In <4o04t4$d4 at nntp4.u.washington.edu> djhart at u.washington.edu (David
Hart) writes:
>>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
>I agree with your suggestions and I would like to add one. If you
take these questions to your OB/GYN and are not satisified with the
answers you get, you always have the option of seeking a 2nd opinion
before undergoing any treatment.
Betsy Feldman, MSW