Q. What is the treatment for submucosal fibroid?

Answered by
Dr. Purushottam Sah
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 27, 2017

Hi doctor,

I am having submucosal fibroid over 10 years. Now for the past three months, I am facing irregular bleeding. My urine does not flow in a straight line when the volume is less. Also, I have a small cyst in clitoris which creates occasional itching, once or twice in a month. I am having this cyst for almost 12 years. Please help.

#

Hi,

Welcome to icliniq.com.

For submucus fibroid you can opt for hysteroscopic removal or arterial embolization or MRI-guided focused ultrasound therapy. Because, at 30 I do not think you would like to go for an open surgery.

Urine may not come out in straight line if volume is less and force is low. But, if you think it is a worrying problem you can go for simple procedure called cystoscopy.

Regarding the cyst on clitoris, no comment can be made without looking at it. For occasional itching you can apply any simple cream. Do not wash with medicated lotion or soap like dettol. Wash only with bathing soap.

For further information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hi doctor,

Will they cut uterus in the open surgery? Please explain the procedure. Can cyst in clitoris cause pregnancy problem?

#

Hi,

Welcome back to icliniq.com.

  • In open surgery your tummy is opened and uterus is cut through to remove the fibroid. If you are trying for pregnancy then it is not suitable for you.
  • Cyst on clitoris will never cause problem in getting a pregnancy or even during pregnancy. So, just relax.

For further information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hi doctor,

Regarding my irregular bleeding and submucosal fibroid I have consulted two doctors. Doctor whom I contacted first gave me Duphaston to regularize period and told me to go for laparoscopic ovarian drilling for PCOS and diagnostic hysteroscopy to check out the portion of the fibroid indenting into the endometrial cavity and said that he will do only resection of that part. Since my family is against surgery we contacted another doctor who did a second TVS to find out that only 20 x 21 mm is projecting into the endometrium. He put me on Novelon for 21 days and told me to do repeat blood test. He is not willing to do surgery right now. If doctor resects only part of the fibroid, can the remaining part easily grow during pregnancy? Novelon is actually birth control pill. So, once I come out of it, how long will it take to conceive? Also can this birth control pill grow the fibroid? Which doctor's prescription to follow? I am 30 already and crossed advanced maternal age? Will I be able to conceive in future if I rectify the defects?

#

Hi,

Welcome to icliniq.com

I have read and understood your problem.

Yes, any residual fibroid can grow during pregnancy.

Yes, hormones in Novelon (Desogestrel and Ethinylestradiol) may increase the size of fibroid. You can conceive any time after one to two months of stopping pills.

PCOS (polycystic ovarian syndrome) can be treated with medicines without going for laparoscopic ovarian drilling.

Up to the age of 35 chance of pregnancy is good, but suddenly drops after that. You are already 31, so you should not delay things anymore; earlier the better.

For further information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hi doctor,

My 2 cm fibroid is mostly intramural with 20 mm endometrium encroachment. What kind of surgery can get the entire fibroid out keeping the uterus intact? Even if I conceive after surgery should I take bed rest throughout pregnancy? Should I take Novelon for 21 days and then do a blood test for prolactin, AMH and LH as prescribed?

#

Hi,

Welcome back to icliniq.com.

  • For complete removal of intramural fibroid laparoscopic myomectomy is a better choice and if it becomes impossible then it can easily be converted to abdominal myomectomy keeping uterus intact and preserving fertility.
  • You may not need bed rest if you have no problem during pregnancy. But, you will have to avoid travel and exertion.

Remember that successful pregnancy and childbirth can occur without any complications in presence of fibroid. But, it cannot be predicted.

  • Taking Novelon for only 21 days does not make any sense, because it is not going to help you in fibroid problem.
  • For PCOS, it must be taken at least three cycles. Also doing blood test for prolactin, AMH (anti-mullerian hormone) and LH (luteinizing hormone) are not relevant for fibroid and are needed if you have very infrequent periods.

Also you should do the test before taking Novelon and not after, because hormones in Novelon may affect the test results.

