Fibroid is a non-cancerous (benign) growth of the womb (uterus). They are also called uterine myomas, fibromyomas or leiomyomas.
Fibroids are common and usually cause no symptoms. However, they can sometimes cause heavy periods, tummy (abdominal) swelling and urinary problems. Bladder or bowel symptoms like constipation are due to pressure. Fibroids may cause pain during intercourse, miscarriage or difficulty in conceiving. During pregnancy fibroids may lead to pain, preterm delivery or abnormal presentation of baby depending on the size and site of fibroid.
Management of fibroids depend upon age of the patient, symptoms, fertility desire, site and size of fibroids. Various medicines are available in market with varying results. If heavy bleeding is a concern, one may try tranexamic acid or if pain is major concern, anti-inflammatory medicine may be tried under supervision of doctor. Medicine to shrink fibroids with certain limitations are available like GnRh analogues and Ulipristal acetate.
Surgical options are hysterectomy and myomectomy. Hysterectomy is the traditional and most common type of treatment for fibroids which cause symptoms. Hysterectomy is the removal of the womb. This can be done by making a bikini line scar in the lower tummy (abdomen). Or, if the fibroids are small enough, the womb can be removed through keyhole (laparoscopic) surgery in the tummy, or through the vagina so there are no scars. A hysterectomy may be a good option for women who have completed their family.
Myomectomy is preferred especially in women who may wish to have children in the future. In this operation, the fibroids are removed and the womb is left. This procedure is not always possible. This operation can be done through a cut (incision) in the abdomen, via keyhole surgery (laparoscopically) or through the vagina (hysteroscopically).
It is always advisable to meet doctor who may help you in selecting the best management option.
By Dr. MEENAKSHI T. SAHU
MD, DNB, FRCOG (UK), FICOG
SENIOR CONSULTANT GYNAECOLOGIST
