UFE of hysterectomy?

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Hi. Dr. Found a 12 cm fibroid about 4-5 weeks ago. I had my first Depo Luprin shot about 2 weeks ago to see if we can reduce the size. I'm looking at possible UFE or hyst in late August. I'm leaning more towards the hyst due to my age (42), my symptoms (back pain, heavy periods, bladder, bowel, 32 years of pain every month, living on anti inflammatory meds and heating pads, and massive hormonal issues). Am I over reacting? And advice?

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  • Posted

    Hi yvette061601.

    32 years of pain every month is not related to the fibroid as it was not in existence for the majority of that period.  If you have always had painful menstruations then that is a separate issue.  I think you should separate your medical complaints and try and determine when each of them started.  If you feel that the back pain, frequent urination and bowel issues started with the discovery of the fibroid then that is the only issue you need to address and then a UFE might be appropriate to shrink the fibroid and reduce the symptoms. It is necessary to be realistic about the shrinkage that you might obtain which could be up to 50%, some people experience more, others experience less shrinkage but ultimately the fibroid dies and there is no further growth.

    ?Unless you can categorically state that every medical complaint that you have is purely based on your fibroid I do not think you should take such drastic steps, if it isn't and you take the permanent step of having an hysterectomy and you still experience back pain and bowel issues that might be very difficult situation for you to overcome.  It has only been 4-5 weeks since you discovered this 12 cm fibroid you still have a lot of research to do and information to gather on both procedures so that you are completely informed before you sign any consent to proceed.  My advice is to go for the least invasive procedure first such as UFE, see how you get along for the next 12 month following the procedure and if this does not work for you, only then should you consider the hysterectomy.  I wish you well and a speedy recovery regardless of what you decide.Unless you can categorically state that every medical complaint is purely based on your fibroid I do mnot think you sjhould take drastic steps, if it isn't and you take the permanet step of having an hysterectomy and you still expereince back pain and bowel issues that might be very difficult for you to overcome.  Go for the least invasive procedure first, see how you get along and if this does not work for you, only then should you consider the hysterectomy.

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  • Posted

    Hi Yvette,

    The hormone therapy has worked immensley for me.  I stopped bleeding on day four.  Although there were the hot flashes and some other minor side effects.  Two out of three fibroids shrunk significantly, although the third appears to be unaffected. I am 10 years older than you, so I am not as good a candidate for surgery.  In the course of my life I have had many surgeries for injuries and accidents and I am not recovering as fast as when I was young.  I don't want to damage any of my other organs during any fibroid treatment either.

    I've had many challenges with fibroids and my family doctor was not even aware that the fibroids were the cause of all my bleeding.  107 days in a row with only a week or so off before it would all start again.  Blood clots that were so bad my uterus would mimic labour to eject them.  There were days I couldn't even leave the toilet because of how fast blood was pouring out.  There was more, but why bother describing it.  

    You might want to look into the MRI guided Focused Ultrasound.  It is a day patient proceedure that doesn't have any surgery and works very well with older women.  The ultrasound actually destroys the fibroids from the inside and it is non-invasive with much faster recovery time.  

    Any surgery discussed on this board I have noted that all of them take 5-8 weeks recovery and sometimes there are infections or complications after.  The surgeries are never as simple as the doctors make it sound.  

    You will need to do more research on all of the methods of treatment in order to find what is right for you of course.  I am only stating my own opinion because I have had every single male doctor recommend that I get the hyst, right from age 24.  I have refused long and hard on that one.  If I would have agreed I wouldn't have been married to my second husband or had our two children.  

    My friend who also has heavy bleeding from fibroids has been seeing an acupuncturist and has actually had her bleeding stop.  So I think that is worthy of looking into as well.  Like I said before, do some research and decide what's best for you.

    good luck in your fibroid treatment and research.

