Uterine fibroids

UTERINE FIBROIDS

Uterine fibroids also called leiomyomas or myomas, are benign or noncancerous growths of the uterus that often appear in women of childbearing age, usually between 30 to 40 years. Fibroids can vary a lot in size from seedlings which the doctor cannot even see them with the naked eye, to bulky masses that can disfigure and enlarge the uterus.

Fibroids can grow in the uterus, uterine wall, or on its surface. They can also attach to the uterus by a stalk- or stem-like structure. Fibroids range in number from one fibroid to multiple ones. Many women carry uterine fibroids during their whole live unknowingly and unaware about the symptoms as they do not experience signs of fibroids, called as asymptomatic uterine fibroids.

Intramural fibroids grow within the muscular uterine wall. Submucosal fibroids extend into the uterine cavity.

Although uterine fibroids generally are not dangerous but should seek urgent medical attention as they can cause discomfort and may lead to conditions like anemia.

WHAT ARE THE SYMPTOMS OF UTERINE FIBROIDS?

Many women who have fibroids do not have any signs and symptoms. The usual symptoms are:

• Heavy menstruation bleeding or painful periods
• Bleeding between periods
• Pelvic pressure, pain, or fullness in the lower stomach
• Enlarged abdomen or uterus
• Constipation
• Painful sexual activity
• Miscarriages or infertility
• Frequent urination
• Difficulty emptying the bladder
• Backache or leg pains

WHAT ARE THE CAUSES OF UTERINE FIBROIDS?

Causes of uterine fibroids are not known exactly but research and clinical experience suggest the following causing factors:

• Hormones: Estrogen and progesterone stimulate the growth of the uterine lining during each menstrual cycle, also appear to promote the growth of fibroids.
• Genetics
• Other growth factors. Insulin-like growth factor may grow fibroids.

DIAGNOSIS

• Pelvic exam physically by the Gynecologist
• Ultrasound
• complete blood count (CBC) to check upon anemia
• Other blood tests to rule out thyroid problems.

Other imaging tests: If traditional ultrasound does not provide enough information, the doctor may recommend other imaging studies, such as:

• Magnetic resonance imaging (MRI).To determine the size and location of fibroids, identify different types of tumors.
• Hysterosonography (HSG). also called a saline infusion sonogram, uses sterile saline to expand the uterine cavity and fallopian tubes on X-ray images, making it easier to get images of submucosal fibroids and the endometrium.
• The hysteroscope, a small, lighted telescope is inserted through the cervix into the uterus. Then saline is injected into the uterus, expanding the uterine cavity and allowing the doctor to examine the walls of the uterus and the openings of the fallopian tubes.

TREATMENT options for Uterine fibroids

There are many treatment options available to treat uterine fibroids.

• Watchful waiting: Many women with uterine fibroids experience no signs or symptoms, in that case, watchful waiting is considered as a good option.
• Medications: few medicines help manage small fibroids.
• Non-invasive procedure: Uterine fibroids that preserve the uterus require no major surgery or operation, it is done on an outpatient basis.
• Focused ultrasound surgery
• MRI-guided focused ultrasound surgery (FUS)

MINIMALLY INVASIVE PROCEDURES

1. Uterine artery embolization :Embolic agents-small particles are administered into the arteries supplying the uterus, stopping blood flow to fibroids. This treatment option can be effective in causing the fibroids to shrink and relieving the symptoms they cause.
2. Myolysis :In this procedure, the fibroids are destroyed using radiofrequency energy, laser or an electric current.
3. Laparoscopic myomectomy :The surgeon removes the fibroids surgically, leaving the uterus in place. If the fibroids are few in number, you and the doctor may opt for a laparoscopic procedure, using laparoscope inserted through small incisions in the abdomen to remove the fibroids from the uterus. The fibroids can be removed through those same small incisions by breaking them into smaller pieces, a process called morcellation, or one incision can be extended to remove whole fibroids. If you think you might want to get pregnant in the future, the doctor might suggest a myomectomy. This surgery removes the fibroids but leaves healthy tissue of the uterus.
4. Hysteroscopic myomectomy :This procedure is also an associate choice if the fibroids area unit contained within the uterus (submucosal). The surgeon accesses and removes fibroids using Hysteroscopeinserted through the vagina and cervix into the uterus. It is carried out in general anesthesia.
5. Endometrial ablation:This procedure is carried out using a specialized instrument which is inserted into the uterus. The lining of the uterus is destroyed using heat, microwave energy, hot water or electric current ending menstruation or reducing the menstrual flow.
6. Hysterectomy :This surgery removes the uterus. It may be the best option if the fibroids are large, you have very heavy periods, or if you know you don’t want children in the future.

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