Gynecologist in Chiang Mai

[Cletus]

My wife has got uterine fibroids, the largest one being 12cm.

We've already been to Mc Cormick and to a Government hospital ( I do not remember the name sorry, it's on the way to Mae Rim from Chiang Mai).

I want to hear the opinion of another doctor as well, could you please suggest where to go?

Can be private or public hospital, just a good doctor that maybe you know.

 

Many thanks

[cnx1204]

My wife really likes the female gynecologist at Bangkok Hosp Chiangmai Dr. Atita Ruengsaen

[Sheryl]

Is she severely symptomatic? As does not require treatment otherwise.

 

And how old is she? (Menopause will usually resolve it).

 

 

[BritManToo]

My former Brit wife had these.

She had them removed as she wanted more children.

Apart from infertility, I don't think they have any other effect.

[Sheryl]

1 minute ago, BritManToo said:

My former Brit wife had these.

She had them removed as she wanted more children.

Apart from infertility, I don't think they have any other effect.

They can cause excessive menstrual nmbleeding in some eomen. And in severe cases can obstruct the urine flie.

 

But indeed in most cases no treatment is necessary. 

[Cletus]

1 hour ago, Sheryl said:

Is she severely symptomatic? As does not require treatment otherwise.

 

And how old is she? (Menopause will usually resolve it).

 

 

No, she is not severely symptomatic (doctors found it unusual considering the size of the fibroids).

She is 48 yo.

Pap test is negative. Doctors said to check again (ultrasound) in a few months and maybe total surgical removal of the uterus should be considered. They were not definitive in their answer about total uterus removal or not. That's why I'd like to talk to another doctor too.

[BritManToo]

2 hours ago, Cletus said:

No, she is not severely symptomatic (doctors found it unusual considering the size of the fibroids).

She is 48 yo.

Pap test is negative. Doctors said to check again (ultrasound) in a few months and maybe total surgical removal of the uterus should be considered. They were not definitive in their answer about total uterus removal or not. That's why I'd like to talk to another doctor too.

Thai doctors always want to cut bits out.

I've encountered this situation 3x (1x my 5yo son appendix, 2x me gall bladder and prostate) in the past 10 years.

We refused each time, and discovered later they were wrong each time.

 

I believe you are right to seek a second opinion, and maybe not mention the first opinion so they don't get the chance to back each other up.

Edited April 16, 2023 by BritManToo

[Sheryl]

If she is not symptomatic (or symptoms are mild and manageable) there is no reason to treat.

 

The average age for menopause in Thai women in 48 - 50, and fibroids usually regress after menopause. Simply wait it out would be my advice. 

 

Doctors in private hospitals are likely to want to operate. And hysterectomy is the single most common unnecessary surgery.

 

If treatment does become necessary (i.e. if she becomes symptomatic) , emboilization is a much less invasive option than surgery and might be an option if it is just the one (albeit large) fibroid. I believe they do that at Maharaj Nakorn (government hospital affiliated with CMU).

 

Out of curiousity - if she is nto symptomatic then how was this discovered?

 

 

 

 

[Cletus]

16 hours ago, Sheryl said:

If she is not symptomatic (or symptoms are mild and manageable) there is no reason to treat.

 

The average age for menopause in Thai women in 48 - 50, and fibroids usually regress after menopause. Simply wait it out would be my advice. 

 

Doctors in private hospitals are likely to want to operate. And hysterectomy is the single most common unnecessary surgery.

 

If treatment does become necessary (i.e. if she becomes symptomatic) , emboilization is a much less invasive option than surgery and might be an option if it is just the one (albeit large) fibroid. I believe they do that at Maharaj Nakorn (government hospital affiliated with CMU).

 

Out of curiousity - if she is nto symptomatic then how was this discovered?

 

 

 

 

It was discovered during a general health check up (ultrasound abdomen).

Thanks for your comments.

[Sheryl]

2 hours ago, Cletus said:

It was discovered during a general health check up (ultrasound abdomen).

Thanks for your comments.

A good example of why abdominal ultrasounds are not recommended for routine screening....and why private hospitals like to include them. From a for-profit hospital viewpoint, very high yield in terms of further tests and elective surgeries. Most of them unnecessary. 

 

Very often uncover unimportant asymptomatic and common anomalies like utetine fibroids, liver and kidney cysts  small gallstones etc. Which patients then feel compelled to further investigate and which often lead to unnecessary treatments. Does more harm than good in majority of cases and is  not recommended for routine preventive  care by any public health authority. 

 

(Diagnostic use in sympomatic patients or patients with certain medical  histories or abnormal lab results is an exception of course).

 

 

[PPMMUU]

Uterine fibroids are a common condition that may not always require treatment, and certainly not always surgery. However, there are cases where treatment may be necessary.

 

In Thailand, virtually any obstetrician-gynecologist is capable of performing a hysterectomy. Therefore, the decision of where to have the procedure done is not a difficult one. The more important consideration is whether or not the surgery is necessary for your wife.

 

When discussing this issue with other Thai doctors, it may be helpful to use the term "myoma" or "myoma in uterus" instead of "fibroid." This terminology is more commonly used in Thailand and may facilitate better understanding among medical professionals.