GYNAECOLOGICAL DISORDERS

Fibroids

Uterine fibroids are a very common benign tumour. They are caused by an over growth of the muscle of the uterus. They are often round or oval in shape and firm in consistency. They may be single or multiple. Fibroids grow in the presence of the hormone oestrogen, but following the menopause the majority of fibroids shrink. Fibroids only need to be treated if they are causing problems. They may cause a problem because of their size which may vary from microscopic to the size of a football. They can cause pressure on the bladder or on the bowel or cause a swelling in the lower abdomen which is noticeable. Alternatively, fibroids can have an effect on women’s periods. They often cause very heavy periods, especially if the Fibroid affects the lining of the uterus. Fibroids may also cause infertility or miscarriages. Occasionally they cause pain and this is most common in pregnancy.

Fibroids can be easily viewed on an ultrasound scan where their size and position can be described.

The majority of fibroids do not require any treatment. If they do require treatment then the commonest treatment is surgery. Many patients have their Fibroids removed together with the uterus (hysterectomy). In younger women, who want to retain their fertility, then a myomectomy operation is possible. Over the last few years a variety of other treatments can be used for patients who have heavy periods as a result of their Fibroids. Uterine Artery Embolisation (UAE) laser coagulation, or focused ultrasound coagulation can all be used to shrink the Fibroids and decrease their symptoms without resulting in extensive surgery. Fibroids which are within the cavity or the uterus can often be removed through a hysterscope.