Uterus Fibroids

Abnormal growth that develops in the uterus is called Fibroids.

Fibroids can become very large and be symptomless which is why it is important to have checks early.

Fibroids have its own blood vessels and oxygen supply it sucks from its host.

It usually affects women 30 – 50 years and 1 in 3 women are affected.

Signs

Lower Back Pain

Difficulty in urination

Diagnosis

Sonogram / Ultrasound and fibroids within uterus can be done saline inflation of the womb.

It looks like this:

MRI can better confirm it as fibroid or cyst and rule out Adenomyosis.

(Adenomyosis is not a fibroid, but a condition in which the inner lining of the uterus (the endometrium) breaks through the muscle wall of the uterus (the myometrium). Adenomyosis can cause menstrual cramps, lower abdominal pressure, and bloating before menstrual periods and can result in heavy periods.)

Treatment

Drugs – Contraceptives to alleviate symtoms although this is controversial. The reason being most fibroids are due to high estrogenic hormones and contraceptives are hormones.

Use of Lupron for example can cause pre-menopause symtoms. Basically you are made to go into menopause. This is usually done if tumor is too big and doctor like to shrink it prior.

Surgical Removal

Embolism – Uterine Artery Embolisation (UAE), minimally invasive procedure. Basically the procedure cut off blood supply to the fibroid.

Blockage of the blood vessel using small gelatin beads to the blood vessels supporting the fibroids allowing it to be starved of blood or surgery where the fibroid is cut off. A tiny plastic tube is inserted through to the fibroid to block blood flow to it. 1 – 1.5 hours and may require overnight care in hospital. Fibroid being starved off from blood supply can be painful and require pain medication. Light activity may resume within a day or two. No exercise within 72 hours. And within 3-6 months, a check via MRI. Embolisation affects the uterus from holding the fetus to term.

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One of the hospital for this procedure is UCSF Health in California.

Surgery – Myomectomy – removal by cutting it out, either via uterus or the belly

It takes about 10 minutes but entire process is about an hour. You normally can go home after as a day surgery.

Endometrium ablation – burning part of the fibroid through vagina, to reduce bleeding. It does not necessarily treat the fibroid. Risk of being sterile.

No Medical Intervention

If left untreated, some fibroids go away on its own or grow.

As fibroids grow, they can block important passages or develop blood vessels of their own and cause bleeding.

Outside of fertility concerns, some patients are concerned if fibroids are cancerous. Fibroids are almost always benign. Having said that, it is always important to have regularly half yearly or yearly check up depending on the advice of your physician. Each individual presents different treatment plan and care.

Reasons for non-intervention

Fibroid is not symptomatic (no pain, doesn’t bother you, not growing) and non-cancerous

Emotional & Self-Image reason

Risk of infection and complication