Caution: You may not need a myomectomy

I just talked with my regular OB.  He was under the impress that I had a Mullerian Anomaly (such as a septate uterus) and a major contributor to my recurrent pregnancy loss.  I’ve seen a Reproductive Endocrinologist recently who came up with his own recommendation.  He suggested that my 1-1/2 inch fibroid was distorting my uterine cavity and causing the recurrent pregnancy loss.  He said that he would be “very concerned” about that fibroid.

I double-checked my obstetric records from my 2004 pregnancy.  The fibroid was discovered during a 10-11 week ultrasound (a first-time mom, I was nervous that the midwife didn’t find my baby’s heartbeat).  The fibroid was roughly 4.5 cm then and is therefore about the same size now.  However, I don’t believe it to be a cause of my recurrent losses.  Rather, it is a symptom.  It is a symptom of imbalanced hormones, usually too much estrogen.

Anyway, my OB’s nurse called me today to say that he (my OB) would NOT recommend a myomectomy for a non-symptomatic small fibroid.  I don’t bleed without stopping; I don’t have unmanageable pain.  Since I already have a cesarean scar, he sees no reason to add to that.  Phew!

So, if anyone tells you that you definitely need a myomectomy, please do seek other opinions.  Your uterus may just say “thank you.”  In my case, it should be thankful that I’m saving it from at least two more uterine surgeries.

13 responses to “Caution: You may not need a myomectomy

  1. Thats great for you. I think I will have to have a myomectomy though. I haven’t even been able to get pregnant and my RE thinks my rather large fibroid is screwing with implantation. It sucks because I trully am scared to have this surgery and have already had two unsuccessful hysteroscopic surgeries.

  2. Echloe, I’m sorry that your fibroid is causing you trouble. How big is your fibroid? Mine is 2.8×2.8×1.9 (or something like that). I think that’s roughly the same size as when I was pregnant with my daughter 4 years ago – around 4cm diameter.

    I hope that the myomectomy is helpful for you. Are you going to have a laproscopic or abdominal myom?

    Best wishes to you!
    ~ Kimberly

  3. About two years ago I had a first-term miscarriage. (I didn’t even know I was pregnant at the time.) Earlier this month I lost a son to pre-term labor at 20 gestational weeks. According to my doctors, they are unsure what caused the pre-term labor. Two weeks later I had to have a D&C performed due to retained placenta. The doctor who performed the D&C is recommending a laparoscopic myomectomy to remove my cue ball-sized fibroid, which is approximately 6 x 6 x 6 cm. (When I went to my first prenatal appointment, the doctor told me the fibroid may or may not cause problems during the pregnancy.) I have done alot of online research and am worried about a number of things related to this surgery; specifically scar tissue, uterine rupture during delivery, and having to have a cesarean when I do get pregnant again. It sounds to me like you would suggest that I have a second opinion regarding this recommendation for a laparoscopic myomectomy. Do you think a consultation with a Repoductive Endocrinologist would be helpful before making plans to get pregnant again?

  4. Sonja,

    Thanks for visiting my blog. I don’t mean for this to ring hollow, but I am so sorry to hear about your losses. I hope you are doing ok emotionally and getting a lot of support and TLC.

    Where is your fibroid located? Is it in the muscle or actually bulging into the uterine cavity. There are other types of myomectomies – abdominal (which does require a hospital stay, but the incision is similar to a cesarean incision) and hysteroscopic (a possibility for the myomas that protrude into the uterus).

    I would recommend consulting with a RE who has a sub-specialty in reproductive surgery to further investigate these losses. Unfortunately you may never really know. Regardless, yes, you DO need at least a second opinion if not a third before you undergo an invasive surgery.

    What sort of diagnostics have been done thus far – HSG, 2-D ultrasound, 3-D ultrasound, MRI, sonohysterogram, hysteroscopy, anything?

    Hugs,
    Kimberly

  5. Hi, this is my first time on this blog–I was looking for blogs about pregnancy/fibroids/myomectomies/etc. and I think I found one! I gave birth three months ago by scheduled C-section and during the C-section the doctors gave me a myomectomy and removed a five pound 11 ounce fibroid. Huge. I got pregnant when the fibroid was about the size of 20 weeks of pregnancy and the fibroid just grew and grew during the pregnancy. I would definately get a second and third opinion before having a myomectomy on a fibroid of that size. I had absolutely NO trouble getting pregnant. My pregnancy was, however, a total nightmare (bedrest, placenta previa, frequent high risk doctor visits and ultrasounds, hospital time, planned C-section at 37 weeks, etc). I was HUGE and in A LOT of pain. But, it was totally worth it. Who knows what would have happened if I had the myomectomy before having a baby? I don’t know the extent of the scar tissue–it could preclude me from having additional children (at least without complications). Its a terrible surgery, I would avoid it if possible.

