FIBROIDS

Uterine fibroids are benign (non-cancerous) tumours, commonly seen in women of childbearing age. Fibroids are composed of muscle cells and other tissues, and develop in and around the wall of the uterus. Uterine fibroids are usually round or semi-round in shape. Based on their location within the uterus, uterine fibroids can be classified as:

Subserosal fibroids: Sited beneath the serosa (the membrane covering the outer surface of the uterus)

Submucosal fibroids: Sited inside the uterine cavity below the innermost layer of the uterus

Intramural fibroids: Sited within the muscular wall of the uterus

Intracavitary fibroids: Sited inside the uterine cavity

Pedunculated fibroids: Develop on a stalk attached to the outer wall of the uterus

Causes
The exact cause for the development of fibroids remains unknown, but some of the proposed causes include:

Genetic abnormalities

Alterations in expression of growth factor (protein involved in rate and extent of cell proliferation)

Abnormalities in the vascular system

Tissue response to injury

Family history of fibroids

Uterine infection

Consumption of alcohol

Elevated blood pressure

Hormonal imbalance during puberty

Symptoms
The majority of women with uterine fibroids are asymptomatic. However, some symptoms that may indicate fibroids include:

Heavy menstrual bleeding

Prolonged menstrual periods

Pelvic pressure or pain

Frequent urination

Constipation

Backache or leg pain

Difficulty in emptying your bladder

These symptoms can indicate may other medical conditions, but if you experience multiple of the above you should ask your doctor to investigate for fibroids, especially if you also have any of the above-listed causes.

Diagnosis
The diagnosis of uterine fibroids requires a pelvic examination followed by pelvic ultrasound. MRI scan and CT scan may also be required, although less commonly.

Treatment
There are a few different treatment options for managing and removing uterine fibroids. Surgery is often very effective, and there are several surgical options which depend on the location, size and persistence of the fibroids. Your doctor will determine the options appropriate to your situation. Common surgeries performed on fibroids include:

Myomectomy or selective removal of the fibroids within the uterus

Destructive techniques that involve boring holes into the fibroids with a laser or freezing probes (cryosurgery)

Uterine artery embolization (UAE) and uterine artery occlusion (UAO)

Hysterectomy or removal of the uterus

Non-surgical methods comprising of steroidal medication are also used to stabilise the oestrogen levels in the body and minimise fibroids and their recurrence.