Fibroid FAQ's

July 8, 2011
Paul D. Indman, MD

It is important to find a surgeon who takes time to talk to you and after a thorough evaluation discusses all of your treatment options. It's difficult to evaluate surgical skills without talking to medical personnel who observe surgery, but you can get some idea of someone's comfort level with a procedure by talking to them.

 

How do I select a surgeon? 

It is important to find a surgeon who takes time to talk to you and after a thorough evaluation discusses all of your treatment options. It's difficult to evaluate surgical skills without talking to medical personnel who observe surgery, but you can get some idea of someone's comfort level with a procedure by talking to them.   While it's important to understand that there are risks to any surgery, I would be steer away from anyone who states that myomectomy is too difficult to do, bleeds too much, or does if they do not seem comfortable with the procedure.  While there is no fixed number of cases required to gain the necessary skill, you want to be sure that you have someone who does more than an occasional myomectomy, and who has the expertise and determination to complete the procedure. 

Are fibroids cancerous?

Fibroids are benign tumors.  This risk of cancer in a fibroid is estimated to be less than 1 in 500.  There's in no evidence that benign fibroids will become cancerous.

Will my fibroids grow back?

Once fibroids are removed those particular fibroids cannot grow back.  But fibroids are caused by genetic mutations within uterine muscle cells.  This process can over time create new fibroids.  In addition, there can be tiny fibroids that cannot be seen or felt, and therefore cannot be removed.  This is most likely to happen in someone who has many little fibroids.  Recurrence is least likely in women with one or few large fibroids than with multiple small ones.

What can you tell be about shrinking fibroids with Depo-Lupron®.

Depo-Lupron® is a medication that induces temporary menopause.  This causes modest and temporary shrinkage of fibroids.  It is not a long term solution, but is used at times prior to surgery.  I offer it for large fibroids if I feel it will allow a substantially smaller incision.  Most women have annoying but tolerable side effects such as hot flashes.  Disadvantages of Depo-Lupron® include the possibility that it may make small fibroids more difficult to find so that they are more likely to be left behind, and that at times it can make it more difficult to separate the fibroids from the wall of the uterus.  I will recommend its use occasionally for very large fibroids, but in most cases see no advantage to its use.

I will be adding FAQ's as they come in, so keep watching this spot

-PDI

Visit Dr. Paul Indman's site:All About Myomectomy for Removal of Uterine Fibroids