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Fibroids again, facing Hysteroscopic Myomectomy --Update! Fibroids again, facing Hysteroscopic Myomectomy --Update!

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Unread 06-28-2006, 04:58 PM
Fibroids again, facing Hysteroscopic Myomectomy

Hallo Dears
It's been awhile since I posted. Had a D&C with Hysteroscopy and insertion of a Mirena IUD last December, but learned today that one of my fibroids has grown significantly. Went in because of having three long periods in six weeks, and with the last one I was surprised when I flooded the seat in the car (enroute to photograph a wedding!). So today I saw my wonderful GYN doc, who gave me these options:

Ablation, Hysteroscopic Myeomectomy or Hysterectomy.

I told her I'd prefer the Myeomectomy...which may happen in August. I chose Myeomectomy because the uterine fibroid is in the uterine wall as well as taking up a big area in the uterus itself. It's not a huge fibroid, but it's a bleedy one and I do not want to get anemic again like last year. I'm 50 and sure wish menopause would kick in. So with this procedure I hope to buy another six months or so. Maybe this will be enough. If not...if the fibroids continue to wreak havoc with life, I think I'll go ahead with the hysterectomy next spring. (My doc says I'm a good candidate for a vaginal hysterectomy and that I can keep my ovaries.) One thing at a time, though.

Presently, here are my wonderings...

My doc said there isn't much more recovery time with this procedure than with the D&C (two days to a week of taking it easy, though there would probably be more discharge). Is that what others have found as well?
I REALLY need an honest answer on this for planning purposes. My first grandchild is due mid-August (which is when the surgery could be) and I do NOT want to miss my plane flight to meet her!! We hope to travel at the start of September. Thoughts on the timing? If need be I would wait until after we get back, for the surgery. Of course, I wouldn't want to flood the seat in the plane... You know how it goes.

Got a link to a good source for "What to expect with a myeomectomy"?

I have a couple of good books and will be checking there too, but they are a few years old and I want to be sure I'm up on the latest info.

Thanks! :smilie5:
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Unread 06-30-2006, 10:51 PM
Fibroids again, facing Hysteroscopic Myomectomy --Update!

There are several links the fibroid section of our resource database that may provide you with the information you are seeking:

Hysterectomy Alternatives -- Fibroids

You may also wish to use the search tab at the upper right of your screen and do a search for each of the for which you are interested. You can do the same if you use the resource tab to the left of your screen.

Before any surgery, I highly recommend at least a second medical opinion.

Many best wishes to you as you do your research and make the right decision for you!
Unread 06-30-2006, 11:38 PM
You'll be fine


I wanted to let you know that I have had three hysteroscopic myomectomies in the last 7 years and my recovery of all three have been very fast. I was not down more then two days for each. I found them to be very easy procedures. I had minimal bleeding and no pain. My first one was to remove a large fibroid and couple little ones. I lost a lot of blood so she had to quit. Three months later I had my second one. Unfortunately I have lots of small fibroids that have caused a lot of bleeding and pain for me so I have decided not to go down another myomectomy route and to go ahead with the hysterectomy. I can't live my life in pain and wondering what outfit I'm going to ruin this month.

I'm sure you will feel much better after the myomectomy and you will be recovered and ready to travel shortly after the surgery. I actually traveled for my third myomectomy and flew home within the week after it. Go away fibroids!

I hope this helps.

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Unread 07-03-2006, 12:41 AM
Fibroids again, facing Hysteroscopic Myomectomy --Update!

Thank-you, Jenny!

I feel very encouraged by your story.

I'm not too worried about the surgery itself, since it will be mostly similar to what I had before...though a bit more this time. I just needed that reassurance about being able to travel. It's especially helpful to hear that you flew so soon afterwards.

Given this (and the reality that I am menstruating for the fourth time in 8 weeks), I am pretty much looking forward to the surgery.
Unread 07-03-2006, 01:22 PM
Fibroids again, facing Hysteroscopic Myomectomy --Update!

Originally Posted by Kythe
So today I saw my wonderful GYN doc, who gave me these options:
Ablation, Hysteroscopic Myeomectomy or Hysterectomy.
You could have both the myomectomy plus the ablation at the same time and that would increase the chances of making it to meno without further problems.

I had both a myomectomy (for a moderate-sized fibroid that caused MAJOR bleeding problems and pain) and a roller-ball ablation during the same surgery. While I still have periods, they are better than they were. And my results may have been better if my doctor had been able to do a more complete job - I was bleeding a lot, I guess.

I needed about a week to feel normal (but I was also still recovering from severe anemia) and my husband and I went on an 18-day trip just ten days after the surgery. I had some very light bleeding and spotting for the first 2 1/2 weeks after the surgery, but really it was not very much at all.

I would ask your doctor about combining the two procedures.
Unread 07-05-2006, 07:52 PM
Fibroids again, facing Hysteroscopic Myomectomy --Update!

Thanks FauxPas!!

