of the uterus is less than 12 cms and you have not as yet tested the fertility status since you haven't planned a ppregnancy as yet. So whether this fibroid will cause difficulty in conceiving cannot be sure at this time. It may NOT cause any problem in conceiving.
Since when this fibroid began cannot be predicted. Neither can one predict how fast it will grow. One thing that is reasonably sure is that fibroids grow in reproductive age groups and slow down in growth after menopause. So, since your wife is young, the only direction is increased growth.

With all these in mind, may i suggest that you plan a pregnancy straight away. If your wife is unable to conceive in 1 year, BOTH of you must be investigated since there is a 30% chance that there may be a problem in you, the male partner.

You could consider removal of fibroid surgically at that time, in consultation with your doctor. I would not recommend this surgery just now, since any surgery heals with fibrosis which may hamper your wife's attempts to conceive by blocking the tubes or by changing the spatial relationship between the tubes and ovaries. This may worsen the situation.

There are medicines - oral and injections, as well as hence treatments get delayed.

You must keep in mind that if your wife conceives with fibroid in uterus, there are problems associated with pregnancy - increasing size of fibroid, degenerative changes at its centre causing pain during pregnancy, increased chances of abortion, preterm delivery, low weight babies etc. Since this comes under the category of high risk pregnancy, you must begin pregnancy (antenatal) check up as soon as discovered pregnant. But don't be alarmed by this last paragraph - once one knows what may happen, the alertness and promptness can greatly decrease complication rates. We have had pregnancies with huge sized, multiple fibrois with both mother and baby doing well.
i'm not aware whom to refer you to in Bangalore but best is to ask around and visit the doctor with a silent mind - it helps in enhancing your intuition about the hospital and doctor.
Wishing you all the best.
Hope it answers all your queries. If there are any more i'll be happy to help. If not, please close this discussion and rate it.
Dr Nirja Chawla
Above answer was peer-reviewed by
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