Fibroids

Fibroids are benign tumors of the uterus and are among the most common tumors of the female reproductive system. They typically arise in women in their thirties and forties and occur in nearly half of women by the age of 50. Many women have no symptoms and do not require treatment, but others develop symptoms that require intervention. The most common symptoms are heavy menstrual bleeding, pelvic pressure or pain, rectal pressure, and urinary frequency or urgency. As they enlarge they can distort the abdominal wall and may interfere with fertility and pregnancy. Fibroids can usually be diagnosed during your pelvic examination, although an ultrasound or MRI may be used to confirm the diagnosis.

 

There are a range of fibroid treatments, depending on the symptoms, the size, and location of the fibroids and the patient’s preferences. For bleeding symptoms, medications, including the birth control pill, are often helpful. Often, though, treatment needs to be directed at the tumors themselves.

For small fibroids within the cavity of the uterus (submucosal), hysteroscopy (use of an operating microscope) can be used to remove them. This may be all the therapy that is needed.

 

A minimally-invasive treatment that can be used to treat more extensive fibroids (intramural) is uterine artery embolization. This procedure is performed by an interventional radiologist and results in the shrinkage of the fibroids with relief of symptoms.

 

For women who are still considering childbearing, myomectomy (surgical removal of the fibroids) is sometimes indicated. This is an operation and requires some time to recover. However, this option may provide the best chance for pregnancy for those women with fibroids who are having trouble getting pregnant or carrying a pregnancy. If the cavity of the uterus is entered during a myomectomy, a Cesarean Section will be required for future deliveries to avoid uterine rupture during labor.

 

While hysterectomy is very effective and is commonly performed for fibroids, it also is an operation and it is not for those who wish to retain their uterus.