qchow at pop.srv.ualberta.ca (Benjamin Chow) writes:
>Dear Medical Professionals:
>I am thirty-seven years old and I am married with two children. Starting in March 96, I had heavier than usual bleeding during menstrual period, so I went to visit my gynecologist in May. She recommended me have an ultrasound of the pelvis examination.
>My ultrasound report of the pelvis with endovaginal scanning is as follows:
>High in the vaginal vault contiguous to the anterior lip of the cervix, there is a focal solid mass measuring 2.2 x 2.6 x 2.4 cm in diameter. Solid masses of the vagina are rare. One wonders if this represents a fibroid or polyp projecting from the inf
erior margin of the cervix. Rarely fibromata occur in the wall of the vagina. Clinical correlation is suggested.
>The Pap test is normal. My gynecologist suggests that I have a fibroid in my cervix. Since the position of the fibroid is low in the cervix, the best way to remove it is to have a complete hysterectomy through a cut in the abdomen. This means that my e
ntire uterus, including the cervix, have to be removed. If only the fibroid is to be removed in myomectomy, my gynecologist warns me that the complication of the surgery may induce heavy bleeding.
>I desperately need your professional advice on the following questions:
>1. How can one knows whether the solid mass of the vagina represents pelvic support problems rather than a fibroid? Is it possible that my pelvic organs sag or even stick out through the opening of the vagina due to stretching in childbirth and chronic c
ough? Can ultrasound detect pelvic support problems? Do I have to do a hysterectomy if I have pelvic support problems?
>>2. Would there be any medications to shrink fibroids? Are there any side effects in taking these medications?
>>3. If the fibroid is in my cervix, is there any way that it can be removed without having a complete hysterectomy? Is there any choice of treatment?
>>4. Is it safe and possible to remove the fibroid in the cervix through the vagina?
>>5. Is it safe and possible to remove part of the cervix and fibroid by myomectomy? Will there be any way to leave part of my cervix and whole uterus intact?
>>6. Can the surgery be done through the laparoscope?
>>7. What happens if the fibroid is in my vagina rather in the cervix? How can the fibroid be removed?
>>8. If I have the entire uterus and cervix removed, would there be any physical and psychological side effects? Do I have to take hormones for the rest of my life?
>>9. If I leave the fibroid without removing it, what is the risk that I have to take?
>Thank you in advance for your professional advice and assistance!
>Sincerely,
>Qi-Yin Chow
In my humble opinion:
If you have this many questions, you and your gynecologist have
not adequately talked about your condition. You deserve to get
answers to these questions from the doctor who knows you.
I suggest you print a copy of this list of questions, and take it
to your gynecologist and insist that he or she answer your
questions. Frankly, answers you get here will mostly be speculation.
David Hart
University of Washington School of Medicine