FAS vs Laparascopy Myomectomy

Dear Dr.delJunco Jr.
My name is LaVieta and I have as 6 fybroids that were seen on ultrasound. I have had 3 yrs of heavy bleeding, mood swings,and all the problems that they create.I am going to see a Dr.in Colorado where I live that does Laparascopy myomectomies.What is your view on this?Thank you,LaVieta

Dear LaVieta-
Laparoscopy does have a place in the treatment of some very superifical fibroid tumors. Unfortunately, we have found that ultrasounds are very inaccurate when revealing the number and extent of tumors. We have had several patients come to the Institute with their U/S reports only to discover in surgery the number of tumors is often 2 to 3 times as many. In particular, one patients had only 6 tumors on her ultrasound and I removed 65! Keep in mind, these tests are very nonspecific. Laparoscopy is capable of removing very surface tumors- but what about the tumors that are usually deep in the muscle or under the endometrium? These are often the tumors that produce the symptoms and these are the tumors that get left behind. With laparoscopy recurrence rates are high and side effects often return because all the tumors are not removed. With FAS the recovery is usually 4 weeks but at least you have the peace of mind that as many of the tumors as possible have been removed.
Sincerely,
Dr. DJ

Dear LaVieta:
I read this message after I wrote my reply to you,
but I wanted to add something. My ultrasound tests
revealed 5-6 fibroids and that’s what I thought I had. My uterus size was that of a 16-20 week pregnancy, and I could feel my left ovarian cyst. I had no idea I had a second right ovarian cyst, an endometrial polyp and even endometriosis. Basically my system was shut down and kept from
massive bleeding with Loestrin Fe 1/20, but ovarian production was beyond menopausal (FSH 68).
Now all my hormone tests are normal, which means
my body has returned to being functional.
Also, in case there is something else that needs
attention, I believe laparoscopically it would be
physically difficult to reach certain areas and then you may need another surgery. I don’t know how you feel about this, but I know it would be hard to take. Well, if you have specific questions, just post them. Regards, Michaela

Dear Dr.delJunco,
Thank you for this information.I suspected that you would say this,as I have done alot of reading on this.I spoke to this Doctor’s assistant about this I was told that your type of surgery would be long to recover from,so I wrote to Michaela to get her reply on her surgery. I am such a active person that the thought of being down for 8weeks was a little too much, so I asked you this question about the laparascopy myomectomy. I am just trying to get all my information. This is a major procedure.In your reply you said that not all the fibroids could be removed, why not? I am 53 yrs old and my hormones are all off and accordingly I am to be in menopause but I am still having periods. So does that mean that not all of the fibroids need to be removed? I wait for your reply. Thank you, LaVieta

Dear Dr.del Junco, I just wanted you to know that I am doing fine.It has been almost four weeks since my surgery and I still can’t believe that I had 40 Fibroids and ect.My body is responding by just feeling better and relieved that I no longer have any problems. I want to thank you again for saving my uterus and I want to tell everyone about it. May you continue helping others.I will see you in December. Thank you,LaVieta

I have had two sessions of bleeding contiually, not heavy but 38 days is a little long,. I have had tests and it shows nothing. I’m scheduled to see a gyn to discuss a roller-ball and maybe hysterectomy. What should I discuss and ask? I am 51, and certainly don’t plan to have more children.

Dear Pam-
You were not specific about the type of tests that had been performed. Before any procedure is done, a diagnosis should be determined or at least considered.
A D&C may alleviate your symtoms and is less invasive than a roller-ball procedure. Your physician should be able to discuss with you all your options depending on what he/she feels is the problem. Good Luck.