myomectomy or hysterectomy

Hi , Im 51 with 2 teenage kids, perimenoapusal and have managed to grow a very large intramural fibroid (at leat 10 com or 4 inches diameter) like Im about 4 months pregnant. Only symptom is a lump and bladder pressure. Gynecologist has recommended laparoscopic myomectomy (booked for Dec 1st)with hysterectomy if it is too difficult. He also says the choice of surgery is mine.
Given Im 51, should I just have a hysterectomy anyway? Also what are the pros and cons of subtotal vs total hystectomy? I dont want to lose my utereus if I dont need to, or alter my libido and sex life which so far have improved with age but also dont want more surgery later? Not sure what to do, Any advice??

Hi. I had an abdominal myomectomy on October 13th, 2005. I was told that the abdominal incision lets the surgeon better see and feel the uterus, giving them greater access to remove all the fibroids, both large and small. My ultrasound said I had one 8.3 cm fibroid, and maybe some smaller ones, but when the doctor got in, he discovered I had just one fibroid measuring 6 inches and it covered the entire top of my uterus. I'm 40 years old, and have had extremely heavy periods for years. I was trying to avoid a hysterectomy, if possible, since I know that SOME women have sexual or hormonal problems afterwards. Anyhow, I'm SO glad that I had a myomectomy. I just had my first period, and it was light and normal, something I haven't experienced for years. My whole experience of surgery was great, very little pain or discomfort compared to what I was expecting. Tomorrow marks four weeks since surgery, and the doctor says I can return to normal activities and sex. My DH and I are looking forward to the latter. My libido has actually INCREASED since having the surgery. I've read that the fibroids can drain your energy, and myomectomy can improve both overall energy and sexual response in your uterus. Good luck, whatever you choose.

Also, I've read that the chances of fibroid regrowth are less if you are nearing menopause and if you have a smaller number of fibroids, so if you are 51 and just have one fibroid then your chances of regrowth and further surgery may be minimal. For me, it was important to try and avoid a hysterectomy for a benign condition like fibroids.

Also, since you are 51 and perimenopausal, is there any chance the doctor can just wait and see with your fibroids? Your symptoms aren't bad, and the fibroids will shrink at menopause, so maybe your doctor can monitor them and see if they shrink?

Hi Penelope flower,

to Hystersisters. I am glad to see you are asking questions. You have come to a good place to find information. The choice must be yours, but here is a link to information that may help with your decision making : Fibroids has information for alternative treatments for fibroids which you may want to consider. A hysterectomy is so final that it makes sense to me to try everything else possible first.

Hysterectomy Recommended to You? is also a good link which has information that can help you know where to begin to find your answers.

Good luck with your research, and keep us up to date with your decision making process. We are here to help and support you in whatever decision you decide is best for you.

s,
Kay

I considered myomectomy for my fibroids but the thought of them growing back and having to have another surgery was too much. I'm 33 years old so more than likely they would grow back.
On one of my favorite TV shows about a group of women working with "Life Coaches" to improve their lives there's one women who has a fibroid that is growing so rapidly they estimate it to be close to 40 pounds. Her doctor said she needs to have surgery within a month because the fibroid could be twisting around her bladder and other organs. The doc also said it could rupture and she could bleed to death. Although it's never been expressly said I believe this woman may have had a myomectomy because she speaks of having had fibroids removed before but they left one inside because it was too close to an artery in her leg. That's the one they think has grown to 40 pounds. Just watching the whole thing scared me but at the same time gave me a perfect example of how dangerous fibroids can be. JMO

Hi

I decided against a myomectomy for 2 reasons. Firstly, being 41, there was a chance the fibroid could grow back and, secondly, my Surgeon told me that a myomectomy was actually a more difficult procedure than a hysterectomy.

If I was in your shoes, at the age of 51, I would hold fire for a bit as the menopause would shrink the fibroid anyway. That's actually more or less what my Surgeon said to me ... "now, if you were in your 50s, it would be a different matter altogether ..."

It's such a difficult decision and we all have our different ideas and feelings. The only thing to do really is to gather as much info as possible and then discuss it again with your Surgeon.

Wishing you all the best and good luck.

I had a myomectomy in 1991 for two large fibroids. I just had a hysterectomy Oct 27th, for a 14cm fibroid.

My doctors (got several opinions) all agreed a myomectomy was a far more dangerous operation and the only reason to do one is if you want to get pregnantand. As I'm 52, none of them would do it. Plus it didn't cure the problem last time.

I also looked into Uterine Fibroid Embolization UTE for this recent fibroid. I was told my fibroid was far too big, but it may be a better option for you. It seems to work better on smaller fibroids. It is less invasive, less recovery and it shuts down the estogen flow to the fibroids.

Good luck.
Kathryn

I agree with what the above ladies said. 7 years ago at age 31, I had a myomectomy. I had new fibroids form and decided to have a hyst at 38. I'm 7 wks post op.

Since you are closer to menopause a myomectomy or "wait and see" might be your two best options.

kbirds

Little Soilder,

I'm also a big fan of the TV show Starting Over. It does seem that Jill, one of the women on the show, will be having a hysterectomy to remove a 40 pound fibroid. It appears that she had a myomectomy about 10 years ago, but they couldn't remove one of the fibroids because it was close to a major artery. Maybe Jill will post her story here.

I think it's great that the show focuses some attention on fibroids, which are so common, but we never hear anything about in the media. When I was first diagnosed I thought, "I have fibroids? What's a fibroid? I've never had a medical condition before." So, I had to do my own research. More people need to know about fibroids, since so many women have them. We also need to learn more about what causes them, and prevention.

Well, today is four weeks post myomectomy, so the doctor has cleared me to return to work and other normal activities. I will go back to job hunting and temping. I've worked as a bankruptcy paralegal for a number of years, and now I'm looking for a change. Wish me luck.