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Gynecology

Hysterectomy for cervical fibroid

05/06/2008

Question:

I have had 3 vaginal myomectomies to remove a cevical fibroid (in between the 1 & 3 o`clock position).It has grown back in the same spot each time. It`s back a 4th time & I`m also 30 weeks pregnant.This fibroid causes alot of pelvic pain & recently started coming partially out of my vagina during BM`s,sneezing.Previous pathologies have come back benign but with increased mitotic activity, which seemed to concern my ObGyn & the Oncologist I was referred to.I will be having a hysterectomy 6 wks post partum &was wondering if I am a canidate for a vag hysterectomy, an LAVH or will the fibroid compromise that & require an abdominal hysterectomy.Current fibroid measures 4.9cm x 5.1cm as of 3/27/08.was 1.4cm x 1.5cm on 12/28/07. Thank you in advance for your time.

Answer:

It could be performed as a vaginal hysterectomy if the fibroid didn't obstruct the access to the vaginal apex. It could also be performed as an LAVH, where vaginal access is less important. Without actually examining you, I can't determine if it is possible for you. Also, depending on whether or not your doctor needs to sample your lymph nodes would also come into consideration.

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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