Fibroids are benign ( not cancerous ) tumours of the uterus. They are also called myomas or leiomyomas. They may be single or multiple. they may vary in size.
Fibroids can be inside the cavity of the uterus …these are called submucous myomas. They can be inside the wall of the uterus…called intramural fibroids or they can be outside the uterus called subserous fibroids.
CAUSE OF FIBROIDS
The exact reasons why some women develop fibroids are unknown. Fibroids tend to run in families, and affected women often have a family history of fibroids. Women of African descent are two to three times more likely to develop fibroids.
Fibroids grow in response to stimulation by the hormone estrogen, produced naturally in the body. These growths can show up as early as age 20 but tend to shrink after menopause when the body stops producing large amounts of estrogen.
SYMPTOMS OF FIBROIDS
- Asymptomatic – The fibroids may be completely asymptomatic, that is they may not have any symptoms and may come as a surprise on a routine check-up.
- Heavy periods
- Pain in periods
- Spotting in between periods
- Infertility – inability to get pregnant – can happen due to submucosal fibroids
- Recurrent abortions – can happen due to submucosal fibroids
- Pressure symptoms like frequent urination, difficult defecation
- Pelvic examination
- MRI may be required
Observation – if the fibroids are not causing any symptoms they may not require any treatment. They may need to be monitored by regular ultrasound. In case there is a sudden increase in size one needs to be alert to the possibility of a cancerous change in the fibroid ( leiomyosarcoma)
Hysteroscopic myomectomy – if the fibroid is inside the cavity of the uterus(submucous myoma) , hysteroscopic myomectomy is advised. Myomectomy is the process of removal of a fibroid. Hysteroscope is an instrument which is inserted through the vagina, cervix and then the uterus to remove the fibroid.
Laparoscopic myomectomy – myomectomy is the process to remove the fibroid. In laparoscopic surgery, very small incisions are given on the tummy and a camera is inserted to see the insides of the abdomen. With the help of the other instruments, the fibroid is separated from its bed and taken out by the process of morcellation
Open myomectomy – myomectomy is the surgery where only the fibroid is removed. If the fibroid is very large or there are some other reasons which make laparoscopy unsafe, open surgery is required.
Laparoscopic Hysterectomy – a hysterectomy is a surgery where the uterus is removed . in laparoscopic surgery the removal is done with the help of laparoscope and this entails very small cuts on the tummy. This is associated with a faster recovery as compared to open surgery
Open hysterectomy – in this the uterus is removed through a large incision on the tummy. This may be required if the size of the uterus is very big.