Fibroid Surgery
Fibroid Surgery
What are the symptoms of fibroids?
Many patients suffering distressing symptoms because of fibroids, but sometimes the symptoms may be overlooked or dismissed because they are thought of as just being ‘part of being a woman’.
You might be suffering symptoms due to fibroids if you are experiencing:
Heavy, painful periods
Irregular bleeding (i.e. bleeding occurring in between periods)
Bleeding after intercourse
Abdominal or back pain
A need to urinate more frequently, or feeling constipated
Period pain which makes everyday life or activity difficult
Problems with fertility
Experiencing tiredness or anaemia through blood loss
What are fibroids?
Fibroids (aka leiomyomas) are benign growths of muscle and fibrous tissue which can grow in the wall or the cavity of the womb. Fibroids can be very small (known as seedlings) but they can also grow to a very large size. When this happens, the lining of the womb may become distorted or increased in surface area, which is why heavy bleeding is a common symptom of fibroids. We don’t fully understand why fibroids occur, but one in three women will develop fibroids and they are more likely to occur in women of African-Caribbean origin. The hormone oestrogen may have an influence over fibroid development, and typically fibroid symptoms will diminish after the menopause.
How are fibroids diagnosed?
If you are experiencing problems with heavy or painful periods, or suspect you may have symptoms relating to fibroids, I’m here to help. When you come to clinic, I’ll take a thorough history of your symptoms and carry out a careful examination. I’m also able to perform a detailed ultrasound scan, so I can assess for fibroids and other gynaecological conditions during your clinic visit.
What can be done to treat fibroids?
If you’re suffering from heavy bleeding, a medication called Tranexamic acid may help reduce the blood loss. The medication is taken on the days you have your period, and it works by limiting blood loss from the lining of the womb.
Hormonal treatments such as the contraceptive pill, or progesterone (which can be taken in the form of a pill, or 3 monthly injection, can also help. Some women may benefit from a kind of intrauterine coil which slowly releases progression into the womb (aka levonrgestrel intrauterine system), and it has the advantage of also being a contraceptive.
In certain situations such as before surgery, you may be advised to try a medication called gonadotrophin releasing hormone analogues (GnRHas), which act to shrink fibroids by preventing your ovaries from releasing oestrogen. Because this induces a menopause-like state, some women may find the treatment intolerable.
Surgery for fibroid symptoms
If you’re tried medical (conservative) treatments for your fibroid symptoms, but are still struggling, surgery may be a good option for you.
If fibroids are projecting into the cavity of the womb (aka submucosal fibroids) it may be possible to remove them via a hysteroscopy procedure. This involves passing a camera via the vagina and through the cervix to remove the fibroids. It preserves the healthy womb tissue and may be a more suitable treatment for women who wish to go on to have children. This can usually be done as a day case procedure, and a few days of resting at home after the surgery.
It may also be possible to remove fibroids that are protruding out of the wall of the womb through laparoscopic (keyhole) surgery.
Some fibroids become so large or multiple that an open incision is needed to remove them; the surgery is carried out through an incision much like that used during a caesarean section. One to two nights in hospital are required after the surgery, and recovery takes around 4-6 weeks.
Finally, some patients may decide to undergo hysterectomy (surgery to remove the entire womb).
What are the potential complications of having surgery to remove fibroids?
Any surgical procedure brings with it some element of risk, such as infection or bleeding, but thankfully serious adverse outcomes are rare.
Fibroid may also re-grow. So-called ‘seedling’ fibroids may grow in time, but this happens very slowly and ceases once a woman enters menopause.
If you’re struggling with symptoms relating to fibroids, or wish to explore treatment options, I’m here to help.
Miss Ghada Salman MBChB MSc FRCOG is a Consultant Gynaecologist at The London Clinic and HCA The Portland Hospital.
To make an appointment for a consultation: