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Fibroids

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What are fibroids?

Fibroids pain

 

These are benign (non-cancerous) growths of the uterus (womb) muscle, which may be present in up to 20% of women. They may be very tiny in size or extremely large, and can be multiple.

 

Fibroids depend on the hormone 'oestrogen'. This means that they tend to enlarge during pregnancy and in those on certain contraceptive Pills, but shrink after the menopause.

 

What symptoms can they cause?

Fibroids often cause no problems whatsoever. They can, however, cause:

  • Heavy periods - the heavy bleeding may also be prolonged

  • Fertility problems - fibroids may interfere from the very start of the pregnancy process, or can cause spontaneous abortion during pregnancy

  • Pain - this can occur if a fibroid becomes twisted or if a clot occurs in the blood supply to it

  • Large growths - large fibroids can grow into the abdomen, which may be felt as a mass. They can press on veins, leading to swollen legs, or press on the bladder causing a feeling of needing to pass water frequently

 

How can fibroids be treated?

Many women need no treatment whatsoever. In some women, medication can be used to bring on early menopause; this may be reversed by stopping the treatment, so allowing pregnancy to occur. Sometimes, though, pregnancy will not be achievable or side effects may be too troublesome to continue with the medication - you should discuss such issues carefully with your specialist before starting a course.

Surgery can also be used to treat fibroids, usually by one of three methods:

  • Myomectomy - this removes the fibroids, but leaves the womb intact. This means that future pregnancy may be possible, but occasionally the scars from the surgery may prevent any further pregnancy. The fibroids may occasionally return, and further surgery may be needed. Significant bleeding can occur during this procedure, and occasionally hysterectomy may be needed to stop the bleeding. The operation is often performed through a long cut made in the abdomen, which is then stitched up after the surgery - you will usually be in hospital for a few days, and will take about a month or more to fully recover. Occasionally, if the fibroids are relatively small in size and number, keyhole surgery can be performed, which leaves smaller wounds and has a shorter recovery time; occasionally problems can occur during surgery and a long abdominal cut may need to be made or even a hysterectomy performed.

  • Uterine artery embolisation - this is a relatively new technique that uses a special substance to block the arteries that supply the fibroids. No scars are made, and recovery takes only 1-2 weeks. Whilst the womb is left in place and pregnancy is therefore possible, complications can occur and hysterectomy may occasionally be needed. Also, it is not clear yet as to the effects on the ovaries - some women have become pregnant after this procedure, but ovarian failure may also occur, preventing further pregnancy.

  • Hysterectomy - this removes the uterus (womb), with or without the cervix, ovaries and tubes. The fibroids will not recur, but pregnancy is no longer possible. The womb is removed through the abdomen if the fibroids are large, or through the vagina if the fibroids are small. Further information on hysterectomy can be found here.

 

Other SurgeryWise articles

You may also be interested to read our articles on hysterectomy, heavy periods, uterus cancer or cervical cancer

 

Any procedure involving skin incision can also result in unfavourable scarring, wound infection, or bleeding. This list of risks is not exhaustive, and you should discuss possible complications with your specialist. Whilst these risks will seem very worrysome, and indeed can be serious, it should also be borne in mind that many people have no postoperative problems whatsoever.

The information provided is as a guide only and you should discuss matters fully with your specialist before deciding if this is the right procedure for you. Please also read our disclaimer

 

 

 
 
 
 
 

 

 

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