Uterine fibroids (or leiomyoma/myomata) are benign tumours that usually grow in the womb (uterus), or in rare cases, the ovaries. They are firm, compact tumours made of smooth muscle cells and fibrous connective tissue, and resemble to meatball-like protrusions.
There is no known definite cause of fibroids, but researches point to factors like:
Hormones: Estrogen and progesterone, the hormones that prompt development of the uterine lining during each menstrual cycle in preparation for pregnancy, are suspected to promote fibroids. Fibroids usually reduce in size after menopause, due to a decreased hormone production.
Growth Factors: Growth factors are substances that occur naturally and are capable of stimulating cellular development, multiplying, healing, and cellular diversity. Their ability to prompt cellular growth may be a cause for fibroids.
Family History: Furthermore, a person with a family history of uterus fibroids may have greater risks of having fibroids.
Fibroids are usually treated through Myomectomy surgery is considered as the mainstay treatment for the problematic fibroids.
Symptoms of Fibroids
Even though there are no visible symptoms identified with this condition, some of the common fibroids tell-tales may include:
- Unusually heavy menstruation
- Pressure on the urinary bladder causing urinary blockage or frequent need to urinate
- Pain stemming from the fibroid degeneration
- Difficult pregnancy or infertility related problems
- Pressure on the lower back & rectum from larger fibroids
Can Uterus Fibroids Be Treated Without Surgery?
Fibroids treatment without surgery is possible. The doctor might prescribe hormone therapy to temporary reduce the size of the fibroid, or they might recommend radiation therapy called uterine fibroid embolization (UFE) to shrink or destroy the fibroid. Small fibroids between 1cm and 3cm without any signs and symptoms can be left untreated.
The surgical removal or treatment of fibroid is recommended by a specialist when:
- Larger fibroids (greater than or equal to 6cm-8cm) are present
- there is visible and rapid growth
- fibroids growth causes other issues
In some cases, surgical treatment of fibroids is recommended to improve fertility.
The fibroids can be temporarily diminished by using GnRH injections. This is primarily prescribed in pre-operatively larger fibroids. Fibroids may also be removed through MRI Focus Ultrasound or Uterine Artery Embolization procedure. However, these procedures are not helpful in permanently curing fibroids.
Laparotomy or a traditional open surgery: may be performed (requiring an abdominal cut of 10cm) to completely remove fibroids. However, this has relatively longer recovery duration.
Conventional Laparoscopy: This is a key-hole surgery, which involves three to four small abdominal cuts of 1cm. The procedure is known to completely remove the problematic and large fibroids along with less pain and faster recovery time. Robotic surgery may also be considered. It is similar to the traditional laparoscopy except that it requires four to five small abdominal cuts.
Transcervical Fibroid Removal: is recommended for fibroids ascending from the womb’s menstruation area. This surgical procedure is performed through the cervix and vagina.
Single Incision Laparoscopy: It requires only a single cut of 2cm-3cm at the belly-button. It is regarded as a more advanced form of laparoscopy as the cut is hidden (scarless) in the belly button.
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