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Old 05-28-2011
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ObGyn Leiomyomas

Hello friends,

When is observation the answer when dealing with a leiomyoma vignette?

Thanks a lot
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Old 05-28-2011
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Mangement Options
No single treatment plan is best for all women with fibroids.. Important factors in deciding therapy are the severity of the symptoms, associated symptoms, age, and preservation of fertility:



Hysterectomy:
This is the only permanent cure for fibroids. It provides definitive treatment, but requires major surgery, abdominal, vaginal or laparoscopic.

Myomectomy:
Removal of just the fibroid, with conservation of the rest of the uterus. For women who wish to preserve their childbearing capacity, this option may be the best. Unfortunately, myomectomy is often a more complicated procedure than hysterectomy, involving longer recovery, greater risk of blood transfusion and infection.
Birth Control Pill/Progestins:
While these will not shrink fibroids, they may be effective enough in controlling the symptoms (particularly bleeding) that the patient can make it through to menopause.
GnRH Analogs:
Through suppression of the release of gonadotropins, these effectively reduce estrogen concentration to menopause or near menopause levels. This has the desired effect of shrinking the fibroids. Unfortunately, after 6 months, when the GnRH must be stopped, the fibroids will rapidly re-grow, making this a temporary treatment. But temporary treatment may be very satisfactory if the goal is to shrink the fibroids to a more manageable size prior to surgery. The menopausal symptoms can usually be controlled with add back estrogen, if desired.
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aktorque (05-28-2011), docoftheworld (05-28-2011), Future Radiolog (05-28-2011)
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Old 05-28-2011
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Perhaps someone could provide vignettes or examples of question that would describe a case wherein (observation only) is the answer? its still not clear in my head
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Old 05-28-2011
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I guess if the mass was discovered by routine examination and did not cause any Symptoms, then observation is the answer ?
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