Fibroids

What are Fibroids?

Fibroid tumours are benign (non-cancerous) growths that develop in the wall of the uterus. They occur in 30-70% of women and are particularly common in Afro-Caribbeans. Whilst fibroids do not always cause trouble, abdominal swelling, heavy or prolonged bleeding and pressure symptoms on the bladder and bowel are common. They typically shrink after menopause when the level of oestrogen, the female hormone that circulates in the blood, decreases dramatically. However, menopausal women who are taking hormone replacement therapy may not experience relief of symptoms.
Fibroids range in size from that of a pea to the size of a melon. In some cases they can grow so big that the woman can look pregnant.



Symptoms of Fibroids
The commonest presentation is that of heavy menstrual period which may be associated with pain and could also lead to anaemia. Pressure symptoms from the size of the fibroid especially if the are resting on the bladder. This may result to frequency in emptying the bladder of urine. There may be pressure on the bowel leading to difficulties emptying the bowel. Maybe associated with pain during sexual intercourse and maybe a cause of repeated miscarriages of pregnancy. There could be recurrent pain in pregnancy which could necessitate admission to the hospital.

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 Diagnosis of Fibroids The diagnosis of fibroid can be made by Ultrasound (Transvaginal or abdominal), MRI, hysteroscopy (if submucous or fibroid polyp) or by laparoscopy. Ultrasound Transvaginal approach is better for smaller fibroids. A probe with a covering sheath is inserted in the vagina and this produces an image on the monitor (screen). The abdominal route is better for large fibroids. There may be need to drink water to fill the bladder before the abdominal scan. MRI This may be used in some cases for making diagnosis of fibroid; however, there are cost implications. Hysteroscopy This involves using a small telescope to view directly inside the uterine cavity. It could be performed under local or general anaesthesia depending on the circumstances. Laparoscopy This employs the use of a small telescope to view the abdominal and pelvic structures through the abdominal wall. It is generally performed under general anaesthesia.

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