Uterine fibroids, also known as Leiomyomas of the Uterus, are benign muscle tumors of the uterine wall. They never turn malignant, but are very common and can cause significant symptoms and problems.
Fifteen to twenty percent of women in the reproductive years can have fibroid tumors, and in women over 35, the incidence can reach 30 to 40 percent, so these are very common problems. These tumors can vary greatly in size and can grow over time. Although some women have one large tumor, most often there are multiple tumors. We have at times removed as many as 30 or more tumors during one operation.
Uterine Fibroids Symptoms
Depending on the size of the tumor and the location within the uterus, fibroid tumors can cause no symptoms to severe symptoms. Symptoms often include pain or pressure due to the size of the tumors, or heavy menstrual bleeding, sometimes producing anemia. They can cause increased cramping with periods, especially when the bleeding is heavy.
Fibroid tumors usually do not cause problems with pregnancy, but they can occasionally lead to pain during a pregnancy, difficulty with delivery, or in rare cases can be a cause of miscarriage.
Fibroid tumors are, to some extent, hormone dependent and have the potential to grow as long as a woman is still having menstrual periods. After menopause, fibroids will usually shrink by about 30% and then stay at that size permanently. Fibroid tumor growth is very unpredictable. Sometimes tumors will grow to a certain point and then remain that size without change. In other cases, the tumors will continue to grow progressively to impressively large sizes, sometimes resulting in a mass that can be felt in the abdomen all the way up to the navel or even beyond.
Treatments for Uterine Fibroids
There are no medications that prevent fibroid tumors, though there are some that can decrease their size temporarily. Often women live with fibroid tumors for many years without major problems, but when bleeding or pain issues occur, or when fibroid tumors simply become too large, hysterectomy may be necessary. Depending on the size and location of the tumors, this can be done as a robotic or laparoscopic procedure, or if the tumors are too large, this may have to be done with an open abdominal incision.
There is a procedure termed Myomectomy for removal of fibroid tumors without taking out the uterus. This too can be done with the DaVinci Robot, laparoscopically, or open, and in some cases of small tumors confined to the endometrial cavity this can be done through the cervix with a hysteroscope. However, generally speaking, myomectomy procedures are bigger procedures than hysterectomy with more postoperative pain and a longer recovery and for this reason, are usually reserved for those patients who have severe fibroid tumor issues, but still desire to have a baby.
There are obviously complex and individualized choices to be made in the treatment of fibroid tumors, so if you have fibroid tumors yourself, or suspect that you do, or if you know someone who does, we would advise a consultation with one of our physicians to help you understand the options.