For further information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hi doctor,

I have taken Novelon tablets for nine days totally in the wrong order. Today I realized it. Now what shall I do? Will this mistake affect my health? Should I start taking the correct order now? Will it affect my periods? Can a 2 cm intramural fibroid get removed by laparoscopy? Does the scar tissue cause uterine rupture or ectopic pregnancy later?

#

Hi,

Welcome back to icliniq.com.

I have read and understood your problem.

  • All the tablets have same composition; the order is there only to remind you. So, you take remaining tablets one tablet daily at fixed time. It will not affect your health or your periods.
  • Laparoscopy is good for sub-serous (on the surface) fibroids. But, a good laparoscopist can remove an intramural as it depends on skill. But, the scar is usually small and usually does not cause uterine rupture or ectopic pregnancy later.
  • You can try MRI-guided focused ultrasound therapy or hysteroscopy. Best wishes.

For further information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hi doctor,

I took Novelon for 21 days after my last periods. But, till date I did not get the period for this month. Only having some brownish mucus that too scanty amount since last 2 days. Is there any underlying problem? I did not have any intercourse over the last month. Can the scar tissue after myomectomy cause uterine rupture or septicemia later?

#

Hi,

Welcome back to icliniq.com.

  • You wait for one more week. Most probably you will get clear periods by then. There does not seem to be an underlying issue.
  • Chance of septicemia or scar rupture is very rare after myomectomy.

For further information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hi doctor,

After taking Novelon for 21 days I had some brown discharge like fake periods for 4 days. Now I am not on Novelon. Again after a week I started releasing brown discharge with mild cramping. The blood is brown and very thick and does not contain the foul smell like menstrual fluid. The bleeding is moderate. Is the bleeding due to fibroids or stopping birth control pill? Can the bleeding be due to endometrial or cervical cancer?

#

Hi,

Welcome back to icliniq.com.

  • The brown thick blood is usually not a fresh blood but some old blood clot which was retained and came out after being liquefied. This is very common and not related to any major problem.
  • The brown bleeding was from a part of bleeding that was not cleared after stopping of pills and does not seem to be due to any cancer.

Still I advise, if you are so much obsessed with cancer then you can go for a cervical cytology and relax.

Revert back with the answer to an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Thanks doctor,

Usually how long will this brown bleeding stay? Is this an alarming feature? The brown blood does not contain the foul smell of menstrual blood but it is producing mild menstrual like cramping. I do not have any family history of cancer.

#

Hi,

Welcome back to icliniq.com.

  • This should stop in some five to six days. Mild cramp can occur.
  • As you have no family history of cancer, do not worry about it.

For further information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hi doctor,

I had spotting only for third days. I had blood test and PCR test on the third day of menses. Prolactin came down normal and PCR test was negative. Doctor again prescribed me Glyciphage SR 500, Normoz tablet two times a day to be continued for 90 days and to take Cifran 500 from day 2 to day 11 of menses and advised to do HSG test on day 6 of the cycle. Doctor does not wish to operate for tumor as according to him the size is small. Now I got periods. On the basis of these facts I have the following questions. I wish to get conceive immediately. Doctor is treating me for PCOS even though I am having periods on time, but not doing anything for fibroid. Is this approach correct? Is HSG test painful and will I be able to resume normal activities after test? The volume of the blood in menses has decreased from last two periods but span is still the same. Is it alarming? If I am diagnosed with tubal blockage then is IVF the only option for me? Can HSG test give a correct position of the fibroid in the uterus than TVS ultrasound?

#

Hi,

Welcome back to icliniq.com.

Yes you need to be treated with these medicines as they help conception.

  • PCOS needs to be treated, even if period is regular, as I mentioned earlier fibroid cannot be treated with medicines but the size is less so it does not matter for pregnancy.
  • Only some discomfort will be present after HSG (hysterosalpingogram), you can resume activity after 30 minutes and can take pain killer like Paracetamol one hour before test.

Depends on the HSG report tubes can be opened in some cases by a HSG like procedure called hydrotubation.

No, for position of fibroid TVS (transvaginal scan) is best and HSG is not so good. You are advised it on day 6, it can be done up to day 10. The best is to do it at least two days after menstrual flow stops.

For further information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hi doctor,

I had my HSG test today. I did not feel much pain but radiologist told something like bilateral spillage. What does that mean? Will it be tough for me to conceive naturally?

