Fibroids are muscular tumours that grow in the muscle wall of the uterus and are almost always benign (not cancerous).
Not all women with fibroids will have symptoms. Some women can even have fibroids pregnant during their pregnancy. On the other hand, Women who do have symptoms associated with Fibroids can find these quite life limiting.
- Intramural fibroid, which grows within the uterine wall
- Subserosal fibroid, which grows on the outside surface of the uterus
- Submucosal fibroid, which grows on the inner surface of the uterus distorting the inner wall
The most common side effects that women experience from fibroids are ;-
- Very heavy bleeding, sometimes to the point of anaemia
- Painful irregular periods
- Pelvic pain or a feeling of fullness in the pelvis
- Enlargement of the lower abdomen
- Pain during sexual intercourse
- Lower back pain
Diagnosis of fibroids can be made by Ultrasound, and sometimes MRI, X-Ray or a CT scan. As mentioned above, fibroids are almost always Benign (non-cancerous). Unfortunately however, Malignancy can occur in fibroids as a particularly unpleasant malignancy known as sarcoma. Having said that, the risk of sarcoma in a fibroid is around 1 in some thousands so the risk is low. If further investigation is required following medical imaging, simple surgery by way of Hysteroscopy or Laparoscopy can be performed.
There is no reason to rush to surgery with most fibroids, if you are not having symptoms and bleeding is not a problem, they are quite fine to live with, but they should be kept under constant surveillance lest they change. Left alone, the menopause should shrink it.
If your problem relates to bleeding secondary to a fibroid, it is likely that the fibroid is large and the bleeding is likely to deteriorate, and in this case your Gynaecologist will discuss treatment options with you. Drugs can be used to shrink a fibroid, or there is a relatively new procedure where the blood supply is cut off to the fibroid by blocking the arterial blood supply to the fibroid, which in turn dies. Fibroids can be removed by myomectomy either done laparoscopically, hysteroscopically, open, or finally with Hysterectomy.
Most options prior to hysterectomy can all be offered if you have a fibroid and are trying for a pregnancy, and due to the uterine cavity being filled with fibroids, are unable to carry a pregnancy. We have had numerous patients go to myomectomy, and then pregnancy.
So, as with most gynae issues, the treatment is largely dependent on the end result you are looking for, it may be a pregnancy, it may be pain relief, or it may be to stop uncontrollable bleeding – regardless, our Specialist Gynaecologists will be able to help you.
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