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Diagnosed With Multiple Uterine Fibroids. Done With Ablation. Suffer Lower Abdominal Discomfort And Pressure In Bladder. Remedy?

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Posted on Wed, 21 Aug 2013
Question: Female, age 48 yrs.
Diagnosed with multiple uterine fibroids 2012- largest 8cm diameter in the uterine wall; uterus size equivalent to 12 week pregnancy.
Ablation carried out Dec 2012 to try and relieve heavy and frequent periods- some relief obtained but periods & cramping continue albeit less heavy.

Persistant low abdominal discomfort, pressure on bladder, right hip and inner thigh pain extending to knee often disturbs sleep, and almost daily paracetamol taken in effort to reduce the pain ( sometimes completely ineffective) Affecting quality of life now.
Could this be related to the fibroid?
doctor
Answered by Dr. Dr. ARIF N K (21 minutes later)
Hi,
Thank you for choosing XXXXXXX Yes I strongly feel all your present symptoms are due to fibroid. For a 8 cms fibroid and of uterine size 12 weeks, ablation is not the answer. Kindly get a review scan to know the present size of fibroids, uterine size and also scan of KUB(kidney, ureter & bladder) to look for any pressure changes.
After considering your age, fibroid & uterine size I personally feel you should undergo total hysterectomy. That will be best option for you. But, as you have undergone twice caesarean and also ablation hysterectomy surgery will be little difficult, as we expect more adhesions.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. If you like my answers kindly rate it, and write a review as well. Please do not forget to accept it.
Thank you,
Wish you good health.
Regards,
Dr Arif
You can consult me again directly through my profile
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. ARIF N K (20 hours later)
It was explained to me prior to ablation that hysterectomy would, in all probability, be tricky due to LSCS so I took the ablation option as recovery would also be quicker ( I run my own business and taking timeout really is going to be difficult ).

If I wait until menopause ( potentially 5 years away?) and put up with the symptoms , realistically how much are fibroids likely to shrink and potentially the side-effects such as this pain decrease?
Many Thanks
doctor
Answered by Dr. Dr. ARIF N K (57 minutes later)
Hi XXXXX,
Yes you can wait, but you need close follow up by doing regular scans at least 6 monthly to see if there is any increase in fibroid size and if any pressure symptoms on bladder, ureter and kidneys. But, I still advise you to go ahead with hysterectomy, with vaginal hysterectomy or laparoscopy route where you can go home within 2 days and start working without affecting your business.
There are medical methods available like GnRH injections(gonadotrophin releasing hormone treatment) or danazole or Levonorgesteral IUD, but all these methods are temporary, they will decrease the size of fibroid but they will recur once you have stopped the treatment. They will shrink the fibroids by 50%, but I repeat they will recur. Its not a permanent solution.
These medicines have their own potential side effects like:
GnRH-----Osteoporosis cannot be used for more than 6 months.
Danazole-----Androgenic side effects
LNG-IUD-----not much effective in fibroids.
If you do not have any clarification you can close the discussion and rate the answer. Wish you good health.
Regards,
Dr Arif
You can consult me again directly through my profile
WWW.WWWW.WW

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. ARIF N K

OB & GYN Specialist

Practicing since :2007

Answered : 1303 Questions

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Diagnosed With Multiple Uterine Fibroids. Done With Ablation. Suffer Lower Abdominal Discomfort And Pressure In Bladder. Remedy?

Hi,
Thank you for choosing XXXXXXX Yes I strongly feel all your present symptoms are due to fibroid. For a 8 cms fibroid and of uterine size 12 weeks, ablation is not the answer. Kindly get a review scan to know the present size of fibroids, uterine size and also scan of KUB(kidney, ureter & bladder) to look for any pressure changes.
After considering your age, fibroid & uterine size I personally feel you should undergo total hysterectomy. That will be best option for you. But, as you have undergone twice caesarean and also ablation hysterectomy surgery will be little difficult, as we expect more adhesions.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. If you like my answers kindly rate it, and write a review as well. Please do not forget to accept it.
Thank you,
Wish you good health.
Regards,
Dr Arif
You can consult me again directly through my profile
WWW.WWWW.WW