Many women have heard the word fibroid at some point in their lives. In fact, fibroids are the most common tumors seen in women. According to research, 30% of women between the ages of 30-60 have fibroids. Fibroids are the most common reason for the removal of the uterus, and therefore being diagnosed with fibroids causes some concern for women.
What is a fibroid?
A fibroid is a benign tumor originating from the smooth muscle layer of the uterus. Fibroids appear as a mass formed by the irregular accumulation of muscle cells. As they grow and put pressure on surrounding tissues, they create a “false capsule” around themselves.
How large can fibroids be and how many can there be?
Fibroids can range in size from a few millimeters in diameter to large enough to completely fill the abdomen (for example 30 cm in diameter). Their number can range from a single fibroid to so many that the entire uterus becomes lumpy like a “sack of potatoes.” They generally tend to grow during pregnancy and shrink after menopause.
Who is more likely to have fibroids?
Never having given birth, obesity, high blood pressure, or having a family history of fibroids puts individuals at greater risk for fibroids.
What kind of complaints can fibroids cause in women?
Many fibroids do not cause any symptoms. However, depending on their location and size, they may cause very heavy menstrual bleeding, prolonged periods, pelvic pain, frequent urination, constipation, difficulty having children, and pregnancy losses. Some women may also feel the fibroid as a swelling in the abdomen.
How is fibroid diagnosis made?
Detecting a large and firm mass in the uterus during examination is considered suggestive of fibroids. Ultrasound is a great help in diagnosis.
What are the medical treatment options for fibroids?
Unfortunately, there is no medication that can completely treat fibroids. However, sometimes—usually before surgery—certain injections may be used temporarily to shrink the fibroid or reduce blood loss during surgery. These injections create a “temporary menopause” condition in women. These medications are not used for long periods because of their side effects.
The definitive treatment for fibroids is surgery. However, “not every fibroid deserves surgery!” Surgery is recommended if:
- There is uncontrollable, very heavy menstrual bleeding,
- There is a fibroid that enlarges the uterus to the size of a 3-month pregnancy or more,
- There is a fibroid that grows very rapidly during follow-up,
- There is pelvic pain that cannot be explained by another reason,
- The fibroid presses on important structures such as the bladder or intestines,
- In cases of fibroids associated with difficulty having children or IVF failure
surgery is offered.
During surgery, if future childbearing is desired or preserving the uterus is the goal, only the fibroid(s) are removed. In women who have completed childbearing, removal of the uterus may be performed. These surgeries can be done either as open surgery or minimally invasive (laparoscopic) surgery.
If some fibroids have grown toward the inside of the uterus, they can be removed by entering through the vagina and cervix and observing the inside of the uterus with a camera (hysteroscopy), then scraping out the fibroid. Blocking the uterine blood vessels radiologically or burning the inside of the fibroids are also among the possible treatments, although they are not yet very common.
Do fibroids recur after surgery?
If only the fibroid is removed, it may recur within 10 years in 3 out of 10 patients after surgery.
Can fibroids turn into cancer?
The possibility of fibroids becoming cancerous is very, very low (0.1-0.5%). For diagnosis and treatment options regarding such common fibroids, it is absolutely necessary to consult a physician. Wishing you healthy and happy days…
Prof. Dr. Ümit İNCEBOZ / Obstetrics and Gynecology Specialist / İRENBE