Reasons not to have a hysterectomy?

Hi
I have been told I have a 15cm fibroid, having an mri today to confirm this.
My gyne said they can't remove the fibroids without a hysterectomy because of the strong blood supply which would cause too much blood loss, but have since read this can be done?
My other options are to leave and monitor it but he said it could start causing issues with my bladder and bowel. Or embolisation.
I was all for the embolisation to start with as less invasive but not keen on it still being in there dead, is it right they only shrink up to 50%?
In last ten years I've had two abnormal smears and am now thinking, take the lot and be done with it. Ideally would like to keep my ovaries.
I really feel uninformed on all of this what are the main reasons not to have a hysterectomy? I already have to children and do not want any more.

Many thanks x

My fibroid has shrunk in the 90% range but this did not happen overnight. UFE is a process. I was intent on keeping my uterus and this has nothing to do with having more children. There is a lot of info available on the value of the uterus for long term health but big fibroids make it hard to do anything but hysterectomy. Lupron may be an idea to shrink it then try UFE.

There are many experienced gyn surgeons who remove very large (larger than yours) fibroids via myomectomy. Your doctor may not be very experienced in working on larger fibroids and thus, is only recommending hysterectomy.

Depending on the number of fibroids you have, a myo can be a longer surgery than hyst (because with myo, they are repairing your uterus, not just taking it out), and with that there is always a risk of blood loss, but according to my surgeon the risk is no more than hyst. I had multiple large fibroids removed via robotic-assisted method and did not experience excessive blood loss and didn't need a transfusion during surgery.

Google "fibroid second opinion" for an example of one well known surgeon who specializes in large fibroids (he treated my aunt).

UFE/UAE might be an option, but it does take a long time for the fibroids to shrink and since yours is so big, you might not ever get full relief. This is definitely the least invasive treatment however. You could ask for a referral to an interventional radiologist to find out about your options.

I have had both myo and UFE/UAE. I think they are both valuable tools in fighting fibroids. Get a second or third opinion and you'll find the right path for you. Good luck!

Somewhat age related question maybe Pickle ? My fibroid got over 20cm. Myo was very new tech back then, and I said no to a hysterectomy. The next thirty years featured no treatment, HEAVY bleeding 8 days a month, chronic anemia, continence problems, and a Daughter. It's 10cm and calcified now.
Your age + how much the symptoms affect you and your life = maybe the abnormal smears are more relevant to decision-making if there's family history or other risk factors. Is two in ten years a concern? Again, Ovary/it's would be nice, depending on your age etc.
Good Luck and Good Health

	Quote:
Originally Posted by Picklepockle Hi I have been told I have a 15cm fibroid, having an mri today to confirm this. My gyne said they can't remove the fibroids without a hysterectomy because of the strong blood supply which would cause too much blood loss, but have since read this can be done? My other options are to leave and monitor it but he said it could start causing issues with my bladder and bowel. Or embolisation. I was all for the embolisation to start with as less invasive but not keen on it still being in there dead, is it right they only shrink up to 50%? In last ten years I've had two abnormal smears and am now thinking, take the lot and be done with it. Ideally would like to keep my ovaries. I really feel uninformed on all of this what are the main reasons not to have a hysterectomy? I already have to children and do not want any more. Many thanks x

I had one night weeks ago and it went great living with fibroids that big is terrible if you follow doctors orders you should be fine and also yes keep your ovaries

Thank you for your replies. My mri confirmed a large fibroid and also "what looks like a benign cyst on the right ovarie" I have an appointmentitment on 3rd of Feb to put a management plan in action x
Ps I'm 43 xx

	Quote:
Originally Posted by Picklepockle Thank you for your replies. My mri confirmed a large fibroid and also "what looks like a benign cyst on the right ovarie" I have an appointmentitment on 3rd of Feb to put a management plan in action x Ps I'm 43 xx

Hi,

I can share my experience with a large (though not as large as yours fibroid). I am 42 and have 3 children with the youngest being 4 yo. I am/was done with having babies prior to my fibroid diagnosis/hysterectomy on 12/16.
I think the ultimate deslcision on what type of treatment to seek depends on how fibroids are affecting your quality of life and what type of fibroid you have. For me, I didn't even know I had a fibroid (or 2) For the past 2 years, I would have 1-2 "can't leave the house" periods every fewonths but then things would normalize. It was just blamed on getting older and hormone changes. Until this past September. I had the most horrible period of my life where I could time my cramps like labor pains. A few weeks later, my heavy bleeding returned, lasting 14 days (this is where I started to get concerned) and I had sudden massive urinary incontience. A CT scan for my bladder isdues revealed a 7 cm pedunculed (on a stalk) fibroid that had/was prolapsing through my cervix (hence the labor like pains in September)I saw gyn who scheduled me for a myomectomy but after they got in there, they were unable to do it because of the enormous blood supply to the fibroid. 3 days later I had a LAVH. I know this was the right choice for me because having severe incontinence at age 42 is awful, totally affecting my quality of life. Plus, I was never regular. So not having suprise periods or worrying if I accidentally got pregnant or the constant spotting of the past 6-8 months will be a blessing. I am glad you have a management plan appointment scheduled. I kept a symptom log (though never used it because from diagnosis to surgery was less than 2 weeks) when I looked back on it, I realized my symptoms wete much more severe than I realized. Unfortunately, when we deal with something chronic, we get used to managing the chronic condition and life and we tend to downplay or don't even recognize how our symptoms are affecting us. S symptom log may help you and your doctor's decide what is the best course of action for you. Hope my experience helps.

Thank you baddecember. It's true what you say about managing symptoms. When I went to the gynecolegist he asked if I'd had problems with my periods and I said no. It was only after that I thought, actually yes they have been heavier and more painful but it's been gradual and I just put it down to getting older lol. Also I do two nightshifts a week so blame a lot of things on that, tiredness bowels not being so regular. The last couple of weeks I've been waking in the night feeling like everything is being pushed up into my ribcage. I'm putting it down to my bladder filling in the night and pushing the fibroid and then everything else upwards. I've also been suffering with a lot of heartburn too.
I'm glad you are on the mend and thanks again x