Fibroid Tumors

Fibroid tumors are muscular tumors that grow in the wall of the uterus. Another medical term for fibroid tumors is “leiomyoma” (leye-oh-meye-OH-muh) or just “myoma”. Fibroid tumors are almost always benign (not cancerous). Rarely (less than one in 1,000) will a cancerous fibroid tumor occur. Fibroid tumors can grow as a single tumor, or there can be many of them in the uterus. They can be as small as an apple seed or as big as a grapefruit.

About 20 percent to 80 percent of women develop fibroids by the time they reach age 50. These are factors that can increase a woman’s risk of developing fibroid tumors:

  • Age. Most common in women in their 40s and 50s before menopause.
  • Family history.
  • Ethnic origin. African-American women are more likely to develop fibroids than Caucasian women.
  • Obesity.
  • Eating habits. Eating a lot of red meat is linked with a higher risk of fibroids.

Most fibroid tumors do not cause any symptoms, but some women with fibroids can have:

  • heavy bleeding or painful periods
  • feeling of fullness in the pelvic area
  • enlargement of the lower abdomen
  • frequent urination
  • pain during sex
  • lower back pain
  • complications during pregnancy and labor
  • reproductive problems, such as infertility, which is very rare

Fibriods and Pregnancy

Women who have fibroid tumors are more likely to have problems during pregnancy and delivery. This doesn’t mean there will be problems. Most women with fibroids have normal pregnancies. The most common problems seen in women with fibroid tumors are:

Cesarean section

  • Baby is breech
  • Labor fails to progress
  • Placental abruption. – The placenta breaks away from the wall of the uterus before delivery.  When this happens, the fetus does not get enough oxygen.
  • Preterm delivery

Talk to your obstetrician if you have fibroids and become pregnant. All obstetricians have experience dealing with fibroid tumors and pregnancy. Most women who have fibroids and become pregnant do not need to see an OB who deals with high-risk pregnancies.

How do I know for sure that I have fibroid tumors?

Your doctor may find that you have fibroids during a regular pelvic exam to check your uterus, ovaries, and vagina. The doctor can feel the fibroid with her or his fingers during an ordinary pelvic exam, as a (usually painless) lump or mass on the uterus.

Your doctor can do imaging tests to confirm that you have fibroid tumors. These are tests that create a “picture” of the inside of your body without surgery. These tests might include:

  • Ultrasound
  • Magnetic Resonance Imaging (MRI)
  • X-rays
  • Cat Scan (CT)
  • Hysterosalpingogram (hiss-tur-oh-sal-PIN-juh-gram) (HSG) or sonohysterogram (soh-noh-HISS-tur-oh-gram)—An HSG involves injecting x-ray dye into the uterus and taking x-ray pictures. A sonohysterogram involves injecting water into the uterus and making ultrasound pictures.

Treatments

Most women with fibroids do not have any symptoms. For women who do have symptoms, there are treatments that can help. Talk with your doctor about the best way to treat your fibroids. She or he will consider many things before helping you choose a treatment.
Some factors to consider when choosing a treatment plan:

  • whether or not you are having symptoms from the fibroids
  • if you might want to become pregnant in the future
  • the size of the fibroids
  • the location of the fibroids
  • your age and how close to menopause you might be

If you have fibroid tumors but do not have any symptoms, you may not need treatment. Your doctor will check during your regular exams to see if they have grown.

Medications

If you have fibroid tumors and have mild symptoms, your doctor may suggest taking medication. Over-the-counter drugs such as ibuprofen or acetaminophen can be used for mild pain. If you have heavy bleeding during your period, taking an iron supplement can keep you from getting anemia or correct it if you already are anemic. Several drugs commonly used for birth control can be prescribed to help control symptoms of fibroids. Low-dose birth control pills do not make fibroids grow and can help control heavy bleeding.

Surgery

If you have fibroids with moderate or severe symptoms, surgery may be the best way to treat them.
Myomectomy (meye-oh-MEK-tuh-mee) – surgery to remove fibroid tumors without taking out the healthy tissue of the uterus. This is best for women who wish to have children after treatment for their fibroids or who wish to keep their uterus for other reasons. However, if your fibroids were imbedded deeply in the uterus, you might need a cesarean section to deliver. Myomectomy can be performed in many ways. It can be major surgery (involving cutting into the abdomen) or performed with laparoscopy, hysteroscopy, or da Vinci robotic surgical system. The type of surgery that can be done depends on the type, size, and location of the fibroid tumors. After myomectomy new fibroids can grow and cause trouble later. All of the possible risks of surgery are present and depend on how extensive the surgery is.  Robotic Myomectomy using the da Vinici Surgical System is optimal as it is the least invasive procedure and provides optimal results.

Other Surgical Treatment Options