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  • Q&A with Australian Health Practitioners

    When is a hysterectomy recomended for fibroids?

    Related Topics
    Fibroids Women's Health
    I have fibroids and am currently taking medication to reduce the size. Is it possible that I may need a hysterectomy?
    • 2 answers
    • Dr David Rosen
    • Dr Yogesh Nikam
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    Dr David Rosen

    Gynaecologist, Laparoscopic Surgeon

    Dr David Rosen is a Specialist Endoscopic (Keyhole) and Robotic Surgeon with expertise in; Prolapse and Incontinence surgery, Endometriosis, menstrual disorders including complicated Hysterectomies by … View Profile

    Fibroids may be completely without symptoms depending upon their location within the uterus. I do not reccomend medication to reduce the size of fibroids unless the aim of reducing the size of the fibroids is to facillitate removal at the conclusion of the cours e of treatment. This is because
    a. The treatment usually has side-effects that can be quite unpleasant, and
    b. The treatment that I think you are using destroys the normal capsule of the fibroid making fibroid removal (myomectomy) more difficult

    In our practice 99% of surgery is performed laparoscopically and the size of the fibroids or uterus does not really make any difference. A hysterectomy is a very effective procedure for the management of fibroids as it guarantees that they can never return and that pain, heavy bleeding or pressure symptoms (depending upon which effects you) will cease to be a problem. Of course it is only suitable if child bearing is no longer desired. In specific answer to your question, depending on your age and the size of the fibroids you may need surgery after completing the course of therapy  as the fibroids will continue to grow once the treatment stops. If so, you should seek out gynaecologists specialising in advanced laparoscopic surgery so that the procedure can be done as a keyhole procedure rather than requiring a large abdominal incsion.

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  • Dr Yogesh Nikam

    Gynaecologist, Laparoscopic Surgeon, Obstetrician

    Dr Yogesh A Nikam is a Specialist Gynaecologist, Laparoscopic and Robotic Surgeon who understands that no woman’s body or experiences are the same, which is … View Profile

    Hi

    Depending on what medication you are taking, the results can be variable. Fibroids will return to their original size when the medication is stopped. I presume fertility is not a concern as all drugs that treat fibroids are antifertility medications

    Medical treatment is a temporary measure, either to ease surgery or tide over to menopause.

    To answer your question, Hysterectomy may be needed if

    1. Medications fail to control your symptoms

    2. Fibroids fail to respond to the medication

    3. You can't continue the medications due to side effects

    4. Fibroids show changes in their architecture.

    You should see and follow up with a specialist gynaecologist who can monitor your symptoms and the size of the fibroids.

    Hope this helps

    Dr Yogesh Nikam

    www.aevafem.com.au

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