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Old 07-01-2003, 04:07 PM   #1
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denisemarie HB User
Arrow HELP!! Fibriod Tumors - Myomectomy or Laparoscopy, Myolysis

Hi all... I posted this on the "Infertility" board but not sure if that is the most helpful, so hoping for the best from ANYONE!!!
Hello, my name is Denise I'm a 36 yr old single woman.
I have a large "synptomatic" fibriod tumor that is over 1/2 the size of my uterus. We're talking big and painful that doubled it's size FAST!
I have been through the ringer, The last two years. Well ruptuerd cysts, a few ultra sounds left me knowing about this "small tumor" last year. The "wait and see" process has lasted a year.
Two weeks agao another ruptured cyst, and it "triggers" the tumors because of the hormonal imbalance.
Anyway - The tumor had "rapidly" grown and and I am in excruating pain. Time to remove it/them.
Having my 5th set of ultrasounds both types tomorrow (what joy! ) and I am having a hystero sonogram to see exactly what they are dealing with NEXT WEEK!!! THAT scared the heck out of me, I KNOW it's painful as I had osmthing like it last year!
Then finally I will be having it(possibly them) tunors taken out.
What myquestion is, is the difference between the two "proceedures/surgeries"
The mamectomy is what they want to do, but I am for the less invasive.
It seems the laporscopy seems to have higher chances of of rendering me infertile after the proceedure. Apparently the uterus ruptures more easily. At least that is what I have been reading. I THOUGHT it was basically the same proceedure but just a different way of "geting to the uterus."
ANyone here know anything about this. Like I said, I'm 36 and PLAN ON haveing at least ONE CHILD. Seems like my chances either way are decreased, I'm looking for the lesser of the two evils here.
I'm a mess, cry, and can't sometimes even THINK STRAIGHT due to all of the information out there that is all "inconclusive." Hoping to hear some success stories.
Thanks for ANY advice, good luck to you all
Denise

 
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Old 07-01-2003, 10:57 PM   #2
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~airforcewife~ HB User
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Hi Denise! Welcome to the boards!

I'm afraid the only area that I can be of any help is the laparoscopy. I had one done in May for endo and liver damage...

The procedure is very simple. I went to the surgery center at 7 am and was back in my living room by 11 am. I went in and the first thing they had me do was go to the bathroom, then change into my gown. The nurse started my IV and the Anesthesiologist came in to talk to me, then I was wheeled into the OR, and he told me he would be putting me out then. He started counting and I went to sleep. While you are asleep, they do put a tube down your throat to help you breathe but it's in and out and you never know it. I had a minor sore throat for about 3 days afterwards. I woke up in the RR and was promptly kicked out! That is the only area I hear differing stories...most places you stay for like an hour in the RR, I woke up and was literally pulled up by the nurse, put in a wheelchair, and rolled out to my SUV with my husband. I was very groggy and very dizzy and sick to my stomach, but all that passed shortly. I came home, rested for awhile, and then went about my day. Honestly, having my stitches removed hurt worse than any other pain associated with the laparoscopy.

Good luck!

------------------
~ Proud Military Wife & Mother Of 3 Beautiful Children! ~

 
Old 07-01-2003, 11:11 PM   #3
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~airforcewife~ HB User
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This is what I read about the myomectomy...

Definition

Myomectomy is the removal of fibroids (noncancerous tumors) from the wall of the uterus. Myomectomy is the preferred treatment for symptomatic fibroids in women who want to keep their uterus. Larger fibroids must be removed with an abdominal incision, but small fibroids can be taken out using laparoscopy or hysteroscopy.


Purpose

A myomectomy can remove uterine fibroids that are causing symptoms. It is an alternative to surgical removal of the whole uterus (hysterectomy). The procedure can relieve fibroid-induced menstrual symptoms that have not responded to medication. Myomectomy also may be an effective treatment for infertility caused by the presence of fibroids.


Precautions

There is a risk that removal of the fibroids may lead to such severe bleeding that the uterus itself will have to be removed. Because of the risk of blood loss during a myomectomy, patients may want to consider banking their own blood before surgery.


Description

Usually, fibroids are buried in the outer wall of the uterus and abdominal surgery is required. If they are on the inner wall of the uterus, uterine fibroids can be removed using hysteroscopy. If they are on a stalk (pedunculated) on the outer surface of the uterus, laparoscopy can be performed.