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  • Posted

    I feel you pain & can understand. I have a slightly larger fibroid & am a little bit older but have similar issues. I agree with the advice given. As it is a worry that if we do have a hysterectomy that for example, the back pain is still there & it wasn't the cause or sole cause. It is a drastic measure when we cannot be fully sure. Look into the less evasive methods first, like for example UFE. Best Wishes

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  • Posted

    Hi

    I have been where you are now. Diagnosed June 14 then 3 Lupron injections which where bad then Endo Ablation then UFE finally in January 2016. If I could rewind time I would go straight to UFE then Esyma the injections and Endo Ablation were an waste of time.

    I have got shrinkage from 10cm Fibroid due to UFE. It's now 7.5 taking Esyma to get more shrinkage.

    Don't be pushed into Hysterectomy straight away. My UFE was not that painful I'm so glad I pushed the Gynocologist to get it done. Do loads of research into Fibroids and treatment options. Think carefully before having a Hysterectomy it's a major op and you may be left with other problems. Good luck and whatever you decide do what's best for you and not what's best for the hospital

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  • Posted

    Well, I get what you are going through with making choices. First I think you have two opinions way opposite of each other and you might could find some middle ground.

    I am weighing UFE with myomectomy. Here's my thoughts.

    My problem with UFE is that it takes up to a year or so for it to maximize it's benefits. There is dead tissue inside of my body which cannot be good. If the fibroid is on the outside like mine, it could fall off of it's "stalk" down and cause other organ complications (adhesions, bowel issues, pain, infection, sepsis). I also heard that the pain is horrible and can be ongoing because the tissues are dying off little by little. One lady complained that she no longer had vaginal or clitoral sensation and no longer had uterine contraction orgasms which I find sad. It was dissatisfying for her.

    Other considerations: where they located (outside, inside intramural, serosal, subserosal), and how big are they? and Do you have orgasms that are uterine related (uterine orgasms)? With hysterectomy those orgasms are GONE once it's out and with UFE this is also a risk because the blood supply that feeds the pelvic cavity, cervix and even clitioris can be impacted by UFE. I do not like that 1 out of 4 grow back, that ONLY up to 50-60% shrinks, and that within 5-7 yrs women usually have to go back for surgery or have this repeated again. 

    Aside from UFE you could consider abdominal laproscopic myomectomy and hysteroscopic vaginal myomectomy (or a combination of the two). I would NOT remove my uterus unless there was no way else for them to take the fibroids. I do have uterine contraction orgasms so my sex life would be NOTHING. Also, they have to clip nerves when they do a hysterectomy so sex can be different. If I had no other option but hysterectomy, I woud have a SUPRACERVICAL hysterectomy (that way part of the nerves are still intact). If I had the money, I would go and try the high intensity ultrasound focused. it's not covered by insurance and can run from $8700-13,500 cash out of pocket. That is the least invasive of them all, but fibroids can grow back with all of them except hysterectomy. If you are close to menopausal age, that part generally doesn't matter b/c when estrogen decreases fibroids do too. 

    Good luck to you. But I would stay somewhere to the middle left on this one (High intensity Ultrasound focused- UFE- myolysis- hysteroscopic vaginal myomectomy - abdominal laproscopic myomectomy (single vs 3 incision approach)- supracervical hysterectomy- partial hysterectomy (take all but ovaries)- hysterectomy (full or complete). Let us know what you decide. I'm trying to decide myself. 

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  • Posted

    UFE hands down! Please don’t get a hysterectomy unless you have no other option and absolutely must.

    Your uterus is the cornerstone of your body, don’t listen to those who say it is just a reproduction organ, check out medical research about the numerous, long term side effects, from pelvic organ prolapse, urinary incontinence, bowel dysfunction, pelvic organ fistula disease, sexual dysfunction, Pelvic floor dysfunction to other problems like cardiovascular diseases and chronic back pain..

    I had two fibroids, 12*10.5 cm and 8.9*7.8 cm in October 2016 when I got my UFE. Today (May 2017) I got a check up and they are degenerating, measuring 6.9*5 and 6.3*4.1. The doctor had said at their original size they might take up to a year or two to completely dissolve.

    Recovery was a bit hard during the first month, like constant PMS. But immediately my period became lighter and all the related symptoms, bloating, back pain, irritability etc subsided.

    Good luck.

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