Fibroids

Fibroids are benign growths that develop in or around the womb.
They consist of muscle and fibrous tissue and vary in size.
They are also known as leiomyomas.
Fibroids are very common and more than one in three women will be diagnosed them.
Not all the fibroids require treatment.

Symptoms

• Heavy and /or painful periods
• Prolonged periods
• Abdominal pain or discomfort
• Back pain
• Urinary frequency
• Difficulty in passing urine
• Pain during sex
• Recurrent miscarriages
• Subfertility
• Constipation

Types of fibroids

Intramural fibroids – They develop in the muscle of the womb.
If large enough, they can distort the shape of the uterus and cause heavy periods, pain and pressure.
Subserosal fibroids – They originate in the muscle wall but protrude outside the womb into the pelvis.
Submucosal fibroids – They grow into the inner cavity of the womb and are more likely to cause bleeding problems or difficulties when trying to conceive

Pregnancy and fibroids

Fibroids usually don’t interfere with conception and pregnancy.
It’s possible though to be the reason for subfertility or pregnancy loss. Submucosal fibroids may prevent implantation and affect the growth of the fetus. In those cases we often recommend removing the fibroids before trying to conceive or if you’ve had recurrent miscarriages. Rarely fibroids can cause severe pain during pregnancy (degeneration of the fibroid) or block the birth passage and necessitate a Caesarean Section.

Diagnosis

Ultrasound: It uses sound waves to assess the shape, size and consistency of the uterus. It can confirm the diagnosis and map and measure fibroids.
Magnetic resonance imaging (MRI): It can evaluate the size and location of fibroids and help determine the appropriate treatment options.
Hysterosonography: This test uses saline to distend the uterine cavity and helps the ultrasound to assess with a great accuracy the presence of submucosal fibroids. It can direct to the appropriate treatment.
Hysteroscopy: It is the gold standard investigation for the diagnosis (and treatment ) of submucosal fibroids. A small telescope is directed through your cervix into the uterus. Saline is expanding the uterine cavity and allows the doctor to examine the walls of your uterus and the openings of the fallopian tubes. In the vast majority of cases it can be performed with local anaesthetic or without anaesthesia.

Treatment Options

Depends on the severity of the symptoms
Different treatments apply to each fibroid type
Fibroids will shrink and maybe eventually disappear after the menopause
Medical and surgical treatments are available
Treatment should be individualised according to each woman’s symptoms and concerns
Minimally invasive surgery (keyhole surgery) is preferable