Dr. Mohamed Omar
General Surgery
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I need a consultation to decide on a health issue. For the past four and a half years I have been suffering from menorrhagia and metrorrhagia due to a fibroid. I tried ayurveda for three years and homeopathy for almost a year. Ayurveda did not work only with medication and they suggested to go take panchakarma treatment. Homeopathy started working for four months and the prolonged heavy bleeding stopped now. The bleeding was there for almost five years on each and every day with few months stopped now and then.
At this juncture, I just got an endometrium biopsy and an ultrasound to monitor the size of the fibroid. My gynecologist suggested immediate hysterectomy to remove the uterus and my Homeopathy doctor asked to try for three to four more months and if homeo treatment fails, then go for surgery. This gynecologist does not believe in any alternative systems. I sent my reports to my ayurvedic doctor too, and he said surgery is not needed. The biopsy report says 'simple hyperplasia without atypia'. Because of prolong non-stop bleeding for years, now I have anemia and went for infusion. I need a second opinion on hysterectomy if it is needed or not. In case if it is needed, when can I go for it?
Hi,
Welcome to icliniq.com.
Failure of conservative treatment and dropping your hemoglobin level to that extent indicates the urgency of surgery. Where is your recent CBC report? If your level of hemoglobin is less than 8 gm/dL then you are at the risk of several diseases affecting the cardiovascular system.
Patient's Query
Thank you doctor,
My query is, is this hyperplasia really dangerous and turns into cancer in the future? The report says the chances are less. If I wait until menopause, does it cure by itself? I have not gone for CBC again, will do now. Are there any iron and hemoglobin levels that I attain unless I should not go for surgery? I mean, what levels of hemoglobin should I have for surgery? Because surgery also creates a loss of blood to some extent right?
Hi,
Welcome back to icliniq.com.
Continuous bleeding and blood loss cause many health issues and risks. The source of this blood loss is your uterine fibroid. Conservative management if failed we proceed for surgery to stop the source of bleeding in your case. To avoid the fear of malignancy, hysterectomy is the only choice.
About the operation risk and side effect, the surgeon who will operate will tell you about it, because he is the one who had examine you. And as for the risk of blood loss during operation, the incidence of this decrease in hands of an expert surgeon.
Patient's Query
Thank you doctor,
The reason for asking questions is, now the bleeding has stopped with a changed medicine in homeopathy. It stopped for four months. My homeo doctor says I must try three to four months of homeopathy further to see whether homeo can help shrink fibroid size. If fibroid sizes decrease in ultrasound, then I should continue with homeopathy to shrink and finally get rid of fibroid. He is very confident. My gynecologist here says fibroid is not an issue here to fear about, but the cells may turn malignant, that is what I should fear about according to her. That is why I am confused.
As far as possible, I want to avoid the surgery if it is not necessary. I have asked my friend's gynecologist regarding this. In her opinion also hyperplasia is not an issue. But my gynecologist is scaring me with cancer in the future. But as of now, bleeding is stopped.
My questions are: Is surgery the only option, even if bleeding has stopped? Is it should be done right away as my gynecologist says or can I take a little more time like five to six months (since the bleeding has stopped), to arrange someone to help post-surgery.
Hi,
Welcome back to icliniq.com.
If bleeding stoped and the level of hemoglobin increased above 10 g/dL without blood transfusion, then no need for surgery and just follow up by an ultrasound every six months for two years to see the size of the fibroid and if increased in size, proceed to surgery at once.
Patient's Query
Thank you doctor,
That is very useful. I know my gynecologist would not be happy with this. I had a feeling that she is pushing me towards the surgery. With your advice, I got some clarity.
Hi,
Welcome back to icliniq.com.
You are welcome. Keep in touch for further doubts. Do not forget to followup with an ultrasound every six months and CBC every two months.
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General Surgery
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