Uterine Fibroids


Uterine fibroids are benign (non-cancerous) growths of the uterus; after endometriosis, they are the most common type of abnormal tissue growth in the pelvis. The most commonly occur during a woman’s reproductive life. Most fibroids remain small – they can be no bigger than a pea – and do not give any symptoms. Some, however, can become large and problematic. In extreme cases one or more fibroids may be large enough to fill the whole abdomen, resembling a pregnancy. The extent of symptoms reflect the size of the fibroids, how many there are, and where they are located in the uterus.

The growth of fibroids is affected by the hormones oestrogen and progesterone. Typically they tend to shrink following the menopause. Very rarely, fibroids may be associated with cancer.
Fibroids can exist without any symptoms, and may be found during the course of a well woman check, or during an ultrasound in pregnancy. Where symptoms do occur, they may include:  
  • changes to menstrual flow
  • heavy periods (sometimes with symptoms of anaemia resulting from heavy blood loss)
  • painful periods (dysmenorrhoea)
  • pelvic discomfort
  • pressure symptoms e.g. urinary frequency or constipation or rectal pressure
  • abdominal enlargement
  • miscarriages or infertility
 
Investigating and treating fibroids

Yinka will take your full medical history and conduct a clinical examination along with an ultrasound scan. Further investigations would depend on the initial findings; in some cases it is useful to conduct a hysteroscopy or a laparoscopy.

The treatment strategy that is right for you will depend on your symptoms and the number, size and location of the fibroids. Medical management may be the preferred option, with the oral contraceptive pill, progesterone medication or non-steroidal anti-inflammatory drugs (NSAIDs)  or gonadotrophin releasing hormone analogues (GnRH analogues).

Surgical treatment for removal of fibroids, or ‘fibroid resection’, is done wherever possible using minimally invasive surgery. Yinka will talk these through with you in detail so that you are clear about the procedure. The fibroids can be removed with abdominal surgery or removed endoscopically. In some cases endometrial ablation or uterine artery embolisation may be used to reduce the blood flow to the fibroids,  thereby reducing their rate of growth.

In extreme cases, usually for large fibroids, myomectomy or, more rarely, hysterectomy, may be recommended.
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