What good timing you have!
When I called the office today to schedule the surgery, I learned that the scheduler needs to talk to my doc one more time before we can schedule because she doesn't understand something the doc wrote. She read me some of it, and it included the words "roller ball"! So it sounds like my doc is thinking she'd like to do both.
I had already said No to an ablation, so that confused me, but it may be that this represents the difference between ONLY an ablation and doing the myomectomy WITH an ablation.

How did your path lab read, if I may ask? Someone mentioned to me recently that you can't tell if there's cancer present in the path lab report after an ablation, and since I registered pre-cancer and a bit more last time, I'd really like to know for sure.

I'm encouraged about the timing of recovery, though. May it be so! I could not bear to miss seeing my new grandbaby in early September!
Unread 07-05-2006, 09:29 PM
Fibroids again, facing Hysteroscopic Myomectomy --Update!

Originally Posted by Kythe
How did your path lab read, if I may ask? Someone mentioned to me recently that you can't tell if there's cancer present in the path lab report after an ablation, and since I registered pre-cancer and a bit more last time, I'd really like to know for sure.

I'm encouraged about the timing of recovery, though. May it be so! I could not bear to miss seeing my new grandbaby in early September!
Hi, I am Canadian and maybe the terms used are a bit different - but I'm not positive what you mean by path lab reading...???? I had a couple of endometrial biopsies before the ablation/myomectomy which came back normal. They also did testing on tissue samples of both the fibroid and the endometrium which were removed during the surgery. There was no sign of cancer.

I have been told that it is a bit harder to detect cancer after an ablation, but I have never heard that it is impossible. If you have had some pre-cancerous cells, I guess you need to talk to your doctor about the implications of an ablation.

As for recovery time, if I hadn't been so severely anemic, I think I would have been OK to travel after a few days.
Unread 07-06-2006, 09:22 AM
Fibroids again, facing Hysteroscopic Myomectomy --Update!

Hi FauxPas,

I'd say you got the meaning of a "path lab" report from the context just fine. It is the lab report that comes back after a procedure is done and the pathology laboratory has had chance to analyse the information.

Sounds like you had quite a rough ride. I hope you're feeling better now.
Unread 07-10-2006, 01:55 PM
Update! Both Myomectomy & Ablation: Here's Why

Greetings Dear Friends

MY DOC CALLED A SHORT WHILE AGO TO DISCUSS MY SURGERY. Following my visit with her, when we did a new sonogram and talked about my options, I called the office to schedule the surgery and was quite surprised to discover she had me listed (in my chart) as having two procedures instead of just one! Today I learned what happened:

Since the scheduler was on vacation the week of my doc visit and my doc would be on vacation the following week, she left a message for the scheduler to plan for 2 hours in the O.R. to do two procedures. This is because as my doc was thinking over my situation, after I left, she thought doing a roller ball ablation along with the agreed upon hysteroscopic myomectomy would be a good idea, and figured we could always use less time if I didn't want both, but getting more time in the O.R. after you've scheduled for less is very difficult.

Then she told me that of all her patients, I am the one who is the best candidate for hysterectomy. ( ! ) That really surprised me, given some of the posts I've read here that sound so much worse. However, I am catching it early this time around (just edgng into anemia and got the iron going; tired but not utterly depleted like last time). She is certainly willing to do the least we can do to set things right. My sense of it is that my situation is in a downward progression, as the bleeding has been worsening slowly but steadily and periods getting closer together. (Four long ones in nine weeks is really a bit much!)

I questioned the wisdom of an ablation since burning off the endometrium makes early detection of cancer much harder or impossible. She said that understanding is not conclusive but, yes, cancer could grow undetected beneath the scar tissue left by an ablation. She pointed out that the incidence of such cancer is very low. However, given that I had pre-cancerous cells (and a few more concerning as well) she made a suggestion, which I have agreed to:

If she can get all of the offending fibroid she won't do an ablation. Instead we'll wait a few weeks for healing to take place, then she'll reinsert the Mirena IUD ~ which has worked great for me in keeping the endometrium nice and thin. (It was very thick and worrisome back in December before my first surgery.) If the fibroid puts up too much of a fight (it's partially in the uterine wall), then she will take what she can of it, and use the rest of the time available to do as much of a roller ball ablation as possible. Time is limited by the fact that she is allowed a finite amount of fluid for doing her work, to keep it all safe.

The point is to end or minimise the bleeding I'm experiencing. I am fully aware that I still may end up with a hysterectomy next year, but I want to try to do the less invasive thing first.

She said to plan on one day post-op very crampy and bleeding, several more days of bleeding, and four weeks of tan to pink discharge as the uterus regroups and expels leftover cautery, etc.. I am going to take 5 days at home, and two weeks off from my part-time job.

Looks like August 10th will be the date; just waiting on the hospital O.R. folks to confirm availability with the doc's office.

Prayers and Good Vibes gratefully appreciated!
Unread 07-10-2006, 02:03 PM
Fibroids again, facing Hysteroscopic Myomectomy --Update!

I am glad that you will be able to try a less invasive surgery, to see if it will resolve your situation. Many best wishes to you for your upcoming surgery!


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