Fibroid is a tumour of the uterus which is very common in females aged between 30 to 40 years.
Approximately 20 to 30 % Females have fibroids. When a fibroid is diagnosed the patient wants to
know if it is cured by medicines or by surgery only and the associated risk.
Fibroids are the tumours of the muscle wall of the uterus and can vary from a pea size to the size of
a football. They can be in different locations; Intramural, submucous and subserosal.
There are three points that we note before treating a fibroid:
1.Size of the fibroid:- If the size of fibroid is less than 4cm and the patient is asymptomatic then we only monitor the fibroid and the patient doesnot require any medical or surgical treatment.
2. If the size of fibroid is more than 4cm and its location is submucosal i.e, towards the lining of the uterus or if the patient is having symptoms like heavy menstrual periods or pressure symptoms like increased frequency of urine or motions or period continue for many days. In that case treatment is required.
3. The age of the patient and if she wants to become pregnant. If her age is more than 40 to 50 years then instead of removing fibroids we advise to remove the uterus.
If the patient wants to preserve her fertility then we can save the uterus and only remove the fibroids which is called Myomectomy.
We have an option of medical treatment which is good for some patients. Tablet ulipristal + urtate can be given for 3 to 6 months to reduce the size of fibroid.
Injection of ynrh agonists can also be given for 3 to 6 months to reduce the size of fibroids and to reduce the amount of menstrual bleeding giving symptomatic relief.
If your doctors feels that the medical management is not the right option then there are options of hysteroscopy and laparoscopy to remove then fibroids. In hysteroscopy we remove the fibroids which are located in the lining of the uterus through resection. Through this technique there is no incision on the body of the uterus as it is done through the vagina and the patient can be discharged the same day. If the fibroid is in the wall or outside the wall of the uterus then through laparoscopic myomectomy we remove the fibroids. This surgery should be done by an expert surgeon and the results are every good.
After this surgery the patient can try for conception after 3-4 months of the surgery. The last option in cases of patients who have very large and multiple fibroids have completed child bearing and their age is 40 to 50 years or more we advise them to remove their uterus , that is called hysterectomy.
It can be done through Laparoscopy which is almost a one day procedure and there is a very small incision on the abdomen and the patients can get back to the routine work in seven days. We at SCI can help you and evaluate which treatment modality is best for you.