Uterine fibroids

Fibroids are one of the common causes of heavy periods, pelvic pain, irregular bleeding and infertility. Mr Raza has the expertise to use modern keyhole surgery to remove fibroids, which causes less pain, early discharge and less trauma.

What are fibroids?

Uterine fibroids are benign lumps that grow in the uterus. These are non-cancerous lumps but can lead to symptoms that can affect the quality of life.

What constitutes fibroids and how do they grow?

The exact cause of fibroids is not known, but they are more common in Afro-Caribbean women. Fibroids usually grow slowly and can sometimes reach impressive size even up to the size of a full term pregnancy!

Fibroids are oestrogen-dependent and therefore uncommon before the age of 20 and tend to shrink after menopause.

What are the common symptoms?

Fibroids cause period-related symptoms. Heavy periods, inter-menstrual bleeding and fatigue due to anaemia are common symptoms. With increasing size, fibroids can be felt as a tummy mass and can press on the bladder leading to frequency and urgency of micturition. Sometimes, they outgrow their own blood-supply and can become painful.

How do you make a diagnosis?

Ultrasound scan is the best way to detect size and location of uterine fibroids. However MRI scan helps to localize them accurately.

What are the treatment options?

Treatment depends on size and location of fibroids along with the symptoms. Asymptomatic fibroids can be managed conservatively.

  1. Management of symptoms: to reduce heaviness of periods and treat anaemia
  2. Hysteroscopic removal: Suitable for intra-cavity (submucous) fibroids
  3. Laparoscopic myomectomy: Suitable for fibroids up to 10cm in size
  4. Open myomectomy: Reserved for very large and numerous fibroids
  5. Uterine artery embolisation: Treatment to block blood supply of fibroids leading to shrinkage. Suitable for women who want to avoid surgery or unfit for surgery.
  6. Hysterectomy (laparoscopic or open): A permanent solution suitable to women with severe symptoms who have completed their family.

Can fibroids be treated by key-hole surgery?

Very often, fibroids can be treated by key-hole surgery. If the fibroids are encroaching into the uterine cavity, they can be easily resected (hysteroscopic resection). Laparoscopic myomectomy is suitable for fibroids up to 10cm in size and usually 1-3 fibroids can be removed in one key-hole procedure. Finally, if hysterectomy is needed, it can be often performed as a key-hole procedure.

Mr Raza is an expert in performing laparoscopic myomectomy. He carries out full assessment and makes a plan of care in line with patient wishes.

Can fibroids affect pregnancy?

Pregnancy often progresses without any problems however occasionally they can give problems. Fibroids can make it difficult to get pregnant and can also increase risk of miscarriage or premature delivery. You are more likely to have a breech presentation or transverse lie and need a caesarean section. Bleeding after delivery can also be a problem. See your doctor to see if removal of fibroids is necessary before getting pregnant.

Can fibroids be cancerous?

Fibroids are benign lumps and it’s rare for them to be cancerous. If the fibroids grow fast then MRI should be done to look at the fibroids closely.