Fibroids

Uterine fibroids are non-cancerous (benign) tumours, commonly seen in women of childbearing age. Fibroids are composed of muscle cells and other tissues. They develop in and around the wall of the uterus. They can cause differing degrees of symptoms and may compromise fertility depending on their size and site on the uterus.

Which sites can fibroids grow?

• Subserosal Fibroids: Sited beneath the serosa (the membrane covering the outer surface of the uterus), this is mostly outside the body of the uterus
• Sub Mucosal Fibroids: Sited inside the uterine cavity below the inside layer of the uterus
• Intramural Fibroids: Sited within the muscular wall of the uterus
• Pedunculated Fibroids: Develop on a stalk attached to the outer wall of the uterus

What are the risk factors associated with developing fibroids?

The exact cause for the development of fibroids remains unknown, but some of these risks factors have been associated with fibroids:

• Ethnicity
• Genetics / Hereditary
• Early onset of periods
• Older age at the time of first baby
• Significant beef/red meat consumption
• Uterine infection
• Elevated blood pressure

What are the Symptoms of fibroids?

The majority of women with uterine fibroids may have no symptoms. Other women may experience:

• Infertility
• Heavy or prolonged menstrual bleeding
• Pelvic pressure or pain
• Frequent urination
• Constipation
• Backache or leg pain
• Difficulty in emptying your bladder

What are the investigations for fibroids?

What are the treatment options?

Some treatments target the symptoms of fibroids, such as medication for heavy or prolonged menstrual bleeding or pain medication for pressure or pain symptoms.

Other treatment options are targeted at treating the fibroids. These include:

• Medical hormonal treatments
• Surgical treatments including:
  • Hysteroscopic myomectomy – removal of fibroids through endoscopic surgery through the cervix
  • Open myomectomy – removal of fibroids through the abdomen
  • Hysterectomy or removal of the uterus
  • Endometrial Ablation
  • Myolysis
  • Uterine artery occlusion
• Radiological treatments including:
  • Uterine Artery Embolization (UAE)
  • Magnetic Resonance Guided Focused Ultrasound (MRgFUS)

What are the risks during pregnancy associated with fibroids?

Some studies indicate that the presence of uterine fibroids during pregnancy increases the risk of complications such as first trimester bleeding, breech presentation, placental abruption, increased chance of caesarean section and problems during labour.