- I am 25 years old and at 20 years old I had an operation in which 7 myomatous nodules were removed on the uterus; after a while they reappeared and I was advised to get pregnant; I stayed, but at 2 months I lost my pregnancy. After half a year and after a treatment, I got pregnant, even though I had these nodules. In June 2005 I gave birth to a healthy baby. Now again I am pregnant in the 7th month and everything is fine so far and I am preparing for another Caesarean section. I want to ask you what to do: remove my entire uterus that is scarred and with many nodules, or tie my tubes and follow hormonal analyzes and treatments for healing (or at least not to develop these nodules)? And another question if I tie my horns what are the consequences?Answer:
The therapeutic attitude towards a uterus with fibro-myomatous nodules differs depending on the age of the woman, the clinical symptoms, the number and size of the nodules, parity (number of births in the background) and the need to maintain the morphofunctional integrity of the female genital tract.
According to the new trends, if there is no annoying symptomatology (severe pain, heavy bleeding) and if the nodules do not exceed 6 cm in diameter, the patient stays in observation (periodic checks are required at intervals of maximum 6 months) and the climax is expected (menopause), the period in which, due to the lack of hormonal stimulus, these nodules can remit by themselves. However, when clinical manifestations occur, the situation is reassessed with the establishment of a new therapeutic behavior that may include drug therapy or surgery, depending on your desire to have children.
Thus, if there is the possibility that you may wish to conceive a child at some point in your life, then the uterus should be preserved and the drug treatment should be tried; If, however, you do not want other children and if you have troublesome symptoms or uterine changes are large or large in number, then hysterectomy may be indicated but keeping the ovaries is because you are still young and your hormonal function should be maintained. .
Your gynecologist, who knows the medical situation best, is best able to advise you on the right treatment for you.
Tubal ligation is a radical and definitive contraceptive method that should only be performed if you are sure you have the desired number of children.
This procedure has no additional risks compared to the usual risks of surgery, which involves primarily the anesthetic risk. It is a simple surgery, has no long-term side effects, does not alter sex life or sexual function (it has no effect on ovarian hormone production), does not affect lactation.
The disadvantages to other contraceptive methods are: that it must be considered definitive and there is a risk of regret later and does not warrant against sexually transmitted diseases.
Dr. Ciprian Pop-Began-Gynecology Obstetrics-Clinical Hospital of Obstetrics-Gynecology Prof. Dr. Panait Sarbu