Fibroids are one of the commonest benign i.e. non cancerous tumors of the uterus.They are whorls of smooth muscle tissue that can be very variable in size (few millimeters to more than 20 cms), in position (sub mucous, intramural, or sub serous), and in number (one or two to multiples of ten). Fibroids usually grow during the reproductive years and they tend to shrink after menopause.Fibroids are very variable in presentation. They may not cause any symptoms. They may cause symptoms on the basis of their location, size, and number.
Fibroids may cause very heavy bleeding during periods and sometimes even before and after the periods. They may be associated with very painful periods. Sometimes they may be implicated in infertility. If they are large enough to give pressure symptoms then one can have frequency of urine and / or constipation. If they are large enough then they may present as a mass felt by the women through her lower abdomen.
Fibroids can be diagnosed on clinical examination of the pelvis. They can be further confirmed by ultrasonography. MRI can be done in special situations.
Treatment of fibroids will depend on various factors such as :
- Symptoms that are present
- Age of the patient
- Location of fibroids
- Desire for child bearing
If they are not causing any problems then they may not need any intervention. If they are causing problems then fibroids may be removed. They can be removed through the uterus if they are bulging into the cavity. They may be removed by an incision in the abdomen and the uterus. Alternatively they can be removed through minimally invasive surgery (key hole surgery). In some situations the doctor may suggest removal of the uterus, for eg perimenopausal patients with a large fibroid.
There are a few modern advances in the management of fibroids such as putting a plug in the blood vessel that supplies the fibroid. This option is not yet widely available.If you have a fibroid then you must do a consultation to decide if it needs any intervention and if yes then seek the best management option. Dr Sangeeta Agrawal provides the full range of options for management of fibroid.