Fibroids are the most common non cancerous tumors of the Uterus (womb). These tumors arise from the muscle layer of the uterus. The size of fibroids may range from few centimeters to as large as a melon.
Causes of Uterine Fibroids
Since fibroids are more common in women of child bearing age, studies have shown that sex hormones are related to increase in size of fibroids.
The main sexual hormones in women are estrogen and progesterone. Estrogen helps in breast and uterus development. Progesterone helps in maintaining pregnancy by contributing to thickening of the endometrium (innermost lining of the uterus). However, how these hormones contribute to growth in size of fibroids is unknown.
Women whose mother, sister, or aunt have the condition, are at an increased risk of developing fibroids during their lifetime.
Symptoms of Uterine Fibroids
- Bleeding more than normal during menstruation
- Lower abdominal pain
- Frequent urination
- Anemia due to heavy monthly menstrual bleeding
- Swelling seen on abdomen, specially when the fibroids are large.
- Difficulty getting pregnant
- Repeated pregnancy loss
- Problems during Pregnancy or Delivery
Diagnosing Uterine Fibroids
Fibroids that arise from the muscle layer (myometrium), might be small in size and hence stay within this layer itself, grow inwards into the endometrium, or outward into the serosal layer. With the help of an ultrasound scan, the exact location of fibroids can be identified.
Trans vaginal Scan
An elongated scanner is inserted through the vagina and uterus is viewed closely. Live video of the uterus and surrounding structures can be seen on the monitor.
If ultrasound is not clear, an MRI might be needed to identify the exact location of fibroid. With help of MRI, the size of fibroid can also be determined.
A thin tube with light at its end is inserted through the vagina into the uterus. A video monitor shows the inside of the uterus on the screen. Fibroids that grow into the innermost layer or endometrium can be easily identified using this technique.
Treatments for Uterine Fibroids
Medical treatment is not the absolute cure for fibroids. However, hormone containing tablets can be prescribed temporarily, in order to reduce the size of fibroids. In addition, pain relievers, iron supplementation and birth control pills that arrest further growth of fibroids may offer temporary solution.
Laparoscopic Myomectomy is a minimally invasive procedure in which only the fibroid is removed and the womb is left behind. This is preferred in younger women who wish to get pregnant in future.
Hysterectomy is the recommended treatment for large fibroids and in women who have crossed their child bearing age or no longer wish to have children.
Ultrasound guided removal of fibroid and Laser surgical techniques have been developed in which only target the fibroid whereas the surrounding tissues are left unaltered.
Prevention of uterine fibroids
There is no proven measure for the prevention of uterine fibroids. However some studies show that the obese women who do not exercise have a higher risk of developing uterine fibroids.
Hence its important to maintain a healthy body weight.
Morcellation and natural orifice extraction of Fibroid
Excess bleeding arrested using Vessel sealant
Dr. Deepa Ganesh
Advance Laparoscopic Gynecologist, Robotic Surgeon & Cosmetic Gynecologist Surgeon
Obstetrician and gynaecologist, Infertility specialist and Laparoscopic surgeon