Uterine fibroids are benign, or noncancerous, fibrous growths that form in the uterus. They can grow on the outside of the uterus called subserosal fibroids , inside the muscle of the uterus called intramural fibroids , or into the uterine cavity called submucosal fibroids. Some women have no symptoms at all from fibroids and don't even know they have them.
Other women have severe symptoms. Symptoms can include very heavy menstrual cycles. Some women have so much bleeding that they become anemic —that's a hallmark symptom.
Fibroids that cause severe bleeding are usually closer to the uterine cavity. Some women can have very large fibroids that cause the uterus to be up to 10 times its normal size. She may have related symptoms due to its bulk size, like constipation or increased urination.
If a woman sees her doctor because she is having increased bleeding or a heavy menstrual cycle, the doctor will likely check for uterine fibroids, but these symptoms can also be due to things such as uterine polyps, dysfunctional uterine bleeding or bleeding caused by hormonal imbalances.
Fibroids are typically diagnosed by ultrasound. The first step might be an exam by your doctor, where he or she would feel an enlarged uterus and suspect fibroids.
For smaller fibroids, the only way to diagnose them is often with ultrasound. Some doctors may choose to also do an MRI of the pelvis as a way to see exactly where the fibroids are. It depends on symptoms and size. For example, if a woman has fibroids inside the uterine cavity, we may do a hysteroscopic myomectomy, in which we look inside the uterus with a camera.
Click on supracervical hysterectomy to learn more. This procedure is done by interventional radiologists. It involves introducing a catheter into the artery and the top of the leg, threading it into the arteries supplying the fibroid or fibroids, then injecting some plastic granules that plug off the blood vessels, essentially starving the fibroid of its blood supply.
Typically, this procedure takes hours, requires an overnight stay in the hospital for pain control, and has a recovery period of weeks. The larger the fibroids treated, the greater the pain and the longer the recovery period.
The rate of recurrence of fibroids over many years is uncertain, as the procedure is relatively new. Patients are usually advised that they should not plan to become pregnant after this procedure, as it is not certain that the uterine wall will be strong enough after this procedure to carry a pregnancy. We have seen a number of women who have had UAE, and then, when their symptoms were not cured, went on to have laparoscopic hysterectomy.
There has not been a scientific study to directly compare the two methods, but these patients have told us that the pain after the procedure was less after hysterectomy than it was after UAE. What are fibroid tumors? Are there medical treatments for fibroids? What surgical treatments are there for fibroids? Myomectomy The uterus can be preserved when fibroids can be removed and the uterine muscle itself repaired.
If more than four fibroids are present when they are removed, the chance of regrowth after myomectomy is more than doubled. Tests such as ultrasounds and MRI scans cannot accurately count fibroids when more than four or five are present.
For this reason, the exact number of fibroids present and therefore the chances of regrowth after myomectomy many times cannot be determined until the myomectomy surgery is begun. The risk of not getting treatment is that fibroids sometimes grow to a size that often leads to significant symptoms, eventually requiring removal. There are several uterine fibroid treatment options :.
Talk to your healthcare provider about the various uterine fibroid treatment options so that you fully understand the risks associated with surgery, as well as the benefits of a minimally invasive alternative treatment such as uterine fibroid embolization.
Sources: i Bradley, J. About Uterine Fibroids. Large Degenerated Broad Ligament Fibroid. Fibroids—noncancerous tumors that grow in the uterus—can greatly vary in size.
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