Fibroids

What are fibroids?

Fibroids, also known as myomas, are growths that develop on the inside wall of the uterus. They are also known as benign tumours. Fibroids are rarely cancerous.

How common are they?

Fibroids are quite common. In fact, around 80% of women will have had a fibroid by the age of 50 but only 20-30% of patients will ever have symptoms of a fibroid at all.

How do fibroids develop?

The formation of fibroids is unknown but the production of sex hormones such as oestrogen and progesterone is thought to be a factor in their development.

What are the signs of a fibroid?

Each patient is different, but some tell tale signs of a fibroid could include;

Sensation of a lump or swelling around the front of the abdomen

Heavy periods (that also last longer than your usual length of a period) 

Painful periods 

Pain during sex

Feeling of fullness near the bladder, back or at the front of the lower abdomen

Frequent urination 

Increased bloating around the abdomen which has come on gradually

What do I do if I have a fibroid?

In most cases, fibroids don't seem to cause any significant problems. However, in a small percentage of cases, fibroids can be an associated with complications in pregnancy including miscarriage, pre-term birth and premature labour.

What age are they likely?

They are most likely to be between the age of puberty and menopause. Fibroids can often shrink once you reach menopause.

How are they diagnosed?

  • Ultrasound scan - Two dimensional images of the uterus are created by using sound waves.
  • Hysteroscopy – during a procedure known as a hysteroscopy, the surgeon uses a small thin scope (hysteroscope) to view the uterus. There is a camera and a light with this equipment, allowing the surgeon to take images during the procedure and visualise the fibroids.

What type of fibroids are there?

Fibroids are categorised by their location, which includes: 

  • Intramural – the most common type, growing in the wall of the uterus
  • Submucosal – growing in the lining of the uterus (endometrium), sometimes causing heavy, long and/or painful periods.
  • Subserosal – growing on the outside of the wall of the uterus, sometimes appearing like long stalks.

Complications of fibroids

Some typical complications caused by fibroids include

  • Anaemia (or iron deficiency or low iron stores) due to heavy bleeding. Heavy bleeding can cause anaemia and the typical signs that the body is not carrying enough oxygen include fatigue, paleness, reduced exercise tolerance and breathlessness.
  • Issues with urinating – larger sized fibroids can alter the shape of the uterus which can in turn pressing against the bladder. 
  • Infertility – fibroids can disrupt the implantation of a fertilised egg including trying to implant onto the fibroid. Larger fibroids can distort the uterine cavity making it difficult to carry a pregnancy to term. 
  • Premature delivery - Fibroids can restrict the blood flow to the placenta. As the baby grows, it has to compete for space in the uterus. 
  • Miscarriage - Early/first trimester miscarriage due to a fibroid is around 14% compared to the group with no fibroids (7%). The larger the fibroids the greater the risk of early miscarriage. 

How do you treat fibroids?

Treatment depends on the size, number and location of the fibroids, but can include: 

  • Monitoring – surveillance over time can be successful, especially if the fibroids are not causing any symptoms.
  • MRI + Ultrasound ablation – A magnetic resonance imaging (MRI) machine detects and monitors the fibroid whilst an ultrasound is used to heat the fibroid and ablate the fibrotic tissue. You don't require anaesthetic for this procedure. 
  • Arterial embolisation – under local anaesthetic, a fine tube is passed through an artery in the arm or leg into the main artery that is supplying the fibroid with blood. The process is monitored by x-ray. Fine, sand-like particles are then injected into the artery to block the blood supply to the fibroid. The fibroid slowly dies and symptoms generally subside over a few months. A local anaesthetic is required for this treatment. 
  • Hysteroscopy – Fibroids are removed through the cervix using a hysteroscope (a thin telescope) with a cutting loop attached. This can be performed in a day surgery setting but it does require a general anaesthetic.
  • Laparoscopy – For larger fibroids, 'key hole' surgery may be an option. Again, a thin telescope like tool is inserted through the abdomen, and other instruments are used to cut, strip and remove the fibroid/s from the abdomen in small pieces.
  • Open surgery – An incision across the abdomen will remove fibroids. This option is usually given for much larger fibroids. However, this method of procedure weakens the wall of the uterus. This would make a c-section for any future pregnancies more likely.
  • Hysterectomy – the surgical removal of some, or all, of the uterus. Pregnancy is not possible after a hysterectomy.

 

Get in touch - to talk to our rooms nurse further about fibroids, please call 03 9428 7572

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