WHAT IS UTERINE FIBROID ?
Uterine fibroids are non cancerous or benign tissue growth of the uterus. It is also called uterine myoma. Uterine fibroids are tumors of smooth muscle found in the uterus of the wall. They may grow as single tumor or in clusters.
Uterine fibroid can cause excessive menstrual bleeding, pelvic pain or frequent urination. Many women have uterine fibroids sometimes during their lives. In fact it is so common that most of the women around 25% to 40% during their child bearing age develop uterine fibroid. But most of them even don’t know they have uterine fibroid because they often cause no symptoms. Your doctor may discover during pelvic ultrasound or prenatal ultrasound examination.
MANAGEMENT OF FIBROIDS
Not all fibroids need to be removed or operated. Small fibroids especially the ones not entering the uterine cavity can be observed. After the menopause, the fibroids often shrink and symptoms tend to ease or go away
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Medication to improve the symptoms
- Medications during periods which reduces the bleeding.
- Anti – inflammatory medicines to ease period pain.
- Combined oral contraceptive pill which can help to have lighter period and ease period pain too
- Intrauterine device that sits inside the womb, originally used as a contraceptive. It is inserted into the womb and slowly releases a regular small amount of progestogen and works by making the lining of the womb very thin, so bleeding is lighter.
- Progesterone tablets or injections may be used sometimes to decrease the bleeding
Medication to shrink the fibroids
Hormones analogue may be given to some women. These act by decreasing the levels of oestrogen in the body. However, as low oestrogen can cause symptoms similar to going through menopause (hot flushes, osteoporosis etc.), this treatment is given maximum for six months. They are often prescribed for three or four months before having an operation to make it easier to remove fibroids.
Hysterectomy is the removal of the womb. It can be done either by a bikini line scar( laparotomy) or laparoscopically by a keyhole surgery in the tummy ( LAVH or TLH) or vaginally.
Myomectomy – In this fibroids are removed and the uterus is left especially in women who may wish to have children in the future. This can be done laparoscopically or hysteroscopically depending on location and size of the fibroid.
Myolysis – It means shrinking of fibroid in some way surgically. It includes Endometrial ablation. This procedure involves removing the lining of the womb. This can be done by different methods – for example, using laser energy, a heated wire loop or by microwave heating.