Removing fibroids through abdominal surgery is a more difficult and slightly more risky operation than a hysterectomy. This is because the uterus bleeds from the sites where the fibroids were, and it may be difficult or impossible to stop the bleeding. This surgery is usually performed under general anesthesia, although some patients may be given a spinal or epidural anesthesia.


The incision may be horizontal (the "bikini" incision) or a vertical incision from the navel downward. After separating the muscle layers underneath the skin, the surgeon makes an opening in the abdominal wall. Next, the surgeon makes an incision over each fibroid, grasping and pulling out each growth.


Every opening in the uterine wall is then stitched with sutures. The uterus must be meticulously repaired in order to eliminate potential sites of bleeding or infection. Then, the surgeon sutures the abdominal wall and muscle layers above it with absorbable stitches, and closes the skin with clips or nonabsorbable stitches.


When appropriate, a laparoscopic myomectomy may be performed. In this procedure, the surgeon removes fibroids with the help of a viewing tube (laparoscope) inserted into the pelvic cavity through an incision in the navel. The fibroids are removed through a tiny incision under the navel that is much smaller than the 4 or 5 inch opening required for a standard myomectomy.


If the fibroids are small and located on the inner surface of the uterus, they can be removed with a thin telescope-like device called a hysteroscope. The hysteroscope is inserted into the vagina through the cervix and into the uterus. This procedure does not require any abdominal incision, so hospitalization is shorter.


Preparation

Surgeons often recommend hormone treatment with a drug called leuprolide (Lupron) two to six months before surgery in order to shrink the fibroids. This makes the fibroids easier to remove. In addition, Lupron stops menstruation, so women who are anemic have an opportunity to build up their blood count. While the drug treatment may reduce the risk of excess blood loss during surgery, there is a small risk that temporarily-smaller fibroids might be missed during myomectomy, only to enlarge later after the surgery is completed.


Aftercare

Patients may need four to six weeks of recovery following a standard myomectomy before they can return to normal activities. Women who have had laparoscopic or hysteroscopic myomectomies, however, can leave the hospital the day after surgery and usually recovery completely within two to three days to one to three weeks.


Risks

The risks of a myomectomy performed by a skilled surgeon are about the same as hysterectomy (one of the most common and safest surgeries). Removing multiple fibroids is more difficult and slightly more risky.


Possible complications include:


Infection.
Blood loss.
The wall of the uterus may be weakened if the removal of a large fibroid leaves a wound that extends the complete thickness of the wall. Special precautions may be needed in future pregnancies. For example, the delivery may need to be performed surgically (Caesarean section).
Adverse reactions to anesthesia.
Internal scarring (and possible infertility).
Since fibroids tend to appear and grow as a woman ages (until menopause), it is possible that new fibroids will appear after myomectomy.

OMG!!! This sounds so much worse than the laparoscopy! Ouch, ouch, ouch! Sorry, I had never heard of a myomectomy before...I have such a weak tummy...


------------------
~ Proud Military Wife & Mother Of 3 Beautiful Children! ~

 
Old 07-02-2003, 02:41 PM   #4
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denisemarie HB User
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Thank you AFW for your post, and yes, thanks for the welcome!
Well, I've read and readm reasearched and reasearched, and I'm just a mess. I'm not SURE I wantto ever had a chile but I dont want that decision taken AWAY from me either.
BOTH of these proceedures seem to be hell. Ya see, my tumor is over 1/2 the size of the uterus itself. EITHER surgery I'm looking at whether it be the M- Ectomy or the laproscop. BOTH render me with the same outcome.
BUT - APparently the laroscope type seems to leave more scr tissue, which means decreased chances of concieving. The Hystersonogram (which I am absolutly DREADING)I have to have next week, and the FOURTH SET of internal/external ultrasounds in the past TWO WEEKS, have just left me feeling just so... ANgry. Violated, just all in all it's degrating. I UNDRESTAND it's their jobs, but do I have to have a conversation that will effect my fertility and my life IN A PAPER GOWN and paper blanket???!!!
I want a straight answer, which is better. COnficting info re: the two proceedures that are SUPPOSED to have the same outcome, but one less invasive. Yea that's what it says - but underlying effects on fertility is all CONFLICTING! I'm VERY upset.
I'm SICK of doctors, I'm SICK of having to see all of these different people for different proceedures, that I'm just not MENTALLY UP to yet again ANOTHER opinion!
I guess, I just really needed to vent in hopes that MAYBE just MAYBE somone elase has been through this and UNDERSTANDS! I'm just so in this alone I feel sometimes.
Thanks again. Really, thanks for taking the time to care.
Denise

