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Scan Report Shows Bulky Uterus With Multiple Fibriods. What Is This Condition And What Is The Treatment?
Question: Hi,
I'm 32 years old, I have recently got CBC and CT Scan of Abdomen and Pelvis done, CBC report showed Hemoglobin count as 5.7 and CT Scan report showed : Right Kidney - Pelvicalyceal dilation note. Right upper uterer is seen kink around the accessory right renal artery supplying the lower pole ( proximal diameter - 10.8mm, distal 3.2mm). it again increases in calibre at middle third ( 8.3mm) and is seen to be compressed by uterine fibroid at the level of right illiac crossing. Distal right ureter and UV junction is normal.
Uterus is bulkey, measures 17 X 13 X 12 CM, shows evidence of multiple large intramural fibriods. Endometrium is displaced anteriorly and towards left. right ovary shows 2.9 X 2.9 cm cyst. left ovary appers unremarkable and measures 2.1 X 1.7 CM.
Minimal free fluid noted in pelvis.
Impression:
- Bulky Uterus with multiple fibriods.
- Mild right Hydroureteronephrosis. Kink in upper ureter by accessory right renal artery ( at the level of L4) and compression by uterine at iliac crossing ( at the level of L5-S1).
Kindly suggest what is my condition and what could be suitable treatment.
Brief Answer:
Risky case
Detailed Answer:
Hello
The right form of treatment in your case will depend on your age. If you have completed your family, then surgery is advised. Since you are only 32, normally surgery isnt advised. But due to the size of your uterus and the pressure symptoms you are showing, surgery will be advised. You have multiple fibroids and their location is risky. The uterine artery is involved in this case. Due to the large size of the uterus, and the distorted anatomy, there are chances of injury to surrounding structures and bleeding. So open surgery is definitely my opinion. I would like to preserve your ovaries if possible, due to your age, but that can only be decided upon after opening you up. Unless the hydronephrosis is relieved you will soon have urinary problems. Ideally open is the mode of treatment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
Thanks for the response. I have 2 kids and got family planning operation done. BTW can you give more details on open surgery for ex: is it hysterectomy or myomectomy and what type would be? Also CBC test shows: Hemoglobin - 5.7, Hametocrit [PCV] - 22.5, MCV - 57.8, MCH - 14.7 MCHC - 25.3. Should I undergo Anaemia treatment before surgery?
Brief Answer:
hystrectomy with/without BSO
Detailed Answer:
If your family is complete, then i suggest you go for surgery. First you will have to take treatment of anemia, which happened due to the heavy bleeding. Once you hemoglobin is corrected, then surgery will be planned. Due to large number of fibroids, a hystrectomy is imminent. Whether both ovaries will need to be removed, will depend on the type of cyst you have. After opening the abdomen, if the surgeon can just remove the cyst, and save the ovaries, thats advisable due to your age.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
I have consulted doctor here with the reports, she had asked me get hystrectomy +/- BSO done, surgery is planned on 5th Dec. Coincidentally my periods cycle fall in that time ( 2nd Dec - 7th dec), will it cause any issue or surgery can still be done. Is there any way to delay periods?
Brief Answer:
no problem
Detailed Answer:
There should be no problem having the surgery during periods. Dont take any medicines to delay your period. It will cause a hormonal imbalance. Either ask your doctor to delay the surgery by a couple of days or have it as planned. Whatever you feel comfortable with.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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