Good afternoon, we want to talk to you about this case, a patient from Colombia, it is the largest fibroid that we have removed, weighing 10 kilos and 125 g. There is a world record from 1880 of 65 kilos, but the truth is we know if it is real or not, but this one is real and we want to show it to you because remember #KnowledgeIsSuccess

I want to explain a little because fortunately we always have images, this patient had sent me the tomography, I want to show you the size of the fibroid, it practically covers the entire abdomen and in one image, this is a cut, well let’s say frontal but in a sagittal cut we can visualize The tumor is a little better from below, here is the pubis, to the top and here is how it even displaces the liver a little, this is the liver and it is a little displaced and this is the kidney.

So, look closely, I want to show you the video and talk to you a little, I turned down the volume because the most important thing about this patient is that we already knew that it was a very large tumor, although she was very young, obviously she was not told that we were going to save the uterus, unfortunately in many cases with such a large size of the fibroids it is almost impossible to try to save the uterus and especially where it is located.

They have seen some of our videos of 4 kilo tumors, one of 6 but when it is a subserous myoma it is not that complicated, hers was unfortunately intramural, it was completely involving the entire uterus and most importantly, anatomically the blood vessels were too large .

Normally the uterine vessels and the plexus that are in the mesosalpinx do not exceed 3 mm or 4 mm in diameter. These vessels were close to 6 mm or 8 mm, so surgery is very dangerous, especially because of the bleeding, and the main thing I always tell patients is to obviously first preserve life and then health and then reproduction. Uploading this video of a surgery that ended in a hysterectomy is for the patient to raise a lot of awareness… They keep asking us if surgery is necessary, if they can wait, if there is some medication or some wonderful formula to remove these fibroids. .. I always tell them that benign myomatous tumors cannot be removed, they can be reduced, the growth can be stopped in some patients slowly but almost all of them will tend to continue growing. So, the most important thing is: It is much better to operate on fibroids of 4, 5, 6 centimeters for this type of tumor because they complicate the surgery a lot and, above all, they further complicate the surgical risk procedure for the patient.

Then lastly, they also always ask me “I have fibroids, can I get pregnant?” Many times what I notice is that the patient is afraid to have surgery because they believe that if they have surgery they will no longer be able to get pregnant and the reality of the things that It is completely the opposite, that is, if you have a giant or large fibroid… I am talking about a fibroid above 8 cm, 9 or if you have multiple fibroids, the possibility of reproduction is half that of a patient who does not has no problem, that is, fibroids are important in reproduction, they cause infertility and it is better to treat them.

Second, if you operate with a surgeon who knows, has knowledge of myomatosis or with us, the possibility of pregnancy will be the same as that of the population of your age, that is, if I am 30 years old, the possibility of getting pregnant month to month it is the same as that of the population that does not have fibroids, fertility is not eliminated by having surgery and third, many people are afraid because since they are already over 35, 36 they say “If I have surgery I’m going to lose a long time,” is also not true. Almost all patients are told at 4 months if they can get pregnant, maximum six months.

If the fibroid is subserous like the one we showed about 3 months ago, in a patient from Colombia who was completely pure subserous, she can get pregnant the following month and third, if you operate… Of all the patients that we have operated on as a 10% of them have returned before the year pregnant spontaneously, so do not let time pass thinking that they told you that if they had surgery they would no longer be able to get pregnant, it is quite the opposite, myomatosis are tumors, even if they are benign, but they are tumors that They distort the uterine cavity, which reduces the vascular supply to the endometrium, that is, where the embryo is going to be implanted, and thirdly, if you get pregnant with fibroids, you also have a significant risk of miscarriage, so please come to us.

In addition to being specialists and experts in fibroids, we also do assisted reproduction both here in Puebla and Veracruz, so you can also make a consultation via Zoom on assisted reproduction, an orientation and if you do not have fibroids, we can do treatments or make your dream come true. of a pregnancy at home.

The ideal is always that they go to an ultrasound to be given the images, the video if possible because it is much better to view the images or video in real time of what that tumor looks like than just an interpretation on paper. With an interpretation on paper, I generally always tell them, they have to come to check you out and be able to give you a presumptive diagnosis of what type of tumor it is, but the most important thing is: The most common is a simple cyst, the second is an endometriotic cyst and The third is a teratoma, so these three represent more than 85% of benign ovarian tumors and are very easy to differentiate.

Sometimes the endometriotic cyst can be slightly complicated with a hemorrhagic cyst and in hemorrhagic cysts many times the radiologist or general practitioner tells you: “Hey, this looks very ugly, you have to have surgery and it’s urgent!” Whether it is benign or malignant, it is urgent! First you have to have tumor markers, make a second choice of doctor or a second opinion and do a tomography or an MRI if we really have a suspicion that it could be a malignant cyst, so please, I invite you to call us , write to us, we can do virtual consultations but with your images and if not… Well, come to us and in an ultrasound in 80%, 90% of the cases we can tell you what type of tumor it is and depending on that the surgery conservative, if it is necessary to be intraoperative and above all to preserve the ovary in that tumor that is there, whether on the right side or the left side. Don’t remove your ovaries!

Now, there is no need to be afraid of a teratoma appearing a second time. We have always said: Once we have identified a tumor, whether benign, borderline, unilateral or bilateral, generally once you operate on the patient, gynecological controls should not be abandoned, that is, they must be done every year. an ultrasound check-up because, as I mentioned, this patient actually already had a pregnancy but the main problem was the fibroid, the bleeding, the pain, the distension and so she went for a gynecological check-up and the teratoma had not been identified until the tomography review . So, on many occasions with large fibroid tumors we cannot visualize the ovaries very well. The ideal in these cases is to operate with experts, with someone who knows about the subject and as I always mention: Try not to remove the ovary.

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