  6. Hi Sarah,
    I’m glad you found me and this blog. I really appreciate your advice. I have no intention currently to schedule surgery. Why would such a small fibroid be causing so much trouble? However, I did see on the u/s that it IS indeed distorting the shape of my uterus. I just find it unlikely that 3 babies would have chosen the same bad part of my uterus. Ain’t our biology smarter than that??

    I’m glad everything turned out well for you. Thanks for reading!
    ~ Kimberly

  7. Kimberly,

    First let me extend my deepest sympathies to anyone who may be reading this who has experienced a loss. (When I first wrote, I was feeling bitter: and admittedly, still am, about what appears to have been a senseless loss.) Since I lost my child, I have heard countless stories of women like myself, who have lost mulitple children, prior to the medical professionals being able to determine a likely cause, much less a plan of action. It makes me angry when I think about all the lost children and the parents’ anguish!

    Kimberly: sorry so long without a reply. I appreciate your heartfelt and warm thoughts regarding our loss. I am grateful to you for your insightful suggestions regarding seeing an RE with a sub-speciality in reproductive surgery.

    In answer to your question regarding my fibroid, it is in the muscle, near the top of my uterus. Regarding testing, we haven’t had any yet. I am embarrased to report that I have not heard of most of the diagnostics that you referrenced in your response; however, I plan to inquire about them at my post-op visit tomorrow.

    Sarah, please allow me to rejoice with you regarding your healthy, new baby! I am so glad to hear that you have a healthy baby despite the terrible discomfort during your pregnancy. I am glad that you shared your story with the rest of us. However, while I know that every woman is different; it is SO frustrating to hear stories like Sarah’s after my loss! It makes me wonder all the more why I wasn’t able to carry my baby closer to viability when my fibroid was no where NEAR the size of yours! (And, yes, they DID know about it!) I hope that that doesn’t sound mean: but I have heard several stories since my loss (both positive and negative) and they really have made me think and have tested my faith. (Has anyone heard about the 2’7″ woman who was able to deliver a baby!) Well, I have alot of questions for the doctor who preformed my D&C. And I also have the daunting task of trying to find an excellent OB/GYN to begin this all over again. (It seems that every OB/GYN to whom I have been referred recently — one who helped perform modern-day, reproductive miracles in the lives of women I know–have retired. If any one has any suggestions for finding a good OB/GYN, please don’t hesitate to share. Thanks, all, for your understanding, patience and advice as I travel the most difficult journey of my life.

    Sincerely,
    Sonya

  8. First let me extend my deepest sympathies to anyone who may be reading this who has experienced a loss. (When I first wrote, I was feeling bitter: and admittedly, still am, about what appears to have been a senseless loss.) Since I lost my child, I have heard countless stories of women like myself, who have lost mulitple children, prior to the medical professionals being able to determine a likely cause, much less a plan of action. It makes me angry when I think about all the lost children and the parents’ anguish!

    Kimberly: sorry so long without a reply. I appreciate your heartfelt and warm thoughts regarding our loss. I am grateful to you for your insightful suggestions regarding seeing an RE with a sub-speciality in reproductive surgery.

    In answer to your question regarding my fibroid, it is in the muscle, near the top of my uterus. Regarding testing, we haven’t had any yet. I am embarrased to report that I have not heard of most of the diagnostics that you referrenced in your response; however, I plan to inquire about them at my post-op visit tomorrow.

    Sarah, please allow me to rejoice with you regarding your healthy, new baby! I am so glad to hear that you have a healthy baby despite the terrible discomfort during your pregnancy. I am glad that you shared your story with the rest of us. However, while I know that every woman is different; it is SO frustrating to hear stories like Sarah’s after my loss! It makes me wonder all the more why I wasn’t able to carry my baby closer to viability when my fibroid was no where NEAR the size of yours! (And, yes, they DID know about it!) I hope that that doesn’t sound mean: but I have heard several stories since my loss (both positive and negative) and they really have made me think and have tested my faith. (Has anyone heard about the 2’7″ woman who was able to deliver a baby!) Well, I have alot of questions for the doctor who preformed my D&C. And I also have the daunting task of trying to find an excellent OB/GYN to begin this all over again. (It seems that every OB/GYN to whom I have been referred recently — one who helped perform modern-day, reproductive miracles in the lives of women I know–have retired. If any one has any suggestions for finding a good OB/GYN, please don’t hesitate to share. Thanks, all, for your understanding, patience and advice as I travel the most difficult journey of my life.

    Sincerely,
    Sonya

  9. Pingback: Recurrent Pregnancy Loss Update « The Trial of Labor

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