Can 10 cm fibroid damage ovary and uterus? Don't know what to do...

My doctor discovered (by accident) a soft tissue mass that is next to my right ovary, measuring about 10 x 8 x 6 cm (about the size of a double deck of cards). Other than one night of urinating four times, I had no symptoms . Ultrasound, cat scan, and MRI were all performed. My OB thinks its a fibroid, but only trace evidence of a stalk was seen. My CA-125 test came in at 7.

If its cancer, obviously I'm prepared to have everything removed, including lymph nodes.

If it is a peduncluated fibroid, my doctor still wants to do a vertical-cut abdominal total hysterectomy and BSO. Her reasons are 1) this size mass in my 105 pound body probably damaged the ovary and uterus (which is not mentioned in any of the books I've read), 2) at my age of 45, keeping the ovaries are not worth the risk of cancer, and 3) hardly anyone performs a subtotal these days.

At 45 years of age, I'm wondering if I should get a second opinion to keep at least one ovary and the cervix. I consider myself to be a low-to-average cancer risk (grandmother had uterine cancer, PAP smears ok, had two babies, take birth control). I also consider myself to have a wonderful quality of life in regards to the reproductive organs (managable menstration using Seasonale birth control, through-the-roof climaxes, no bouts of depression, no debilitating cramps, etc).

I would appreciated any words of wisdom from you all.

In a sentence: Get a second opinion.

As for how to go about that, I would get a 2nd opinion from a doctor that has an excellent track record of doing all types of hysterectomy, all approaches, including (especially) LSH. This will ensure your doc is at a skill level where he/she can recommend the best thing for you and your particular situation, and won't just do the one thing he/she is good at. There are good reasons for taking the ovaries and/or cervix but there are also a lot of good reasons for leaving them be, and if these boards reflect total stats, subtotals are not at all uncommon.

I've never heard of bulk damaging organs or glands but that doesn't mean it can't happen. It does occur to me though that a full term baby plus placenta plus amniotic fluid, etc is a heckova lot bigger than a double deck of cards.

Hi SafeandHealthy,

I agree with Jandybee. Get a 2nd or even a 3rd opinion. Fibroids are cancerous only 1% of the time so try not to worry.

In my humble opinion?? Your Dr. sounds a little old school saying to take out healthy ovaries just because you are 45. The ovaries secrete important hormones that help with the bones, skin and hair to name a few. Newer studies are also showing that the ovaries secrete important hormones well into menopause and the hormones are *free*. And...ovarian cancer runs in approx. 5% or less of women. Those were good odds for me.

Your Dr. sounds a lot like my 1st Dr. I had 2 large fibroids and they were a big surprise to me at an annual exam. I couldn't believe it. I had never had any gyneo problems. My Dr. wanted to do an abdominal hyst and remove everything since I was 46 at the time. She said I was *not* a candidate for a less invasive hyst.

I got a 2nd opinion and he recommended a LSH, the surgery type that both JandyBee and I had. I am still very pleased with my surgery results.

My fibroids were 9.1 cm total before my hyst and I kept my cervix and ovaries. In my case, my fibroids did not cause any damage to my ovaries. I agree with Jandybee. A baby in the uterus is bigger than a deck of cards!! With the cervix...I was a good candidate to keep my cervix since it was sturdy and I had had normal pap smears for years. My Dr. felt the cervix helps with pelvic support and with sex.

Here is a Hyster Sisters link that goes over the different types of hysts. Possibly you are a candidate for a less invasive hyst such as a TVH, a LAVH or a LSH:

http://www.hystersisters.com/vb2/view_preop.htm

or maybe you are a candidate for a UFE (Uterine Fibroid Embolization). The procedure helps to shrink fibroids and it leaves the uterus intact.

Best wishes. We Hyster Sisters are here to help if we can.

