Updated: Apr 30, 2019
Fibroids are overgrowths of the muscle and fibrous soft tissue of the female pelvis. These non cancerous benign growths virtually never become cancerous. It affects women of the reproductive age group and linked to the main hormone secreted in this phase which is Estrogen. Females before puberty and after menopause (after cessation of menstruation) do not develop fibroids.
There are many types of Fibroids; Subserosal/Extramural, Intramural, Submucosal and Pedunculated, which refers to growths protruding outside of the uterus, present within the uterine musculature, growths into the uterine cavity and growths connected by a stalk.
Presentation of Fibroids
Women affected with fibroids can but not necessarily experience the following features:
Abdominal pain either cramp or vague pain
Back pain affecting commonly the lower back
Prolonged and excessive Menstruation (Periods)
Excessive Pain during Menstruation
Increased frequency of Urination
Constipation
Discomfort or Pain during contact with partner
Issues related to Pregnancy
Infertility
Treatment of Fibroid
The management of fibroid depends on the age, presentation and number of fibroids.
Usually fibroids are left under observation as they tend to shrink when oestrogen levels decrease.
However in the instances when troublesome or multiple resulting in inability to conceive, fibroids can be removed.
The most common procedure undertaken for removal of fibroids is referred to as Laproscopic Fibroidectomy. This is described as the insertion of fibre optic instrument that has a video camera at one end in order to visualise the abnormal growths and remove the same in total either by direct removal or larger growths can be crushed prior to removal to avoid large surgical openings.
Another fairly similar procedure is Hysteroscopic Myomectomy deals with intramural fibroids (those growths within the uterine musculature) by using an instrument to visualise the interior of the uterus and removing the growths.
More recent therapeutic options include:
MRI-guided focused ultrasound surgery (FUS)
Endometrial ablation
Myolysis
Uterine artery embolization
General surgical methods done previously that resulted in longer recovery period and larger scars are Abdominal Myomectomy and Hysterectomy that are nowadays only carried out in selected cases i.e. when fibroid is too large or post menopausal women or when associated with uterine conditions.
Medical options include:
Gonadotropin releasing hormone (GnRH) agonists
Progestin releasing intrauterine device
Tranexamic acid
Oral contraceptives
NSAIDs
However, these agents have no to minimal efficacy in reducing the size of fibroids and are not commonly employed. Furthermore, their use as a preventive strategy has been studied over and found to have no such effect.
This information is brought to you by Specialized doctors in Al Arif Heart and Children Medical Center, Al Mujarrah, Sharjah, UAE. Keep yourselves fit as a fiddle.
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