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.

Understanding Robotic Gynecological Surgery

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.

  • Management of symptoms: to reduce heaviness of periods and treat anaemia
  • Hysteroscopic removal: Suitable for intra-cavity (submucous) fibroids
  • Laparoscopic myomectomy: Suitable for fibroids up to 10cm in size
  • Open myomectomy: Reserved for very large and numerous fibroids
  • 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.
  • Hysterectomy (laparoscopic or open): A permanent solution suitable to women with severe symptoms who have completed their family.

Fibroids

“I am 38 years old and have been suffering from heavy periods and pelvic pain. I developed an increased frequency of urine with mild leakage of urine. I had pelvic scan a year ago which showed a large fibroid. As my symptoms were increasing, I decided to contact a specialist. I called Mr Raza’s office for an appointment and was booked to see him in the same week.

Mr Raza spent a good 30 minutes with me to through my history, carry out a pelvic examination and also a transvaginal ultrasound scan. The scan showed a big fibroid measuring 9.5 cm in the uterus, which was the cause of my pain, very heavy periods and urinary leakage.

I was given two options including medical treatment with tranexamic acid to stop the bleeding and pain killers to ease the pain. The second option was to have a surgical treatment with laparoscopic myomectomy, which is keyhole surgery to remove the fibroid. After considering all the options I wanted to proceed with laparoscopic myomectomy. My operation was booked for the next week. I had the operation in Chelsea and Westminster hospital. Mr Raza’s secretary explained to me the time I needed to fast where I needed to go and what I needed to bring. When I arrived at the private wing I had my own private room and met Mr Raza and the anaesthetist prior to surgery.

My operation went very well and Mr Raza visited me the next day as I needed to stay 1 night for recovery. He also showed me images of the operation, which I found very interesting and helpful.

I returned for my follow up after 10 days for him to review my wounds post-operation. The operations was extremely successful and carried out as planned. 3 months down the line I can see the improvement. I couldn’t be more pleased with the outcome.”

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 is rare for them to be cancerous. If the fibroids grow fast then MRI should be done to look at the fibroids closely.