Fibroids

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Fibroids are benign (non-cancerous) tumours that grow in the muscles of the uterus. They are very common and affects almost 30% of women in child bearing age, and are hormone dependent. They shrink with loss of or reduced ovarian activity and become smaller in size after menopause. Fibroids can vary in size from about 1cmx1cm (size of a pea) to 12cmx12cm (size of a melon), and some can be even larger.

They may be located on the surface of the uterus (subserosal) or within the uterine muscles (intra mural) or on the inner lining of the uterus (submucosal).

Symptoms: Most women do not have any symptoms and the fibroid is incidentally found during a scan. However, symptoms do occur and are usually in relation to the size and location. A large fibroid may cause pressure on surrounding organs, especially on the bladder with urinary symptoms or on the bowels with bloatedness. Menstrual problems are more common, especially heavy periods if the fibroid is submucosal.

Treatment depends on the symptoms, number and size of the fibroids and the woman’s age. Small fibroids may not need any treatment at all, while those that cause heavy periods and pain may need surgical treatment.  Myomectomy is removal of the fibroid with preservation of uterus, and may be indicated in younger women. Transcervical resection of fibroid (TCRF) is a hysteroscopic procedure where the bulge of a submucous fibroid is shaved off with reduction in menstrual loss. Some women find hysterectomy (removal of uterus with the fibroids) as the better option especially when the fibroid is large.