I encounter many women who have fibroids. In fact I come across many women with many fibroids!
What are fibroids?
Fibroids are benign growths in the womb muscle. They vary in their size and position in the womb and can be single or multiple. Some fibroids grow up to 25 or even 30 cm in size. It’s not only their size but also their position that is important. We know that small fibroids that are inside the womb cavity (bit like a grape on a stalk) can cause lots of problems, even if they are very small. While fibroids that sit on the outside of the womb are often not a problem even if they are much bigger.
Fibroids can cause irregular and heavy and prolonged bleeding, miscarriage and implantation problems with fertility treatment. If fibroids are large then they can cause issues by putting pressure other organs. This could be the bladder (making you want to pass urine more often) or the bowels, causing constipation. Some patients can press on their fibroids and wobble them. These fibroids can actually move about with exercise or sex and this can be an uncomfortable sensation.
What to do with fibroids?
First of all, most women with fibroids don’t require any sort of treatment. I only recommend treating them if they are causing problems. There are many types treatment including medication and surgery. Some medicines will be non-hormonal and taken only during the period, whilst hormonal treatment is useful for many.
Unfortunately there is not a tablet or medication that will take fibroids away permanently (if only). Some medication is used to shrink fibroids before surgery but can only be used for a limited amount of time.
Fibroids that sit inside the womb cavity (the technical term is sub-mucous fibroids) can be removed by a vaginal approach, so no skin cuts. The medical term is “Trans-cervical resection of Fibroid” (TCRF). It is performed under sedation or general anaesthetic and takes around 30 minutes. Post-operatively patients may have some cramping discomfort that settles with paracetomol or ibuprofen. If the fibroid is quite big then two operations may be necessary, but this is quite unusual.
If the fibroids are on the outside (sub-serous) or in the in the middle of the muscle (intra-mural) then removing them needs to be done through from above (so skin incisions are necessary). The choice is either via a keyhole approach (laparoscopic) or an open operation (like a caesarean section incision). If there are not too many fibroids and they are not too big then a keyhole procedure can be done. The surgery will take longer but your recovery is much quicker and is a lot less painful afterwards. However if you have very large or multiple fibroids then it is normal to need a larger skin incision. This can normally be done quite low down so it can be hidden as much as possible.
Want to talk about fibroids?
If you are worried about fibroids and want to talk through investigations and treatment then contact my PA Yvonne Baillie on 0207 125 0547 firstname.lastname@example.org to arrange an appointment