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Hope For Fibroids
Poster (PDF)
To download Adobe Reader
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NOTE: The new section is not
intended to take the place of seeing a physician for a consultation.
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Case Example:
Urinary
Tract Infections
I have fibroids and get
Urinary Tract Infections (UTI). Can fibroids cause Urinary Tract
Infections?
Analysis: I have seen fibroids cause
increased UTIs because the fibroids can obstruct the outlet of the
bladder and cause some urinary retention. If the urine sits in
the bladder, it becomes a reservoir for infection. - William
Parker, M.D. |
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Case Example: DCIS
Breast Cancer – Fibroid, Uterus, and Ovary removal
My Gyn would like to remove my uterus and
ovaries in light of the fact that I was just diagnosed with DCIS
non-invasive breast cancer...stage o. I chose the
mastectomy - no radiation, no chemo, no Tamoxifen. If the lymph
glands are clear and they find no invasive sites after the mastectomy
I will be cured the doctor said. This is the only type they can
cure. What kind of doctor should I go to for a second opinion
about my fibroids, uterus, and ovaries being removed?
Analysis:
The
patient should consider getting a second doctor opinion from a medical
oncologist who deals with breast cancer. DCIS is not as
aggressive as breast cancer and you may be disease free after the
mastectomy. I see no reason to remove the uterus unless you are
having symptoms that YOU wish to resolve with surgery. This all
seems a bit drastic to me. – William Parker, M.D.
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Case Example:
A fibroid patient looking at pregnancy options
History: Diagnosed with fibroids
2001 during a routine Ob/Gyn visit. I wasn’t experiencing any
symptoms other than frequent urination and some heavy bleeding during
my period. Had ultrasound which showed one fibroid, 6 cm, on
front posterior of uterus. Fibroids in my family - Mother had
them.
Started fertility treatments the fall of
2002. I think this is when the second fibroid was spotted –
another one outside the uterus pressing on my bladder. My
Reproductive Endocrinologist (RE) could see them on the ultrasound
during cycles.
Had two cancelled cycles due to follicle
issues. The doctor noticed fibroids were enlarging as expected
from the hormones and thought they could block egg retrieval.
The doctor had me undergo an MRI which uncovered many small fibroids
in the walls of my uterus. Not sure how many, but I remember my
uterus looking like a bag of golf balls and a reference to it being
the size of a 12 week pregnancy.
My Reproductive Endocrinologist (RE)
thought that UAE was best option due to the number of fibroids, which
could result in a hysterectomy if a myomectomy was performed.
January 2003 I underwent UAE performed by
an Interventional Radiologist. There were no complications from
the procedure.
November 2003, had another IVF cycle which
resulted in 7 frozen embryos but they weren’t implanted because the
Interventional Radiologist said my uterus wasn’t ready.
January 2004, I had a repeat MRI and a
consultation. He gave me the go ahead to implant the frozen
embryos.
When starting FET cycle, Reproductive
Endocrinologist (RE) noticed what looked like another fibroid inside
my uterus which was the first interior one found. Since the
doctor couldn’t get surgery time quickly we setup surgery to have my
OB/Gyn remove it. During this surgery my doctor saw that my
uterus was filled with cotton candy like tissue which the doctor
couldn’t identify. I don’t think much was removed during this
surgery.
RE referred me to another specialist.
He said the cotton candy like substance was dead fibroid tissue and in
April 2004 he performed surgery to remove it. There might have
been another live fibroid in with the dead tissue.
At this point I stopped having periods.
During office exams the doctor diagnosed me with Asherman’s Syndrome,
which was scarring over my cervix and preventing me from having
periods. He removed the scarring several times in his office and
in July we started a FET cycle since my lining was looking healthy.
At the start of this cycle the doctor
found another live fibroid in my uterus and performed another surgery
in October to remove it. He wasn’t able to remove all the live
fibroid.
At this point I had another MRI done which showed quite a bit of dead
tissue still in my uterus walls. During a January 2005
appointment, the doctor said a myomectomy to remove that tissue
wouldn’t be successful since the tissue is very spongy and harder to
remove than a live fibroid. He also didn’t want to perform any
other type of surgery on me at this point. His advice was for us
to either use a gestational surrogate (GS) or pursue adoption as we
had discussed. If we adopted, he agreed to continue treating me
but didn’t know whether my uterus would ever get better.
