Fibroids

The uterus is made of a smooth muscle that allows it to expand many times its normal size during pregnancy. This same muscle can sometimes grow in discrete balls within the uterus, these balls are known as fibroids or myomas. Fibroids are very common and can be found in 30% to 50% of all women.

How do they affect me?

Depending on their location within the uterus, fibroids can have different impacts on each woman:

When found on the outside of the uterus they may cause pressure on the bladder or bowel causing more frequent passage of urine, a bloating feeling or abdominal swelling.
When found on the inside of the uterus (the endometrial cavity) they often cause heavy menstrual bleeding.
When found within the wall of the uterus they may also have an impact on the heaviness of a menstrual period.
In general, other symptoms caused by fibroids can include:

Reduced fertility
Severe abdominal pain, especially if the blood supply to a fibroid is compromised.

How do I know if have them?

There is a genetic predisposition of fibroids in certain races of people. This coupled with your family medical history will alert your Gynaecologist to the possibility of fibroids. Usually a pelvic examination and ultrasound will confirm these findings.

What do I do about them?

Managing fibroids depends on your individual situation and the particular symptoms you may be experiencing. For some women heavy bleeding can be simply controlled by hormonal methods such as the contraceptive pill. This however is unsuitable for women hoping to fall pregnant.

Removing the fibroids surgically is usually the best plan of action for women hoping to fall pregnant, experiencing issues with infertility and miscarriages and for cases relating to increased pressure on the bladder causing frequent passing of urine.

How can they be removed?

The removal of fibroids depends on where they are located within the abdomen.

Fibroids found inside the cavity of the uterus can be removed by a technique called hysteroscopic resection. Here we place a small camera through the cervix to find the fibroid. Once it has been located a small electrical current is used to cut the fibroid tissue out from the uterine wall. This is usually a routine day-surgery procedure.

Fibroids found on the outside of the uterus can also be removed surgically using a similar method. In the past hysterscopic resections were not available and this procedure required a large cut across the lower abdomen allowing access to the uterus and then removal of the fibroids (laparotomy). This not only caused scarring and adhesions but was also quite a painful procedure which required a long recovery period. At SWEC, our Surgeons are now able to remove fibroids of almost any size using the less invasive keyhole techniques.

Are there any other options?

Some patients may be suitable for fibroid embolization using advanced radiological techniques to block the blood supply to the fibroid. Others, who have completed their family, may find a laparoscopic hysterectomy (keyhole operation) more suitable. These options can all be discussed at your consultation.

What do I do now?

Every woman is individual and her situation requires an individual plan of management. If you think these issues relate to you, call us at SWEC on 1300 498 448 to arrange a personal consultation and discussion of your case.

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