Fibroids

Fibroids are benign tumors that develop in the uterus. They are also known as uterine myomas, leiomyomas or fibromas and are firm in consistency and made of smooth muscle cells and fibrous connective tissue. These tumors do not increase a woman’s risk for cancer. They vary in size from the size of a pea to a small grape fruit.

Types Of Fibroids

  • Intramural fibroids grow within the lining of the uterus
  • Intra-cavitary
  • Sub serosal fibroids form on the outside of the uterus
  • Sub mucosal fibroid develop in the muscle layer of the uterus and cause heavy bleeding and trouble conceiving
  • Pedunculated fibroids which are sub serosal fibroids with a stem

Causes Of Fibroids and Risk Factors

  • It is believed to develop from an aberrant muscle cell in the uterus that multiplies rapidly due to the influence of estrogen.
  • Fibroids may run in the family
  • Obesity
  • Age over 30 years

Common Symptoms of Fibroid

Symptoms depend on the size and location of the fibroid

  • Heavy or prolonged periods
  • Abnormal bleeding between periods
  • Increased menstrual cramping
  • Pelvic pain due to tumor pressing on surrounding organs
  • Increased frequency of urination
  • Low back ache
  • Pain during intercourse
  • Pressure or fullness in the lower abdomen

Diagnosis

  • A detailed history
  • An abdominal and a pelvic examination
  • Ultrasonogram preferably a transvaginal ultrasound
  • Magnetic resonance imaging (MRI)s
  • Hysterosalpingography to rule out tubal obstruction
  • Hysteroscopy to visually examine the inside of the uterus
  • Endometrial biopsy
  • Blood test to rule out iron deficiency anemia

Treatment

Treatment will be based on:

  • Overall health status
  • Symptoms
  • Desire for pregnancy

Treatment options include:

  • Hysterectomy involves removing the uterus and is done for multiple fibroids when the woman is not interested in pregnancy
  • Myomectomy is the surgical procedure where only the fibroids are removed and the uterus is left intact to enable a future pregnancy. This can be done laparoscopically or if the fibroids are large, conventional surgery through an abdominal incision is done
  • Anti-hormonal agents to oppose the effects of estrogen
  • Uterine artery embolization, which is a newer minimally invasive technique, where the arteries supplying blood to the fibroids are blocked to cut off blood supply to the fibroids thus shrinking them.

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