 
Old 07-16-2003, 07:59 PM   #5
j27 j27 is offline
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Hi Denisemarie- I had surgery in February for fibroids. The dr suspected that there were lots of them and didn't know what to expect so she did a full c-section cut and found 18 tumors! (laparotomy/multiple myomectomy)All over- on my ovary, my intestine, my uterus, my bladder, etc- some of them were the size of baseballs- but she removed them all! I was in excrutiating pain for 3 yrs- I am 30 yrs old and also would love to someday have a child- so I was scared too. I had to sign a form stating that if my uterus bled profusely I'd agree to an emergency hystorectomy- which really frightened me- but everything went very smoothly... even though she had to slice thru my 2 of the big ab muscles and part of my intestine and go into my uterus and on my right ovary, which required internal (disolving) stitches. She said the only "complication" is that I will need a c-section if I have a child- due to the resulted weakening of my ab muscles- but I am so grateful and thankful that my pain is finally completely gone that I am fine with that idea. It's a great trade-off to be pain-free! I was in the hospital for a week and had an infection and it did take a good full couple of months to heal, it was a pretty painful and frustrating recovery and my tummy is still swollen; but I cannot begin to explain how thankful and happy I am! I figure I may not be able to wear a bikini this summer, 'cuz of my swollen "pouch" but that's fine with me!! At least I'm not spending the summer bedridden again! Besides none of my friends wear bikinis these days either!! I hope this gives you some insight?- Please let me know how you are doing- Good luck... My prayers are with you.

 
Old 07-16-2003, 08:12 PM   #6
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Hey- I just read your 2nd post- and wanted to add: Please know that you are definitely NOT alone- I totally know where you're coming from- I felt so alone and in pain and scared for 3 yrs- I felt like no one understood. Not to mention the countless- sometimes inconclusive tests- they were invasive and painful and I often felt like crying laying there all exposed and "covered" only by paper garments, feeling embarrassed to ask all the questions flying thru my mind. My surgery was considered major and quite risky and it took over 4 hours- but my dr/surgeon has been my angel the past year- I hope that you are equally comfortable with yours- I live in San Jose,CA- I don't know about you but I have gone to like 4-5 different hospitals all over and a zillion doctors, before I found her. I'd reccomend her strongly if you are near here at all- let me know and I'll forward you her name, etc. There is a light at the end of the tunnel- but if you asked me 7 months ago and I would never have said that! Take it easy- don't worry so much- it makes the pain worse- everything happens for a reason- you'll get thru this... really.

 
Old 07-27-2003, 05:49 PM   #7
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Hi........

I am 31 yrs old. TTC #1 for a year. In May I had a abdominal myomectomy. If your fibroid is that large and in the uterine wall....your Dr. should not do a lap.Mine was suspected (from U/S) to be 5cm......when they opened me up and found the fibroid it really was 8.5 cm. It was "hiding" in the wall of my uterus.
They also found my ovaries were "stuck" to the pelvic was by adhesions.....from what I dont know. Anyhow....
Now I am awaiting the ok to ttc again. i feel great. The first two weeks are the hardest. i banked my own blood, just in case of blood loss. However, i did not need it ..I feel the myomectomy was the best thing I could have done even though it put a halt to my ttc...I would hate for anything to have gone wrong in pregnancy because I was too chicken to get the fibroid out.....
Hope this helps anyone

Diana

 
Old 07-28-2003, 10:26 PM   #8
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fachina1 HB User
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Hey Lady, you are not alone, women everyday are degraded by the medical system and treated like numbers. the worst for me is the ultrasound techs who don't even look you in the eye when inserting the wand for an intravaginal ultrasound. I think the posts have been great thus far and it may be important to have the surgery right now to increase your chances for pregnancy in the future (so that you can carry a baby in your uterus without the fibroids blocking the way.) It is hard to say how much scarring will occur but there are things to do preventatively to help with inflammation and bruising during procedures. I would suggest seeking out a licensed naturopathic doctor in your area who can help with the pre and post surgery stuff as well as treating the cause of why the fibroids arrived in the first place. try looking on the american association of naturopathic physicians web site.

 
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