Fibroids Treatment: Everything You Need To Know
Posted By Dr. Deepti Asthana on 24-11-2020
Uterine Fibroidsare experienced by approximately 80 percent of women globally in their lifetime although not every woman notices severe complications. It is important that you must seek immediate medical intervention if you experience any signs or symptoms of uterine fibroids.
Table of Contents
Feel free to skip ahead if one topic catches your eye:
- What are uterine fibroids?
- What causes fibroids?
- What are the symptoms of uterine fibroids?
- How are uterine fibroids diagnosed?
- How are uterine fibroids treated?
- How does the recovery look like after fibroid removal?
1. What are uterine fibroids?
Uterine fibroids (also known as fibromas, myomas, leiomyomas, and uterine myomas) are abnormal growths that develop on or in the uterus of a woman. In most cases, they don't demonstrate any signs or symptoms at all. They may, however, become quite large and result in heavy periods or severe abdominal pain in some cases. The growths of uterine fibroids are usually benign or noncancerous.
Different types of fibroids
The type of fibroids depends on its location on or in the uterus.
- Intramural fibroids: They appear within the uterus's muscular wall and grow larger and may even stretch the womb.
- Subserosal fibroids: They form on the outer region of the uterus and may grow big enough to make the womb look bigger on one side.
- Submucosal fibroids: Submucosal fibroids develop in the myometrium, the middle muscle layer, of the uterus.
- Pedunculated fibroids: Subserosal fibroids may develop a slender base (stem) that supports the tumour. When they do, they are referred to as pedunculated fibroids.
2. What causes fibroids?
According to clinical experience and research, the causes of fibroids are:
- Hormones: Two hormones (estrogen and progesterone) that have the ability to stimulate uterine lining development during each menstrual cycle in the quest to pregnancy appear to promote the growth of fibroids.
- Genetic changes: Many fibroids include genetic changes that vary from those in the normal uterine muscle cells.
- Extracellular matrix (ECM): Extracellular matrix is the material that makes cells in the body stick together. It stores growth factors and results in biological changes in the cells themselves.
- Other growth factors: The growth of fibroids may be impacted by substances that assist the body in the maintenance of tissues, such as insulin-like growth factor.
3. What are the symptoms of uterine fibroids?
The symptoms of uterine fibroids include:
- Pelvic pain or pressure
- Heavy menstrual bleeding
- Leg pains or backache
- Difficulty in emptying the bladder
- Menstrual periods lasting more than a week
- Frequent urination
Immediate medical intervention is highly recommended if you are experiencing signs such as unexplained low red blood cell count, bleeding or spotting between periods, difficulty in emptying the bladder, or overly prolonged, heavy, or painful periods.
4. How are uterine fibroids diagnosed?
If you have symptoms of uterine fibroids, the doctor may recommend these tests:
- Ultrasound: Your doctor may recommend an ultrasound test to confirm the presence of uterine fibroids in your body. During the ultrasound procedure, the technician or doctor would move the ultrasound device over your abdomen or place it inside the vagina to get images of the uterus.
- Lab tests: The doctor may recommend lab tests if you are experiencing abnormal menstrual bleeding to investigate the potential causes. The purpose of these tests would be to ascertain if you have anemia because of chronic loss of blood. These tests could also be recommended to rule out the possibility of thyroid problems or bleeding disorders.
- Magnetic resonance imaging (MRI): The doctor may recommend an MRI test to ascertain the location, type, and size of fibroids as well as to identify appropriate treatment options. Generally, the Magnetic resonance imaging test is suggested to women approaching menopause or those with a larger uterus.
- Hysteroscopy: During this clinical procedure, the doctor would insert a lighted, small telescope known as a hysteroscope into the uterus through your cervix. Thereafter, saline is injected by the doctor into the uterus to expand the uterine activity. This procedure allows the doctor to evaluate the uterus walls and the opening of your fallopian tubes.
5. How are uterine fibroids treated?
Fibroid treatment depends on the age of the patient, fertility status or the desire for child bearing in the future, the size and the number of fibroids. Many non-invasive methods have also come up that sometimes delay or eliminate the need for invasive methods.
Let us look at the options available:
- Watchful waiting- If the fibroid size is less than 3 cm and not causing any symptoms, regular follow-up for ascertaining size of the fibroid is performed by an ultrasound. You should not worry about these small fibroids.
- MR-guided focused ultrasound surgery (MRgFUS)- This uses ultrasonic pulses to heat up and destroy fibroid tumors. It is a non-invasive, incisionless technique that is performed under the guidance of an interventional radiologist. However, it should not be used for very large fibroids or when multiple fibroids are present. Less data is available on the safety of child bearing after this procedure.
- Uterine Artery Embolisation- This procedure involves the administration of injecting embolic agents into arteries that cut off the flow of blood to fibroids and cause shrinkage in the size. This method is also not a preferred one for females desiring future childbearing and for large fibroids.
- Laparoscopic/Robotic/Open Myomectomy-During this procedure, only the fibroid is removed and the uterus is preserved. This is a preferable surgery for those who want to plan pregnancy after the surgery. It is preferable to remove fibroids if they are more than 3 to 4 cm and cause endometrium indentation before going for pregnancy planning. Less invasive methods by laparoscopy or robotic cause less pain, less scarring, small abdominal incision, and faster recovery. However, it is preferable to go for open myomectomy surgery if the size of fibroid is too large or if multiple complicated fibroids are present.
- Hysteroscopic Surgery-If the fibroids are submucous and pedunculated, they are best dealt through hysteroscopic approach via the vagina. Very large fibroids may be given preoperative GnRH analogues to decrease the size of the fibroid and ease of the surgery. This medical procedure may also help in building up hemoglobin.
- Hysterectomy-This is the last resort if child bearing is complete, when the woman is over the age of 40 years, or when associated with malignancy. This minimally-invasive approach is also effective for large complicated fibroids.
At the Kalosa clinic, you will get the right suggestion with the best treatment options.
6. How does the recovery look like after fibroid removal?
The success rate of fibroids is better with surgical methods as compared to non-surgical methods. Patients may take 4-12 weeks for complete recovery. It is advisable to plan pregnancy after 6 months of myomectomy surgery.
At Kalosa Clinic, you will get the best advice for your treatment and Dr. Deepti Asthana is an experienced laparoscopic surgeon who will help you plan best for your condition.
If you or anyone known to you has suffering from uterine fibroids, there is nothing to worry about. You can reach out to us and our team of specialists would help you with everything so you don’t have to ever worry about anything. Following the highest standards of care and hygiene, we are always there to help you.