Surgery or wait and see?

I am a 38 yr. old who has 2 fibroids that show up on ultrasound. One is a 4inch pedunculated fibroid outside the uterus, the other 2 are about 1inch and in the lining of the uterus. Currently the only problem I have is some monthly pain around menstruation usually lasting for a few hours or all night. I am not anemic nor having any bowel or kidney problems. Is it necessary at my age to undergoe a myomectomy at this time or can I wait and follow their growth w/ ultrasounds every 6 months? I am not prepared to undergo surgery at this time – I am concerned that if they are removed, I may develop more and by age 45 will have to have another operation. I am still 4-5 years away from the period of time when fibroids cause the most problems for women. I’m not sure that having surgery at this time is the best decision. That perhaps I should wait and monitor them. They may stay the same and if they do grow then it might alleviate having to undergo surgery more than once. What is your opinion? I am terrified of any kind of surgery and a myomectomy is major surgery with risks of blood loss, infection and adhesions. Please advise. Thanks.

Dear Cara-
The wait and see approach is a typical response from most gynecologists. Your tumors will only continue to grow with every cycle, the longer you wait the greater the chance of a hysterectomy with traditional medicine.
Your concern of recurrent tumors with a traditional myomectomy is very valid-this is one of the reasons we perform FAS. Our procedure is extremely intensive and thorough and remove approx. 25 tumors per patient-sometimes many more. Our patients have a significantly reduced recurrence rate. We also do not transfuse patients despite basketball size tumors-lasers and vascular techniques help us prevent extensive bleeding. The decision is yours.

Dear Cara,

I am writing to you because I used to be in your shoes at about your age, too. I was 37 when I was diagnosed with fibroids and lost a pregnancy thanks to a doctor who didn’t even notice either of my conditions! Sounds unreal, but I can assure you, if I knew at that time that FAS was an option, I would have solved many problems along the way, meaning the next 8 years. Finally I did have this surgery 8 months ago and I can truly say it’s a lifesaver. If you are scared of myomectomy I don’t blame you – but FAS is designed and performed on an entirely different basis. If after having 37 fibroids removed I was able to walk for 2 hours only 5 days post-op to go shopping, then you can imagine I wasn’t exactly an invalid! I hope you read this post and start researching options NOW, because time is always short when it comes to health-related decisions.
Good luck,

Mica