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Re: endometioma and hysterectomy..?From: J.Glenn Bradley MD (anonymous@obgyn.net)Sun, 28 Jun 1998 12:21:24 -0500 (CDT)
At Sun, 28 Jun 1998, Lisa wrote: > >i am 37.frequent periods/exam last yr. resulted in lap. & d&c to >remove "suspicious-looking" surface area and tie tubes. no >complications; periods returned to normal. > >march began frequent periods again; dr. insists on provera, i insist on >other choices. he does exam, finds "pelvic mass, enlarged uterus". >vaginal sono. shows large mass, left ovary/fallopian tube. blood work >done, sent home to wait out my cycle (2 wks.) and see if this thing >would shrink. 5 days later, dr. calls to see me "right away". wants >pelvic ct and chest x-ray (WHY?) immediately, pre-op blood work NOW, >with surgery no later than next week. got to remove this thing he now >thinks is an endometrioma. > >from what i read, there is no emergency with endometrioma...why the >chest x-ray (except my complaints of fatigue, perhaps)..now the >laparoscopy (one-week down-time, relatively un-complicated, as before) >to remove this has turned into a laparotomy (which i understand is much >more complicated and has longer down-time, more risks, etc.)and possible >hysterectomy. i understand that adhesion would cause the "part adhered >to" to need to come out with the endometrioma however, my concern now is >that i do not trust my dr. to be selective in his removal process. i >fear the typical "oh, she won't need any of this any more sydrome" and a >life-change that i do not feel is necessary at my age. > >monday, i will visit with my dr. again to ask more questions. are >there any key-things to ask that will help me understand what all the >rush is about and how i can prevent an un-necessary hysterectomy by a >dr. with a tee time he doesn't want to miss? my choices in this area >are limited and, he seems pretty confident he's doing the right thing >but, two surgeries in less than a year on an otherwise VERY healthy and >very aware-of-her-body individual is making me very uncomfortable with >this dr. right now. > >any suggestions? words of encouragement? "qualifying questions to ask? >please respond! i thank you all, in advance and apologize for my >lengthiness. Lisa:There is a load of material on obgyn.net re:hysterectomy alternatives as well as info on abnormal uterine bleeding, and options for therapy. A repeat laparoscopy to assess the nature of the cyst, consideration of laparoscopic removal of the cyst/ovary, and possible endometrial resection and ablation (OPERA) for permanent alleviation of the bleeding would be a more conservative surgical approach if that is your desire. Ask about these alternative approaches, and always remember if you are not comfortable with the proposed treatment approach, consider a second opinion. Good Luck
Dr.B
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