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Have fibroid uterus and bulky uterus. Multiple hypoechoic lesion. Removed fibroids. What are the treatments available?

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General & Family Physician
Practicing since : 2004
Answered : 1775 Questions
My name is XXXXXXX and I am 45 years old. I have fibroid uterus.Uterus is bulky and endometrial thickness is 10mm. LArge anterior myometrial fibroid size 66&53mm. Multiple hypoechoic lesion size 30mm noted in anterior and posterior myometrium.well defined submucosal fibroid size 25mm noted.

I had infertility issue with cause undiagnosed and my doctor suggested that small fibroids could be the issue. She gave me hormonal treatment for 3 months to increase the size of the fibroids and I was operated in 2000 and later I conceived. I had c- section.

I undergo annual medical check ups and do not have any medical conditions.

What are the treatment options available to me today.
Posted Tue, 8 Oct 2013 in Vaginal and Uterus Health
Answered by Dr. Chakravarthy Mazumdar 28 minutes later
Brief Answer:
Do you have any problems I mean symptoms

Detailed Answer:

Thank you for the description. I understood that you are concerned about the fibroids inside the uterus. It is good that you do not have any medical conditions

I have simple and specific questions for you to give my opinion:
Do you have any symptoms now like intense bleeding?
Are you having regular periods? Do you bleed in between the periods?
What is your hemoglobin?
Do you have any other problems like dizziness, shortness of breath, swelling of the feet and not able to carry your daily routine?
Do you have lower abdominal pain during your periods?
What is your Gynecologist opinion on annual physicals?

The multiple fibroids should regress on their own as the women ages as the oestrogen levels are dropped in women from 45 yrs of age. If you do not have any symptoms you may leave them alone. Yes they are big in size but a lot of women still get through without any symptoms though they have large fibroids.

Let me know the information and if you have any specific queries?
Above answer was peer-reviewed by
Follow-up: Have fibroid uterus and bulky uterus. Multiple hypoechoic lesion. Removed fibroids. What are the treatments available? 39 minutes later
Dear Dr.,

I had hoped that by increase in age, this problem would reduce. However, the size is increasing every year and in last examination , my Gynaec told me that the uterus is abt 4 m pregnancy size and need to undergo Hysteryctomy. Since it is a corporate hospital doctor advise, I want second opinion.

I have regular periods ..28 days.The bleeding is intense for first two days only. Bleeding for rest is moderate. My cycle duration also increased to 8 days with just spotting in last 2-3 days. I have intense unbearable pain in lower abdomen for the first two days.I take Meftal spas or meftalD for these days. However, sometimes I need to take a day off from working because of this issue.Except the pain , I do not have any other major symptons.

I do not bleed between periods nor have i have any other health issues.My haemoglobin is 12.9 and RBC count is on higher side touching XXXXXXX limit.

I also had CA 125 done on doctor's advise . Even that is normal...score of 10.1 against <21.
Answered by Dr. Chakravarthy Mazumdar 1 hour later
Brief Answer:
Hysterectomy improves quality of life check myomectomy

Detailed Answer:

Hysterectomy is commonly advised by most doctors to improve the quality of life of the suffering woman and the results are actually quite comparable. So in your case the conditions that may lead to a hysterectomy is mainly discomfort and inconvenience rather than threatened life as per your doctor. If you are looking for improved Quality of Life then you may go ahead but with myomectomy rather than hysterectomy. Few Gynecologists would have the skill to myomectomy and save the uterus. Check if it is feasible to do this before opting for Hysterectomy.

In contrast your description say your issue is not so serious and is hampering only couple of days in a month, am I right? The other days you are alright with small bleed. Your general condition and your mental status appears to be normal. You seem not frustrated with the fibroids. You seem to be bothered about the 4 month pregnant like Uterine size.

According to a blog by OBGYN experts, The average size of the uterus including fibroids in the late thirties to early forties is a ten to twelve week pregnancy size (about 13cm in the largest dimension), in the middle forties fourteen to sixteen weeks is average (about 17cm in the largest dimension), and in the late forties to early fifties eighteen to twenty weeks is average (about 21cm in the largest dimension).

Everything else seems normal to me.

Above answer was peer-reviewed by
Follow-up: Have fibroid uterus and bulky uterus. Multiple hypoechoic lesion. Removed fibroids. What are the treatments available? 25 hours later
Dear Dr,
Thanks for the detailed response. Along with firboids, there are mentioned in report. I do not know what this means. Would myomectomy address that well. There is also nabothian cyst noted in cervix. Does it need to be taken care of or will it go away on its own? Is it possible to remove such large fibroids through laproscopy?
Answered by Dr. Chakravarthy Mazumdar 21 minutes later
Brief Answer:
Treatment is individualized

Detailed Answer:
Unless we know the nypoechoic lesions we will not be able to know how to treat it. Your doctor can only tell the possibilities of these hypoechoic lesions likely fibroids only. Nabothian cysts should resolve on their own however larger ones need to be treated.

Laparoscopic if for subserosal fibroids not submucosal fibroids. Hysteroscopic removal is applied for this but unlikely helpful for such large ones.

Above answer was peer-reviewed by
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