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Gynecology

Is a hysterectomy a good choice for me?

03/25/2008

Question:

My latest annual endovaginal exam shows no great increase in fibroid size, but my uterus size has increased from 10.8cm. to 11.2cm. in length, 6.9cm. to 11.4cm. in AP dimension and 5.7cm. to 8.5cm. in width. I have many fibroids, the largest at 4.6 x 3.5cm and two others in the 3.5cm. range. I am 54 years old, still having regular periods with very heavy bleeding but no real pain or other symptoms. Should I consider hysterectomy and if so, could it be done vaginally? Thanks!

Answer:

A hysterectomy for uterine fibroids should be considered for heavy bleeding, pelvic pain/pressure or rapid enlargement of the uterus. Heavy bleeding is more than 7 days, passage of clots or anemia. Pain or pressure that is bad enough that it isn't relieved with medication. Lastly, a rapidly enlarging uterus is one that increases by more than 6 gestational weeks in a year. Other than the size of the uterus, most of the indications are based on how badly the symptoms are bothering you. Abdominal versus vaginal depends on the size of the uterus as well as other indications such as prior surgery, previous vaginal deliveries, etc.

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Response by:

Thomas  A deHoop, MD Thomas A deHoop, MD
Formerly Associate Professor of Clinical Obstetrics and Gynecology
Director, Medical Student Education
No longer associated