How dangerous are uterine fibroids, and when is surgery necessary?!??
Uterine fibroids (Myoma Uteri) are common tumors found in women of reproductive or working age. Their number and size may vary among patients. Most uterine fibroids are non-cancerous and often shrink after menopause.
Uterine Fibroids
What causes uterine fibroids?
Uterine fibroids result from abnormal growth of uterine smooth-muscle cells. They may arise within the uterine wall, inside the uterine cavity, or on the outer surface. The exact cause is unknown, but they are associated with estrogen and several risk factors:
• Age: women of reproductive age, especially 30-50 years, are most commonly affected.
• Ethnicity: Black women have a higher prevalence than other groups.
• Early onset of menstruation.
• Obesity.
What are the symptoms of uterine fibroids?
Small fibroids may cause no symptoms. As they enlarge or increase in number, symptoms can include:
• Lower abdominal/pelvic pain, with pain radiating to the back or thighs
• Heavy menstrual bleeding
• Bleeding between periods
• Painful menstruation
• Pain during intercourse
• Frequent urination or difficulty urinating
• Constipation
• Anemia, fatigue, lightheadedness
• Infertility or recurrent miscarriage
• A palpable abdominal mass
How are uterine fibroids diagnosed?
1. History and physical examination, including abdominal and pelvic exams
2. Laboratory tests, e.g., evaluation for anemia
3. Ultrasound (high-frequency sound imaging)
4. Imaging as indicated to plan treatment, such as:
- Computed tomography (CT) or magnetic resonance imaging (MRI)
- Hysteroscopy to visualize the endometrium and tubal openings
- Hysterosalpingography (dye test) for patients with infe
How are uterine fibroids treated?
If fibroids are small and asymptomatic, observation with ultrasound every 6-12 months is reasonable. If symptoms develop, treatment depends on factors such as fibroid size and location, patient age, comorbidities, and fertility goals.
1. Medication: pain relievers; oral contraceptives to reduce heavy bleeding: hormone-suppressing injections (temporary amenorrhea and fibroid shrinkage); iron supplements for anemia
2. Fibroid shrinkage procedures: uterine artery embolization (blocking blood supply to fibroids); radiofrequency ablation- suitable for selected smaller fibroids
3. Surgery for severe symptoms or when other treatments fail
• Myomectomy (removing fibroids only): for patients wishing future pregnancy, recurrence is possible.
• Hysterectomy (removing fibroids and the uterus): for large fibroids in older patients who have completed childbearing: this is definitive.
Surgery may be performed via open abdominal surgery, laparoscopy, or through the vagina.
Gynecologic Cancer CenterObstetrics & Gynecology Department, Synphaet Ramintra Hospital-comprehensive gynecologic care by specialist OB-GYNs.
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Synphaet Ramintra Hospital How dangerous are uterine fibroids, and when is surgery necessary?!??
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