Fibroid Treatment
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 can vary in size, from that of a bean to as large as a melon. Overweight and obese women are at significantly higher risk of developing fibroids, compared to women of normal weight.
Symptoms:
Most women have no symptoms. When symptoms do develop, they may include:
- Anemia (as a result of heavy periods)
- Backache
- Constipation
- Discomfort in the lower abdomen (especially if fibroids are large)
- Frequent urination
- Heavy painful periods
- Pain in the legs
- Painful sex
- Swelling in the lower abdomen (especially if fibroids are large)
Other symptoms may include:
- Labor problems
- Pregnancy problems
- Fertility problems
- Repeated miscarriages
Diagnosis:
- Ultrasound
- Trans-vaginal scan – A small scanner is inserted into the patient’s vagina so that the uterus can be viewed close up.
- Hysteroscopy
- Laparoscopy
- Biopsy – A small sample of the lining of the uterus is taken and then examined under a microscope
Treatment:
The presence of a fibroid does not mean that it needs to be removed. Removal is necessary when the fibroid causes pain or pressure, abnormal bleeding, or interferes with reproduction.
Medications for uterine fibroids target hormones that regulate your menstrual cycle, treating symptoms such as heavy menstrual bleeding and pelvic pressure. They don’t eliminate fibroids, but may shrink them.
Surgery to treat fibroids:
Hysterectomy – removing the uterus. This is only ever considered if the fibroids are very large, or if the patient is bleeding too much. Hysterectomies are sometimes considered as an option to stop recurrences of fibroids (stop them coming back).
Myomectomy – the fibroids are surgically removed from the wall of the uterus. This option is more popular for women who want to get pregnant (as opposed to a hysterectomy).
Women with large fibroids, as well as those whose fibroids are located in particular parts of the uterus may not be able to benefit from this procedure.
Minimally invasive procedures
Certain procedures can destroy uterine fibroids without actually removing them through surgery. They include:
- Uterine artery embolization – Small particles (embolic agents) are injected into the arteries supplying the uterus, cutting off blood flow to fibroids, causing them to shrink and die. This technique can be effective in shrinking fibroids and relieving the symptoms they cause.
- Myolysis – In this laparoscopic procedure, an electric current or laser destroys the fibroids and shrinks the blood vessels that feed them. A similar procedure called cryomyolysis freezes the fibroids.
- Laparoscopic or robotic myomectomy – Robotic myomectomy gives your surgeon a magnified, 3-D view of your uterus, offering more precision, flexibility and dexterity than is possible using some other techniques.
- Hysteroscopic myomectomy – This procedure may be an option if the fibroids are contained inside the uterus (submucosal). Your surgeon accesses and removes fibroids using instruments inserted through your vagina and cervix into your uterus.
- Endometrial ablation and resection of submucosal fibroids. This treatment, performed with a specialized instrument inserted into your uterus, uses heat, microwave energy, hot water or electric current to destroy the lining of your uterus, either ending menstruation or reducing your menstrual flow.