This past May I started having a regular
discharge. I hesitate to call it a period because its very light
and brown but it does come on a 26/27 day cycle. At first it was
just a day or two but this past month it lasted several days. It
also includes some clots that are dark brown and very sticky – like
when I’ve ovulated. Having intercourse during this time
sometimes produces a little bright red spotting right after.
Currently I’m doing
acupuncture and herbal treatments along with massage therapy.
I’ve taken a Mind Body Class during my fertility treatments, and I
have changed my job to lower my stress level.
I try to exercise regularly and maintain
a healthy diet
(I'm slightly overweight). I am in my
early 40's.
Analysis:
As far as losing periods while ovulating,
Gaylene Pron in Toronto has reported a number of cases of
Asherman's syndrome (intrauterine adhesions)
after
UFE, which can
cause amenorrhea. - Paul Indman, M.D.
Analysis (Patient): At this
point of research - questions to ask the doctor.
1.
Can I expect the remaining dead tissue in my uterus to be
reabsorbed or expelled?
2.
Can I do anything to keep new live fibroids from forming?
Would
hormone therapy of any kind be helpful at this point?
3.
Is there anything I can do to encourage the ‘periods’ I have to
become stronger and more productive? Any medication that can do
this?
4.
Have you even known a woman in my situation to have a
successful pregnancy? If so, how long after UAE?
5.
Can I carry a pregnancy even with the dead tissue in the walls
of my uterus as long as my lining looks good and the interior is
fibroid free?
Medical Article:
“Influence of acupuncture on the
pregnancy rate in patients who undergo assisted reproduction therapy”,
Paulus et al., Fertility and Sterility 2002, Vol 77, p. 721,
Elsevier. [Entrez
PubMed] A 2002 German study, published in the
reproductive journal 'Fertility & Sterility', recounts how adding
acupuncture to vitro fertilization treatment substantially increased
pregnancy success.
One group of 80 patients underwent
embryo transfer with no acupuncture. The second group of 80
patients received two (2) 25-minute acupuncture treatments, one prior
to having fertilized embryos transfer and one after the transfer.
RESULTS: Clinical pregnancies were
documented in 34 of 80 patients (42. 5%) in the acupuncture group,
whereas pregnancy rate was only 26. 3% (21 out of 80 patients) in the
control group.
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Case
Example: Robot Assisted
Myomectomy for Uterine Fibroids
The largest of my
multiple tumors were around 8 cm and boy were they painful!
My OB/GYN removed 3 of them during my C-section in 2003, while leaving
the other fibroids behind. I had UAE done in 2004 and had
minimal results with it. At my last GYN visit my uterus measured
around a 14-week pregnancy. I am researching the following:
Robotic Assisted
Myomectomy and
Laparoscopic Myomectomy.
Analysis:
Robot assisted myomectomy: It is a device to simplify
laparoscopic surgery. When the bugs are worked out it promises
to allow laparoscopic treatment of some fibroids that otherwise would
require an incision. I played with one last year and it's nice.
It is very slow to gain acceptance because it's extremely expensive to
buy and use, and GREATLY extends OR time. I gather a few
hospitals that bought one are no longer using it because it takes so
long.
I think this, or a laparoscopic approach
may be good for one or a few fibroids relatively near the surface.
But if there are multiple or deep fibroids I still would like to have
the uterus in my hands in order to feel and manipulate the deep and
the small fibroids. No point in taking out the tip of the
iceberg and leaving the rest. Recovery from an abdominal
myomectomy is somewhat longer than through a scope, but not as much as
you'd think. More importantly is the question of how to do the
best procedure on the uterus. If it can be done with a scope or
robot (which is a scope) great, but it's not worth compromising the
procedure to use it.
Laparoscopic myomectomy is a procedure where a doctor inserts a small
device, laparoscope, through an incision in the abdomen to remove the
uterine fibroids.
– Paul Indman, M.D.
Refer to
Dr. Indman's web site URL:
http://www.myomectomy.net/laparoscopic_myomectomy.htm.
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