Uterine Fibroids Uterine Fibroids
Fibroids are benign tumours of the uterus that usually occur during reproductive age. They can range in size from a few millimetres to several centimetres and there may be one or several moles in number.
What are the symptoms?
Very often fibroids do not cause any symptoms and are diagnosed in a random ultrasound scan. In women who do have symptoms, however, these depend on the size, location and number of fibroids.
The most common symptoms are :
- Large amount of blood in the period (Menorrhagia)
- Long period duration
- Abdominal pain or pressure in the abdomen
- Synchronicity
- Constipation
- Back pain
How is the diagnosis made?
The diagnosis is made by gynaecological ultrasound. In some cases of multiple or large fibroids, the woman may also need to undergo an abdominal MRI.
What is the treatment?
The type of treatment depends on the location, number and symptoms. Monitoring
If fibroids do not cause symptoms, the gynaecologist monitors them by ultrasound to assess their size and location each time. Note that fibroids do not progress to malignancy and often regress in size during menopause. Laparoscopic removal
In the case of laparoscopic removal, fibroids are removed through small holes in the abdomen. The operation is performed under general anaesthesia and requires a one-day hospital stay. The patient can return to her daily activities very soon as the pain is minimal, while if she wishes to become pregnant she will have to wait for 4 to 6 months to start trying. Hysteroscopy
This method is used when fibroids are located within the endometrial cavity (submucosal). The procedure is performed under general anaesthesia. A hysteroscope is inserted through the cervix, which has a camera at its tip and surveys the entire endometrial cavity. The fibroid is then removed under direct vision. The patient can return home in a few hours and to her daily activities in 2-3 days. If she wants pregnancy, she can try after the next period. The method is painless. Open fibroid removal
The method of traditional fibroid removal through a skin incision, similar to that of caesarean section, is applied only in cases of very large (>10 cm) and multiple fibroids. Laparoscopy has significantly reduced those cases where open surgery may be required. The procedure is performed under general anesthesia and requires hospitalization for 2 to 3 days. Return to daily activities is possible after about 15 to 20 days. Hysterectomy
If a woman has completed her family and the symptoms are long-lasting (e.g. heavy bleeding, drop in haematocrit, fatigue, etc.), or is close to menopause or even because she wants it, the uterus can be removed. This operation is performed under general anaesthesia either laparoscopically or openly.