Mary

I am going for a total hysterectomy on 12/13. I had a Novasure, D&C, etc. on 10/10. The reason for the Novasure was heavy and/or constant bleeding spotting. I've had this fibroid outside my uterous for some time. It seems that about three days after the Novasure, I started to experience a lot of pressure. It hasn't gone away. The fibroid seems to really be pressing on my bladder and rectum.
I went for a third opinion and it's a total hyster. They all say the same thing.
I too am 45 and am concerned about losing the ovaries. All three doctors feel (one ovary is full of cysts) that it is best to remove them now rather than in three years to go in again.
In any event, I just want this to be over with as I haven't slept since the Novasure.
Good Luck with your decision. I'm still having a tough time.

I am the opinion queen. The minute i have anything questionable I seek 2 to 3 other opinions, especially when they want stuff to come out.

I am also small and had a 14cm fibroid in my uterine wall. I was never told it damaged other organs. It did put pressure on my ureters due to bulk but that was reversied by my UAE.

I am going for a hyst now because my uterus is still too big for a lap procedure to remove an ongoing ovarian cyst. Even with my cyst my gyn is not taking my ovary unless something is wrong, he is removing the cyst. He believes ovaries should remain, I am 46.

You will be surprised how many opinions there are out there but get them and think it through carefully.

The doctors think there is a higher probability that it is only a fibroid, but since the MRI did not show a definite stalk between the mass and the uterus, they cannot rule out cancer.

jandybee & sbcvulcan: the fact that you two have never heard of damage due to overcrowding is comforting to me. I wonder if my OB/GYN spouted this out hoping I wasn't being educated by the HysterSisters!

Mary: Good News: my engineering hubby looked up the SEER statistics, and found that the probability of a white female developing ovarian cancer from age 45 to end-of-life is less than 1.4%. Bad News: a consultation with a interventional radiologist indicated my fibroid was not a good candidate for UFE.

Katetype: check your local libraries for "The Woman's Guide to Hysterectomy" by Adelaide Haas and Susan Puretz, and also "The Essential Guide to Hysterectomy" by Lauren Streicher. They are wonderful resources to help you make your decision regarding ovaries and cervix.

We have requested a second opinion from a well-respected local surgeon, who has already reviewed my file. Preliminary discussions with her nurse indicates that one ovary and the cervix could stay, provided its just a fibroid. Stay tuned!!

Thank you ladies! Thank you very much!
Christine

Thank you. I did go for three opinions and I cannot believe how much they all "stick" together. Only one opinion questioned it. Then he back peddled. He also was surprised by the abdominal hyster. Then he asked if I had c-sections. I said I did and he said that is why? Ever hear of that. I just know that I don't sleep because, even though this thing is small, it must be very happy and content on my bladder.

I was told not that large fibroids could damage other organs but that there could be some friction, because of the above mentioned overcrowdedness.

Well, this isn't what I was hoping for. All three doctors in my clinic (two OB/GYN surgeons and the Oncologist) have banded together and are now united in their opinion that, due to the fact that neither the ultrasound, nor CAT scan, nor the MRI were able to rule out cancer, the only treatment they will offer me is a total abdominal hysterectomy and BOS (removal of both ovaries), scheduled to take place this Tuesday 11/21. They are not willing to make a "mid course" change in plans after getting a visual look at the mass during surgery. Its all or nothing.

The fact that the soonest I can get a second opinion isn't until Dec 8th, and who knows how long after that to schedule a procedure to remove the fibriod, and the fact that my doctors keep throwing out the "C" word, makes me just want to get this over with as soon as possible.

If I delay the surgery in an effort to find a doctor willing to save one ovary and the cervix, only to find out it is cancer, I would never forgive myself.

At this point, I can only hope it is indeed just a fibroid, and that I won't get lost too deep in the Hormone Jungle.

Fingers crossed,
Christine

Hi Safeandhealthy

I agree with the other writers get a 2nd and 3rd opinion.
Let me teel you why, I was diagnose about five years ago (before my surgery) and I waited and prayer, then I got a 2nd opinion from a female gyno, I then waited another 6 months before I made a decision, upon making that decision my doctor then told me Wendy I am saving your cervix , so I had a sub total (partial) abdominal hyst. on Aug 3, 2006 and I feel that my life was restored to me.
I FEEL GREAT and it's over 3 months, I had no complications (just a little gas) and I resumed full time work after three weeks.