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20 Week Fibroid UterusFrom: Suddoc@aol.comTue Oct 31 01:22:09 1995
I have a 47 yo G2 P2002 patient who has a 20 week fibroid uterus. She has regular menses of normal flow and no pain. She is asymptomatic. When first seen in 1993 I did an endometrial biopsy which was benign and an IVP which was within normal limits. She was against surgery of any type. I treated her for three months with Synarel with the warning that it will probably regrow which it did. It did shrink to 15 week size. ! used a course of Danazol for nine months in 1994-early 1995 (starting with low doses and reaching 800 mgm/day) which had some but not as impressive results, I then opted for expectant management. It has regained all of its former glory and seems to have picked up some additional lateral volume so I am ordering another IVP. The patient is intelligent, she travels on her job most of the week. She is thin so that her abdomen protrudes as a 20 week pregnancy. When the uterus would shrink she did notice that her clothes seemed to fit better. She would like to try medical therapy again (surgery is again out of the question). Does anyone have any experience treating fibroids with long term GnRHa therapy using "addback". I have no idea when she will enter menopause other than the statistical age of 51.5. If that is so (or longer), this would end up being several years of expensive therapy. Otherwise this patient seems content to let her uterus grow until it becomes symptomatic or causes renal obstruction Thanks. Stephen Sudler, M.D. Private Practice Haverhill, MA
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