| |
This
website was appraised in July 2004 by C-H-i-Q the Centre for Health
Information Quality ‘Working to maximise public confidence in health
information’.
|
|
|
|
Fibroids
Definition
Fibroids are a benign (non-cancerous) growth of the muscle of the uterus (womb).
They can be small (pea sized) or large (the size of a melon) but most are somewhere
in between. There may be just one fibroid but more often multiple fibroids exist.
Incidence
Fibroids are very common and probably affect about a quarter of all women. They
are more frequent amongst black women.
Causes/prevention
Some women have an underlying tendency for the development of fibroids and there
is little that can be done to prevent them. They are however more common in obese
women and in those who have never had children. They can increase in size with
hormone replacement therapy.
Signs and Symptoms
Many women have fibroids and have no symptoms at all. It all depends on where
in the womb the fibroids are located and their size. The fibroids can be found
inside the womb cavity (called sub-mucosal), in the wall of the womb (called intra-mural)
and on the outer aspect of the womb (called sub-serosal). Symptoms caused by fibroids
might include:
- Heavy periods
- Lower tummy pain
- Bladder problems
- Infertility
- Miscarriage
Complications of disorder
Heavy periods can cause anaemia
and ill-health. Sometimes they are associated with difficulties in becoming
pregnant but they are not a major cause of infertility. If they grow very large,
then the bladder (which is situated in front of the womb) gets squashed and
this can cause the problem of passing water more often.
Very occasionally (1:1000 risk) fibroids can become cancerous (fibrosarcoma).
This is more likely with large fibroids and fibroids getting bigger rapidly
or developing pain should be removed.
Most fibroids cause no problems with pregnancy but in some women they can degenerate
and cause pain, cause miscarriage or premature labour and some prevent the baby
delivering normally.
Tests
Fibroids are usually detected by an internal examination carried out by the
doctor. The diagnosis can be confirmed by carrying out an ultrasound scan. In
some circumstances a hysteroscopy
and/or a laparoscopy would
be performed.
Treatment
The treatment carried out depends on what problems the fibroids are causing,
the size of the fibroids and where in the womb they are located. If they are
small and causing no problems no treatment is necessary. Other treatments include:
Medical – risks & complications
If the fibroids are causing heavy
periods it is still worth trying medication. A group of drugs (Gonadotrophin
releasing hormone analogues, GnRHa) are effective in shrinking fibroids but
after discontinuing therapy, fibroids grow back. These drugs are useful before
surgery to remove the fibroid (myomectomy)
Surgical – refer to operation
Myomectomy – this is an operation to remove the fibroids only. It is usually
reserved for women who wish to maintain their fertility. The fibroids are removed
and the womb reconstructed. It is a major operation and carries a 1% risk of
serious bleeding during the operation, which could result in a life saving hysterectomy
being necessary. Pregnancy rates following myomectomy are in the region of 60%
and for heavy periods in the region of 80%. In subsequent pregnancies the gynaecologist
might recommend a Caesarian section but normal delivery is possible in some
circumstances.
Hysterectomy - if you have
completed your family this is the more common procedure.
Hysteroscopic Resection – if the fibroids project into the cavity of the womb,
it may be possible to treat them by cutting them off or burning them off using
an instrument called a hysteroscope
with a small cutting device attached.
Outcome
Following treatment the outcome is good.
|
|
|
Sat, Jul 31, 2010
 |
 |
 |
 |
 |
 |
We
have been selected for inclusion into OMNI,
the UK gateway to quality medical information on
the web
|
|
