What is the suggested treatment for a 6 cm fibroid in a 41-year-old woman?

Question

Hello doctor,

I am a 41-year-old woman having a 15-year-old son. I have heavy periods and iron deficiency anemia. I was given an appointment for a salpingectomy next week and my coil got removed. The scan showed a six-centimeter fibroid in the muscle. I am also having pressure in the bladder and a frequent tendency to urinate. I cannot take any hormone-based treatment due to other health conditions. So I think surgery will be the only option. Is it unnecessary to have this operation next week? Or it would be better to have a subtotal hysterectomy by leaving my ovaries and cervix in place? I consulted my specialist and she still recommends salpingectomy. I cannot understand why? I am taking Lithium and Carbamazepine medications for bipolar disorder for the past 15 years. This is the reason I do not take any mood-altering or hormone-based medications. I am taking iron tablets daily for the past three years.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I went through your query and understood your concern.

It would be better if you send the scans and blood reports that have been done recently. For a woman of your age with multiple reasons for hysterectomy, it is better to have the ovaries and tubes to be removed as the ovaries have risks of cancer in the future. So in the case of hysterectomy and oophorectomy, you will need hormonal therapy to prevent menopausal side effects after the removal of ovaries. Menopausal symptoms include bone pain, hot flashes, loss of libido, and all the symptoms of post-menopausal life would be observed. But as said you cannot take hormonal medications due to other health issues. With many medical conditions surgery is difficult and mostly anesthesia department does not give permission for long surgery or longer unconsciousness. This is the reason you can have a subtotal hysterectomy with ring removal as this could be a less prolonged surgery when compared to total abdominal hysterectomy and salpingo-oophorectomy.

I hope this has helped you.

Thanks and regards.