What are fibroids?
Fibroids are non-cancerous (benign) tumors that grow from the muscle layers of the uterus (womb). They are also known as uterine fibroids, myomas, or fibromyomas. Fibroids are growths of smooth muscle and fibrous tissue. Fibroids can vary in size, from that of a bean to as large as a melon. They can grow and cause heavy and painful menstruation, painful sexual intercourse, urinary frequency and urgency.
Many fibroids that have been present during pregnancy shrink or disappear after pregnancy, as the uterus goes back to a normal size. They are typically found in women in their middle and later reproductive years.
Type of fibroids
- Intramural fibroids: Are the most common type and are located within the wall of the uterus. Over a period of time these types of fibroids can expand inwards distorting and elongating the uterine cavity as also resulting in heavy bleeding with clots.
- Subserosal fibroids: are located underneath the mucosal (peritoneal) surface of the uterus and can become very large. They may detach from the uterus to become parasitic leiomyoma. It can result in pressure over bladder and rectum causing constipation and back pain.
- Submucosal (submucous) fibroids: are located inside the uterine cavity beneath the lining of the uterus (called the endometrium). The entire cavity of uterus may get distorted and small lesions may cause bleeding and infertility.
- Cervical fibroids: These are located in the neck of the womb (the cervix).
Diagnosis and Symptoms
General gynaecological examination can reveal fibroids, however it needs to be confirmed by a good ultrasound at times requiring MRI (Magnetic Resonance Imaging). Common symptoms or indications would be one or more.
- Long, gushing periods and cramping.
- Fullness or pressure in their belly.
- Low back pain.
- Pain during sex.
- An urge to urinate often
- Pressure symptoms on bladder and rectum
- Infertility and miscarriages repeatedly.
If fibroids do not cause symptoms, treatment is not needed. They will often shrink and disappear without any treatment over time, particularly after menopause.
If one does have symptoms caused by fibroids, medication to help relieve the symptoms will usually be recommended first.
Myomectomy- is the selective removal of just the fibroids within the uterus. Myomectomy can be done through :-
- Hysteroscopic – the fibroid is removed by use of resectoscope or an endoscopic instrument inserted through the vagina and cervix.
- Laparoscopic – This is done through a small incision near the navel
- Laprotomic/Abdominal – This is the most invasive surgical procedure making an incision on the abdominal wall.
Hysterectomy – Surgery to remove the uterus. This surgery is the only sure way to cure uterine fibroids. Fibroids are the most common reason that hysterectomy is performed. This surgery is used when a woman’s fibroids are large, if she has heavy bleeding, is either near or past menopause, or does not want children.
Uterine Artery Embolisation (UAE) – This is a non invasive procedure effectively treating symptomatic fibroids. Through interventional radiology both uterine arteries are occluded reducing blood supply to the fibroid. Limited blood supply to the fibroids prevents them from further growth, heavy bleeding and shrinking them.
Myolysis – A needle is inserted into the fibroids, usually guided by laparoscopy, and electric current or freezing is used to destroy the fibroids.
MR (magnetic Resonance) guided focused ultrasound – It is a non invasive technique using high intensity focused ultrasound waves to destroy tissue guided and monitored by Magnetic Resonance Imaging (MRI)
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