PerfixImage

Treatment - Magnetic Resonance Guided Focused Ultrasound

Is a non-invasive intervention (requiring no incision) that uses high intensity focused ultrasound waves to destroy tissue in combination with magnetic resonance imaging (MRI), which guides and monitors the treatment.

During the procedure, delivery of focused ultrasound energy is guided and controlled using MR thermal imaging)

It is an outpatient procedure and takes one to three hours depending on the size of the fibroids

Symptomatic improvement is sustained for two plus years

Need for additional treatment  varies from 16-20% and is largely dependent on the amount of fibroid that can be safely ablated

The higher the ablated volume, the lower the re-treatment rate

 

Singapore General Hospital
Screened (LJC) 07/05/2014
Pelvic Scan
Dr Hwang Siok Gek
Pathologist
Ng Lay Kieng
Ultrasonist

Ultrasound
US system
VOLUSON PRO
transvaginal transabdominal

Result:
-TA & TV scans
- Uterus - enlarged, fibroids
- Both ovaries - vaguely demonstrated, impression is they are within normal size range
- No other mass seen in pelvis
- No fluid in POD

Uterus:
Uterus - present anteverted
Longitudinal - 87mm, AP 98mm, transverse 106mm
Volume - 473.2 cm(3)

Endometrium
Total Thickness - 11.8mm

Myometrium
Morphology - Uterus is enlarged with irregular contour and heterogeneous echotexture

Leiomyomas
Leiomyoma 1
Size - 79mm x 60mm x 70mm Volume 173.7 cm(3)
Site - intramural
Position - Right lateral

Leiomyoma 2
Size - 37mm x 35mm x 39mm Volume 26.4 cm(3)
Site - intramural
Position - Left fundus
                smaller ones
                cannot be
                excluded
Cervix
Cervix Length - 26mm

Right Ovary
Visibility - Vaguely demonstrated
Size - 26mm x 24mm x 12mm
Volume - 3.9 cm(3)

Left Ovary
Visibility - Vaguely demonstrated
Size - 20mm x 11mm x 14mm
Volume - 1.6 cm(3)

 

Dr Esther Yeo
Walk in only
They said they are General doctor not O&G

MON TO FRI
8.30am to 12pm , 2pm to 4.30pm
Sat - Half day
4 Oct to 6 Oct closed
Dr Esther M L Yeo
Fibroids
Consultation : $20 to $35
 

Fibroids Payment
Fibroids operation can use CPF to pay for partial bill

Payment 1:
-using scopes
-Approximated bill $10k
-Base on Class A1 room
-Need to be warded for about 3 days
-use CPF up to $4050

Payment 2:
-using surgery
-Approximated bill $11k
-Base on Class A1 room
-Need to be warded for about 5 days
-use CPF up to $4950

 

Will irregular  menses lead to womb cancer?

I recently had a dilation and curettage (D&C) procedure and a hysteroscopy.

The lab results indicated that I have a disordered proliferative endometrium with irregular shedding

No polyp or malignancy was noted.

The diagnosis was "focal complex endometrial hyperplasia with atypia ".


Endometrial hyperplasia is the thickening of the lining of the womb (endometrium), caused by an overgrowth of cells that line the womb.

Some women, it can develop into womb cancer over time, particularly if left untreated.

Endometrial hyperplasia is often related to prolonged imbalance between the two female hormones, oestrogen and progesterone.

There may be times when the  body is exposed to oestrogen without progesterone in the body to balance it.

Number of reasons why this occurs:

- hormonal changes that happen at the time around menopause

- drug treatment such as oestrogen-only hormone replacement therapy (HRT)

- taking tamoxifen, a drug used to treat breast cancer

- it can also be associated with a condition known as polycystic ovarian syndrome (PCOS), which had symptoms such as irregular, heavy menses.


A standard practice for a gynaecologist to take a sample of the lining of the womb in women with menstrual problems, or younger women with symptoms suggestive of PCOS, to exclude hyperplasia or cancer of the lining if the womb.

Your doctor took a sample of the lining of the womb through a D&C procedure and hysteroscopy.

After a microscopic examination of the sample by a pathologist, were reported as "focal complex hyperplasia with atypia".

Endometrial hyperplasia may be classified as simple or complex.

It is further classified by whether certain abnormal cell changes are present or absent.

If abnormal changes are present, it is called atypical.

Simple hyperplasia without atypical changes, at has the least risk of a cancerous change, at 1 per cent.

Complex hyperplasia with atypical cells has a 29 per cent risk of progressing to cancer of the womb lining, even more so for women who have undergone menopause.

The time it takes to develop into cancer, from the point of diagnosis of hyperplasia. Is not well-established but is usually estimated to be in years.

 

The recommended treatment for hyperplasia depends on the age of the patient, if she has completed her family, and the presence of atypical cells.

For older woman who has no desire for more children and has atypical cells, hysterectomy (surgery for the removal of the womb) may be the recommended treatment as this eliminates the risk of cancer developing in the future.

If hormonal treatment is opted for, close surveillance and further samples of the lining of the womb are required to ensure a response to treatment.

Relapse of endometrial hyperplasia after an initial regression with hormonal treatment can occur even after five years in 14 to 30 per cent of cases.

Long term gynaecological follow up is essential.