What Are Fibroids

Fibroids are most commonly found tumour of uterus which is usually non cancerous tissue, which grow in the muscular part of the uterus. They are very common – up to 80% of women have at least one fibroid – and increase with age. Nobody knows what causes fibroids. They just grow in the uterus and become more common as women get older. it is also commoner in Africans .

Most fibroids do not cause any symptoms. If the fibroids become very large, they can cause significant period problems or pelvic discomfort.

Whether fibroids affect your fertility, and therefore whether you need them removed, depends on the size of the uterus and where in the uterus, the fibroid is located.

If the fibroid is located on the inside of your uterus (submucosal fibroid) distorting or obstructing the uterine cavity or blocking the fallopian tubes, they are highly likely to be affecting your fertility by interfering with implantation of embryo and most specialists would recommend their removal.
However if the fibroid does not affect the lining of the uterus, they have much less effect on your fertility and you may not need to have anything done about them.
Most fibroids do not affect a woman’s fertility. They are mostly found as incidental findings during an ultrasound scan and the vast majority have no effect and do not need any treatment.

The only two situations where fibroids interfere with fertility are:

• Where the fibroid is very large distorting the lining of the uterus
• Where the fibroid is located inside the uterus itself (called a submucous fibroid).

In these two situations, surgery to remove the fibroid may be needed.
If treatment is needed at all surgery is usually the best approach. Where the woman is still trying to conceive, surgery to remove the fibroid (called a myomectomy) is normally carried out. Where a woman’s family is complete, and the fibroids are causing severe symptoms, a hysterectomy may be considered.

Other treatments are less effective. Uterine artery embolisation (UAE) involves injecting small pellets into the blood supply to the uterus to partially cut off the blood supply to the uterus. This can help a fibroid to shrink without invasive surgery but is only recommended for women whose family is complete. Some anti-hormonal agents can be used to shrink a fibroid but the effects are relatively small.

Most women with fibroids have no symptoms.  However, abnormal uterine bleeding is the most common symptom of fibroids. If the tumors are near the uterus lining or interfere with the lining’s blood flow, they can cause heavy periods, painful periods, prolonged periods, or spotting between periods. Iron deficiency anemia can occur in women with excessive bleeding due to fibroids.  Uterine fibroids that are degenerating can sometimes cause severe, localized pain. Fibroids can also cause a number of symptoms depending on their size, location within the uterus, and how close they are to nearby pelvic organs. There may be large fibroids.

How are uterine fibroids treated?  

To check for uterine fibroids, your doctor may ask some questions or perform a pelvic exam.  It can be seen that there is a change in the size of the womb. Diagnosing fibroids is not always easy. Being obese can make fibroids difficult to detect. You may need these tests to look for fibroids.

1. For example, ultrasound makes a picture of the uterus by using sound waves.
2. MRI uses powerful magnets and radio waves to create images.
3. Saline infusion sonogram (hysterosonography): Saline is injected into the uterus to make the uterus easier to see using ultrasound.
4. Hysteroscopy: A long, thin tube is used to examine the inside of the vagina and the uterus.
5. Endometrial biopsy: Removes a small piece of the uterus lining to check for cancer if you have abnormal bleeding.

Several methods can be used to treat uterine fibroids.

1. Surgery (hysterectomy, myomectomy, cryosurgery).
2. MRI-guided high-intensity focused ultrasound.
3.  Embolization of the uterine artery.
4. Uterine artery occlusion (UAO) involves occluding the involved uterine arteries as opposed to injecting polyvinyl alcohol beads.
5. Non-surgical techniques are usually hormonal and involve the use of drugs that turn off the production of estrogen by the ovaries.  These drugs are given for three to six months.  If successful, they can shrink fibroids by up to 50%.

How to care for uterine fibroids?  

After uterine fibroids, it is essential to keep the following things in mind.

1. Getting checked for recurrence of fibroids.
2. Follow-up testing is necessary.
3. There should be post-procedure pelvic exams.
4. It is essential to maintain hygiene during periods.
5. If there is a serious complication, then you can contact the doctor.

What complications can come after uterine fibroids?

Following are the risks you may face after having uterine fibroids.

1. Severe pain or very heavy bleeding that requires emergency surgery.
2. Twisting of the fibroid can cause it to block the blood vessels that feed the tumor. If this happens, you may need surgery.
3. Anemia (not enough red blood cells) from heavy bleeding.
4. Urinary tract infection – If fibroids put pressure on the bladder, it can be difficult to empty your bladder completely.
5. Infertility, in rare cases.
6. If you are pregnant, there is a small risk that fibroids may cause complications.
7. You can deliver your baby early because there is not enough space in your womb.
8. If fibroids block the birth canal or place the baby in a dangerous position, you may need a cesarean section (C-section).
9. You may have heavy bleeding right after giving birth.