#

Hi,

Welcome back to icliniq.com.

  • Bilateral spillage means both tubes are open and you have good chance of getting pregnant.
  • You can upload pictures of HSG.

Revert back with the HSG reports to an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Hi doctor,

My HSG reports are normal spillage seen on both sides of the tube and uterine cavity normal. Results of TVS ultrasound are uterine fibroid 16 x 17 mm compressing endometrial cavity. No dominant follicle seen on ovaries. Doctor has mentioned ovulation dysfunction in TVS ultrasound reports even though I am having regular periods. My cycle is 30 to 33 days. But, recently I found my vaginal mucous more fluid and a mild abdominal pain and increased sex drive. So, I am feeling that was the day of my ovulation. Doctor had told me to conceive and prescribed to take tablets Ovagen 50 and Darden on second day of my cycle if my periods do not stop for this month. I have heard Ovagen creates multiple pregnancies and my husband wishes to start this after three months and not now. Should I take Ovagen now? Is there any way to prevent multiple births?

#

Hi,

Welcome back to icliniq.com.

Your HSG report is good.

The uterine fibroid is small. Depends on the stage of menstrual cycle, your cycle is 30 - 33 days. So, on 11th day no dominant follicle may be visible.

  • Ovulation dysfunction can be diagnosed with serial TVS (folliculometry) and not with a single scan.
  • Your doubt regarding your day of ovulation may be true.
  • Multiple pregnancies are caused in small percentage and not in all women. Lower doses give some protection, if you do not want to try for the next three months then no need to take medicine now.

For further information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist


Was this answer helpful?

 | 

Related Questions:
Post fibroids operation there is gradual deterioration in health. What to do?

She had a fibroids operation seven years back ...   Read full

All about Cervical Cancer

.. detail about cervical cancer, one of the most common illnesses in women these days .. ...   Read full

Uterine fibroid detected during sixth week of pregnancy.What do I do?

For info,there are high chances of threatened abortion or placental separation in the early weeks of pregnancy due to such large fibroids, as the pregnancy grows due to inadequate room for growth and fibroid generally no...   Read full

 

This is a sponsored Ad. icliniq or icliniq doctors do not endorse the content in the Ad.

Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers


Can PCOS cause irregular periods?

Query: Hi doctor, I am a 28 year old unmarried woman. Last month my period was irregular. I got my periods on the 30th of last month and it was already 20 days later from the actual due. Initially, I had spotting for five days, then I bled for seven days and again, had spotting for three days. Now, I am bl...  Read Full »

Conquering Cervical Cancer

Article Overview: Cancer cervix (mouth of the womb or uterus) is one of the leading causes of death due to cancer in women. Read on this article to know how to conquer cervical cancer. Read Article


Dr. Gowrimeena
Obstetrician And Gynaecologist

Virtually all types of cervical cancers are caused by high risk types of HPV (Human Papilloma Virus) which is usually spread through sexual contact. Hence, in effect the HPV vaccines can prevent 70 percent of cervical cancers before exposure to HPV (i.e, before onset of sexual activity). These...  Read Article

Will PCOS delay pregnancy?

Query: Hi doctor, I am 28 years old. My height is 5'4" and weight is 70 kg. We have been trying for pregnancy for a year. My husband's reports were all normal. I am having PCOS, but my periods are very regular. I am on Oxetol 300 mg for partial seizure since one year. I am also taking Metformin 500 mg t...  Read Full »

Also Read


I am suffering from dry and scaly scalp. Is that scalp psoriasis?
Hello doctor, I am suffering from dry, scaly patches on the scalp for the last six to eight months. Since childhood, I h...  Read more»
Birth Control Methods - Facts, and Types
Devices or treatments done to prevent unwanted pregnancy are called birth control methods.In this article, I am going to...  Read more»
Crohn's Disease
Crohn's disease causes inflammation of the digestive tract, which results in symptoms like severe diarrhea, stomach pain...  Read more»

Ask your health query to a doctor online?

Ask an Obstetrician & Gynaecologist Now

* guaranteed answer within 4 hours.

Disclaimer: All health Q&As published on this website are not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.