What are fibroids?
Uterine fibroids are benign lumps that grow in the uterus. Almost 50% of women will get uterine fibroids by the age of 50. These are benign (non-cancerous) lumps but can lead to symptoms that can affect the quality of your life.
What causes fibroids?
The exact cause of fibroids is not known, but they are more common in Afro-Caribbean women. Fibroids usually grow slowly and can sometimes reach impressive size even upto the size of a full term pregnancy!
Fibroids are oestrogen-dependent and therefore are uncommon before the age of 20 and tend to shrink after menopause.
What are the common symptoms?
Fibroids are known to cause period-related symptoms. Heavy periods, intermenstrual bleeding and fatigue due to anemia are common symptoms. With increasing size, fibroids can be felt as a tummy mass and can press on the bladder leading to frequency and urgency of micturition. Sometimes, they outgrow their own blood-supply and can become painful.
How do you make a diagnosis?
Ultrasound scan is the best way to detect size and location of uterine fibroids.
What are the treatment options?
Treatment depends on size and location of fibroids and symptoms caused. Asymptomatic fibroids can be left alone.
- Management of symptoms: to reduce heaviness of periods and treat anaemia
- Hysteroscopic resection: Suitable for intra-cavity (submucous) fibroids
- Laparoscopic myomectomy: Suitable for fibroids up to 10cm in size
- Open myomectomy: Reserved for very large and numerous fibroids
- Uterine artery embolisation: Treatment to block blood supply of fibroids leading to shrinkage
- MRI-guided focused ultrasound: New treatment useful for small-medium sized fibroids
- Hysterectomy (laparoscopic or open): A permanent solution suitable to women with severe symptoms who have completed their family
Can fibroids be treated by key-hole surgery?
Very often, fibroids can be treated by key-hole surgery. If the fibroids are encroaching into the uterine cavity, they can be easily resected (hysteroscopic resection). Laparoscopic myomectomy is suitable for fibroids up to 10cm in size and usually 1-3 fibroids can be removed in one key-hole procedure. Finally, if hysterectomy is needed, it can be often performed as a key-hole procedure.
Can fibroids affect pregnancy?
In presence of fibroids, pregnancy often progresses without any problems but it can also be a rocky relationship! Fibroids can make it more difficult to get pregnant and can also increase risk of miscarriage or premature delivery. You are more likely to have a breech presentation or transverse lie and need a caesarean section. Bleeding after delivery can also be a problem. See your doctor to see if removal of fibroids is necessary before getting pregnant.
Is there a risk of fibroids turning malignant?
This is very rare and is quoted as 1 in 1000. If the fibroids are growing at a very rapid rate, an MRI scan may be needed to obtain more information.