Uterine Fibroids

Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas (lie-o-my-O-muhs) or myomas. They aren’t associated with an increased risk of uterine cancer and almost never develop into cancer.

Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus.

You can have a single fibroid or multiple ones. In extreme cases, multiple fibroids can expand the uterus so much that it reaches the rib cage and can add weight.

Many women have uterine fibroids sometime during their lives. But you might not know you have uterine fibroids because they often cause no symptoms. Your doctor may discover fibroids incidentally during a pelvic exam or pelvic ultrasound.

WHAT TYPE OF SYMPTOMS CAN FIBROIDS CAUSE?

 

The size and location of the fibroids, as well as the extent of the tumor, can cause a variety of symptoms, including:

  • Heavy menstrual bleeding
  • Difficulty getting pregnant
  • Irregular bleeding between periods
  • Lower back pain
  • Pain during intercourse
  • Frequent urination
  • Lower abdomen-fullness and enlargement with pressure

HOW ARE FIBROIDS DIAGNOSED?

A pelvic and abdominal examination, an ultrasound and at times they are noted incidentally on imaging as CT scan/ MRI.

HOW ARE FIBROIDS TREATED?

The treatment of fibroids depends on their age, symptoms and location. A small fibroid may only be 1 or 2 cm in dimension, but it may be present inside the cavity of the uterus, and hence, it may cause problems with pregnancy or heavy bleeding. A hysteroscopic myomectomy may be used to remove these fibroids. The procedure is done through the vagina in an outpatient fashion.
For patients with 3-5 cm fibroids that are not causing any symptoms, serial ultrasounds can be used to keep a watch on the tumor. Some patients may have several very large fibroids, which can cause pressure symptoms and may need to be removed.

TREATMENT OPTIONS:

Hysteroscopic Myomectomy

By performing a myomectomy, only fibroids are removed through surgery. This enables the patient to preserve the uterus for future fertility. Hysteroscopic myomectomy is performed by putting a small camera into the uterus through the vagina to remove small fibroids in the cavity of the uterus (submucous fibroids). This can significantly help patients with heavy bleeding or fertility issues.
This method avoids making any incisions or cuts on the wall of the uterus, which is why it is preferred by patients who want to get pregnant in the future. This does not cause future pregnancies to be delayed and allows for a vaginal delivery during childbirth.

Abdominal/Laparoscopic or robotic myomectomy

This surgical option is used for larger fibroids present in the muscle of the uterus. In this procedure, an incision is made on the uterus to remove the fibroid. The incision is then stitched in several layers to maintain uterine integrity for future pregnancies. Many patients may need a caesarean section after the removal of these types of fibroid tumours.

Hysterectomy

A hysterectomy is a surgical procedure that removes the uterus. This type of treatment is used for women who have large fibroid tumours and have completed their families.