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What Does This Ultrasonography Report Indicate?

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Posted on Thu, 16 Jun 2016
Question: Hi,

I have a large subserosal fundal fibroid measuring about 13.5x10.6 cms noted posteriorly. My doctor suggested me to go for surgical removal of it and since the size of it is big Laparoscopy is not feasible. I just want to is there any other/better option of getting this fibroid removed?

-----Copying the report content below, not sure how to attach-------
ABDOMINO-PELVIC ULTRASONOGRAPHY
LIVER shows normal in shape, size and has uniform echopattern. No evidence of focal lesion or intrahepatic biliary ductal dilatation. Hepatic and portal vein radicals are normal.
GALL BLADDER shows normal shape and has clear contents. Gall bladder wall is of normal thickness. CBD is of normal calibre.
PANCREAS has normal shape, size and uniform echopattern. No evidence of ductal dilatation or calcification.
SPLEEN shows normal shape, size and echopattern. Spleen measures 9.1cms in long axis and 3.5cms in short axis. No demonstrable Para -aortic lymphadenopathy.
KIDNEYS move well with respiration and have normal shape, size and echopattern. Cortico- medullary differentiations are well madeout. No evidence of calculus or hydronephrosis. The kidney measures as follows:
URINARY BLADDER shows normal shape and wall thickness. It has clear contents. No evidence of diverticula. Prevoid: 180cc Postvoid: 5cc
UTERUS is anteverted and mildly retroflexed and is enlarged in size reaching to just above the level of the umbilicus. It has uniform myometrial echopattern. Myometrial vessels appear prominent. A large subserosal fibroid measuring about 13.5 x 10.6cms is noted in the fundus posteriorly. Endometrial thickness measures 12mm
OVARIES are normal in size and are polycystic. No focal lesion seen. Ovaries measure as follows: Right ovary: 3.9 x 2.5cms Left ovary: 4.0 x 2.3cms
No evidence of ascites/pleural effusion.

Thanks,
XXXXX
doctor
Answered by Dr. Dr. Soumen Patra (1 hour later)
Brief Answer:
Surgical removal is the only option.

Detailed Answer:
Hello dear,

Thanks for writing to us. Followings are my comments:

1) I have reviewed your attached report. Subserous fibroid is quite LARGE and situated in the posterior part of uterine fundus. You have also both side poly cystic ovary.

2) If uterus or fibroid is quite large, laparoscopic or robotic myomectomy is NOT possible as there will be not enough space to fit robotic or laparoscopic instruments. Uterine artery embolization is NOT recommended due to large fibroid and it is not successful in most of the cases.

3) Open surgery or laparotomy is the only solution to remove this kind of large fibroid. You should consult with your treating doctor regarding this and do necessary investigation before proceeding this surgery. Anemia should be corrected to avoid risk and complication during procedure.

Hope, I have answered your query. Wish your good health and take care.

For future query, you can directly approach me through

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326

Regards,
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Dr. Soumen Patra (57 minutes later)
Thank you Dr for your detail reply. Got to know about MRI-guided focused ultrasound surgery (FUS) while browsing on net. What are your thoughts on this? Will it be an option for me ? Any disadvantage going for this option?

Thanks,
XXXX
doctor
Answered by Dr. Dr. Soumen Patra (28 minutes later)
Brief Answer:
Not recommended FUS.

Detailed Answer:
Hello Dear,

Welcome back again.

1) MRI-guided focused ultrasound surgery is done for small fibroid only. Best result is obtained when size is between 3 to 7 cm. However, your fibroid size is quite large (>10 cm) and surgical removal is the best option. I personally DON'T recommend the procedure.

2) Another thing, if you want to get pregnant in future, this procedure (FUS) should be avoided because it may cause fertility related problem.

Hope, it helps for your information. Good luck and take care.

Regards,
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. Prasad
doctor
Answered by
Dr.
Dr. Dr. Soumen Patra

OB & GYN Specialist

Practicing since :2011

Answered : 4058 Questions

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What Does This Ultrasonography Report Indicate?

Brief Answer: Surgical removal is the only option. Detailed Answer: Hello dear, Thanks for writing to us. Followings are my comments: 1) I have reviewed your attached report. Subserous fibroid is quite LARGE and situated in the posterior part of uterine fundus. You have also both side poly cystic ovary. 2) If uterus or fibroid is quite large, laparoscopic or robotic myomectomy is NOT possible as there will be not enough space to fit robotic or laparoscopic instruments. Uterine artery embolization is NOT recommended due to large fibroid and it is not successful in most of the cases. 3) Open surgery or laparotomy is the only solution to remove this kind of large fibroid. You should consult with your treating doctor regarding this and do necessary investigation before proceeding this surgery. Anemia should be corrected to avoid risk and complication during procedure. Hope, I have answered your query. Wish your good health and take care. For future query, you can directly approach me through http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326 Regards,