Obstetrics, Gynecology & Reproductive Sciences Archive Questions

Below are Dr. Morozov’s answers to Obstetrics, Gynecology & Reproductive Sciences questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.



Now displaying records 1 to 12 of 12.

1

---

Q : 1 12/31/2009	I have a nabothian cyst on my cervix. Should I see a doctor to have this biopsied? No. This is considered a normal finding.
Q : 2 11/03/2009	How can cysts form in the lower abdomen after having a hysterectomy? It is possible that you have ended up with an inclusion or peritoneal cyst. This is not uncommon after having surgery like a hysterectomy.
Q : 3 10/25/2009	Can you have a diagnostic laparoscopy with possible appendectomy if you are on your menstrual cycle? Yes. Menstration is not a contraindication for surgery.
Q : 4 09/10/2009	What is the recovery time for a hysterectomy? If it is an open procedure, then the recovery time could be as much as 3-6 months. However, if it is performed laparoscopically (minimally invasive) or vaginally, the recovery time is reduced to 3-6 weeks.
Q : 5 08/05/2009	I am a 29-year-old female about to undergo laproscopic surgery to treat endometriosis. I also have the option of undergoing a presacral neurectomy simultaneously. Is it worth the risk? What are some of the worst complications? Is there any chance of paralysis, or incontinence? If done correctly - PSN will relieve most, if not all, of your "central" pain. However, it is a major surgery and you need to ensure that your doctor is well-skilled and a trained laparoscopist before letting him/her perform a LPSN. The largest risk is damage to the abdominal aorta or vena cava which could result in hemorrhaging. There are risks of constipation and transient urinary retention, but these are minor. Sometimes oozing of the lymph creates chylous ascites and this would need to be drained surgically. Damage to the sigmoid colon and the ureters are always possibilities as well. You should tell your doctor all of your concerns and find out if he/she is the most skilled surgeon in your area.
Q : 6 07/28/2009	I'm 66, female, and have been sexually inactive for years. As a result, I have experienced atrophy. Now I'm thinking of remarrying, and would like to know what, if anything, can be done to reverse the atrophied genitals or at least improve the situation. I read that comfrey ointment can improve the vulva, but discovered that preparation can be dangerous. Any suggestions? The best way to address the vaginal/vulvar atrophy is the local (topical) estrogen preparations. You may also need some testosterone supplementation to improve your sex drive. You will need to use them for at least a month or two before you see any results.
Q : 7 06/09/2009	After my pregnancy, my doctor found a large fibroid tumor. I would like to get pregnant again, do I need to have the tumor removed first? I don't have many symptoms aside from lower abdominal pain, which is usually controlled with Tylenol. One doctor has suggested surgery now, another has advised me to wait. Can you please provide some advice? I am not looking forward to a myomectomy. If your fibroid doesn't involve the cavity of the uterus, then you don't need to remove it for the pregnancy. If it's submucosal (does involve the cavity), then you are at the higher risk for pregnancy failure and preterm labor, breech baby, etc., if you do not have the myomectomy.
Q : 8 04/27/2009	Hello Dr. Morozov. I am 50 years old and diagnosed with fibroids in my uterus, a 9 3/4cm cyst on my right ovary. I was told that a total hysterectomy is necessary since I have an irregular cycle and had to be put on Provera to stop the bleeding. My cycle started on 4/5/09 and I'm still bleeding. A week ago I received Provera for 7 days. I am due for surgery for total hysterectomy on 4/30/09. My concern is recovery time, and if it necessary to have a total hysterrctomy done. Please let me what you think is best alternative. In you age group, hysterectomy is a best choice for the treatment of the fibroid uterus. You might not need total hysterectomy, rather a supracervical one. In any case, you should find a gynecologist who can do it laparoscopically - you recovery time will be ONE week, incisions are less that 1/2 inch, etc. Don't let anyone tell you otherwise, do the research on-line! Hope that helps.
Q : 9 04/23/2009	What are the reasons you couldn't have a da Vinci hysterectomy? I have had two c-sections before and two laparoscopic surgeries. I have a fibroid 6cm and polyps, endometriosis and PCOS. There are many, although all are relative contraindications. It's between you and your physician to decide whether you are the good candidate for da Vinci. Most cases should be accomplished with laparoscopic approach, da Vinci or not.
Q : 10 04/08/2009	My daughter is a nursing student. Her MRI shows she has a 7 cm fibroid in the uterine corpus. She has talked to a nurse and surgeon at the hospital where she is a student, and they have told her she needs to have it done open but have not seen her MRI. I believe she may be a candidate for da Vinci but they are not familiar with it. They told her she would have more scarring and the surgery would take longer wwith da Vinci so she would be under anesthesia longer-- is the scarring correct? I know surgery does take longer but is it not better than open myomectomy? The da Vinci myomectomy (removing the fibroid) is probably one the best indications for the robotic surgery. Her scarring will be minimal, if any, and her recovery time, not to mention cosmesis, will be so much better and shorter. She may want to get a second opinion with another gynecologist.
Q : 11 01/23/2009	Hi Doctor, I've been struggling with an ovarian complex cyst on my left side for sometime. I am in the premenopausal stage. I have no pain nor discomfort. My current doctor is suggesting I remove the ovary but I don't want to. I strongly believe that the ovaries continues to release hormones even after menopause has set in. Why doesn't the doctor just laser off the cyst and leave the ovary? I have been reading on the internet that this is another option. What do you recommend in this case? You obviously have a choice to save your ovary, assuming this is not a cancer. Sometimes, the cyst is so large that it "consumes" the whole ovary and there is no viable tissue left. That can only be determined during surgery. Whatever you decide, find the surgeon who can do it laparoscopically (minimally invasive surgery). Hope it helps.
Q : 12 01/23/2009	I am 43 years old, and a candidate for a hysterectomy due to uterine fibroids. Polyps were removed and a Therma-Choice ablation was performed in 2004 to address problems with heavy bleeding, but the uterus has increased in size to the point where my gynecologist feels it would be best to remove it. He also is reasonably certain that the surgery will require an abdominal incision, due to the size of the fibroids and location of the uterus relatively far back in the pelvis. The surgery will probably be scheduled in April. A coworker suggested that I get more information about laparoscopic options, based on his recent experience with laparoscopic splenectomy. I was wondering if it would it be possible to see you, or another qualified surgeon in your department, for a second opinion? I'd really rather avoid the pain and long healing process of a large incision if possible! I truly appreciate any advice you can offer. In majority of cases, even with the large fibroid uterus, it's possible to remove it laparoscopically. The only obstacle is the uterus so large that it rises above belly button. You can definitely see me in the office and we can discuss the options you have. Pleae call 410-328-6640 for an appointment. Dr. Vadim Morozov.

1