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'Myths' used to justify some fibroid surgeries. (Expert Opinion).

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| June 15, 2003 | Boschert, Sherry | COPYRIGHT 2003 International Medical News Group. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

SCOTTSDALE, ARIZ. -- Too often the reasons physicians give for surgically removing uterine fibroids aren't based on fact, Dr. William H. Parker said at an international congress on uterine fibroids sponsored by the American Association of Gynecologic Laparoscopists.

Surgical treatment is justified if the fibroid is significantly blocking a ureter or if a sarcoma is suspected, said Dr. Parker of the University of California, Los Angeles.

Removing fibroids helps women with recurrent hemorrhage, especially those who are chronically anemic. It's also legitimate when a patient chooses the surgery to improve quality of life by reducing bleeding, pain, a bulky appearance, or bladder and bowel symptoms associated with the fibroid. But Dr. Parker warned audience members to beware of six "myths" that are frequently used to justify fibroid surgery:

* The physician can't feel the ovaries. According to this line of thinking, if you can't physically examine the ovaries, you won't be able to detect ovarian cancer so why not do a hysterectomy and remove the ovaries to keep the patient safe?

In reality, Dr. Parker said, physicians fail to detect most ovarian cancers until late in the course of the disease, regardless of whether fibroids are present. It would be surgical overkill to perform hysterectomies on all women with fibroids whose ovaries can't be felt, such as women with tight abdominal muscles who would be extremely uncomfortable during physical examination of the ovaries. Instead, ultrasound should be used to examine the ovaries of these women, he suggested.

* A growing fibroid might be a sarcoma. As a resident Dr. Parker was taught that fibroids that grew enough in 1 year to increase uterine size by 6 weeks should be removed because they might be sarcomas. He never found a sarcoma in ...

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