Kalavati, a 29 year old nulliparous women complains of severe menorrhagia and lower abdominal pain since 3 months. On examination there is a 14 wks size uterus with fundal fibroid. The treatment of choice is.
Ans. is 'a' is i.e.,. Myomectomy (Ref.: Robert Shaw, Patrice Soutter, 3/e, p 487, 488, Shows, 73/e, p 346 (72/e, p 283;;Guidelines for the management of MvomaAbout medical t/t of myoma with GnRH analogues * For this we have consulted many books and consultants in gynecology. Allof them except 'Shaws gynae' were of the opinion that the medical t/t is not used as a curative therapy. Though it can reduce the size of the fibroid by upto 50%, the effect persists only for the duration of t/t. Once its stopped, the fibroid rapidly regrows to its pretreatment size. So It's only used in patients who are keen to avoid surgery or those with contraindications to surgery.Main aim of medical management in myomaRelief of symptomsReduction in fibroid size and vascularity preoperatively.
Myomectomy
GnRh analogues
Hysterectomy
Wait and watch
Treatment and Recurrence