Myomectomy vs Hysterectomy - need advice!

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I'm 39 and have recently been diagnosed with 2 x large subserosal fibroids (1 x 20cm & 1 x 8cm), on on top of the other. They were initially identified during a routine health assessment as I don't have any severe symptoms and shrugged off the back/pelvic pain, bloating, constipation etc as either signs of aging or Digestion related. Quite a shock to see I have a large snowman filling my insides from the MRI!

I'm now weighing up my treatment options and am stressing as there's so much contradictory info on the web. Before my last consultation I was thinking myomectomy was the best option to get rid of the fibroids but retain my uterus. I don't want to have kids, but no need to remove uterus if no medical need to. At my most recent consultation my gynaecologist made it seem like only deciding factor was kids vs no kids with his advice being UAE or hysterectomy- which seemed over simplistic. He said he'd probably steer me to UAE over myomectomy due to adhesion and blood loss risk.

Has anyone else been in a similar position or had a myomectomy and able to help?

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  • Posted

    Well its not just about whether or not you want to have children. At my age 59, post menopausal,  I still wanted to keep it in preference to having a hysterectomy which is a big operation.    I had only a small fibroid removed July last year, but was having post menopausal bleeding and it was considred the fibroid might be the cause as it had a large blood supply.  I have numerous small fibroids, but this one was considered to be causing the bleeding.  The first male gynaecolgoist I saw said hysterectomy as first option but I said it would not be my first option, so I saw another gynaecologist, female, who said myomectomy which was done via hysteroscopy under a general anaesthetic.  6 months later the daily  bleeding was still ongoing, but has now after 7 months has stopped, it seems it might have taken me longer than the normal recovery time as we are all individual.

    I wouldn't have a hysterectomy if there are other options and you don't need a hysterectomy.  I have had 2 hysteroscopies and biopsy and this was clear.

    I take HRT and it was also considered might be causing the bleeding problem, i now take it at a different time of day and the gynae consultant thinks the combination of taking it at a differnent time of day and the fibroid removal may have resulted in the bleeding stopping.  You don't have to have UAE either but an abdominal myomectomy as yours are larger.   I understand that you can only have a hysteroscopy myomectomy if the fibroid is 10 cm or under.  My was only 2 cms.

  • Posted

    One other thing I would say is that our ages can be a big factor too when deciding on treatment. If one is nearing menopause, I think generally they recommend trying the drugs to help shrink fibroids and buy some time, as once our hormone levels decrease the fibroids shrink anyway.

    However, for me at 41yrs old, my fibroid was just going to keep growing due to my hormones and although i researched all the natural things like lowering oestrogen via diet and tried acupuncture, my fibroid was already too large and causing me grief, for the natural things to have any effect so medical treatment was my only option.

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