Fibroids can be painful and disrupt your regular activities. Though not cancerous, if they are causing too much trouble, you need to attend to them. Have you ever wondered why sometimes just monitoring is enough, but some fibroids require surgery? Does your fibroid require surgery? Come, let’s find out!
Fibroids are small lumps that grow in the uterus. These lumps are non-cancerous tumours that are made up of smooth muscles and tissues. A fibroid can be classified as submucosal, subserosal, myometrial and pedunculated based on its location.
The impact of these fibroids and the treatments varies not just from person to person but from fibroid to fibroid as well. While some fibroids can be ignored, some need immediate attention. Many people are unaware of the fibroids in them. Not all fibroids present any symptoms, so it is difficult to determine what percentage of people have them.
Some common symptoms of fibroids are:
● Heavy bleeding during periods
● Bleeding between menstrual periods
● Pain, discomfort, or pressure in the lower stomach area
● Frequent urination
● Inability or trouble emptying the bladder which makes you want to visit the toilet frequently.
Unlike many other health conditions, there is no one fixed option when it comes to surgery for fibroids. Fibroids come in different shapes, sizes and locations. If they are giving you trouble and no treatment seems to work, your doctor might suggest surgery. If the fibroid is located on the uterine lining or is preventing you from getting pregnant, you need to remove it, irrespective of its size.
Usually, your doctor will try hormonal contraceptives or birth control pills to slow down the fibroids’ growth and control the symptoms. They may even try over-the-counter pain medications, iron supplements to help those losing a lot of blood due to heavy bleeding, or GnRH (Gonadotropin-releasing hormone agonists) to help shrink the fibroids. If none of these works as expected or gives the required relief, surgery is the only other option.
If you are nearing menopause and your fibroids are not causing too much pain or discomfort, you can wait or manage symptoms using medications until you attain menopause. Fibroids can shrink or disappear after menopause.
The benefits of fibroid surgery can differ from person to person and from procedure to procedure. When you undergo a hysterectomy, there is no risk in the future. However, with other procedures, there is a risk of the fibroid growing back and presenting with other symptoms.
Common benefits of fibroid surgery may include:
● Reduction in bleeding
● Decrease in pain
● Reduction in pressure caused by fibroids
● Complete removal of the fibroids causing trouble
● Fibroids may not grow back at all or may not grow back as big as before the surgery.
While generally safe, fibroid removal surgery can carry some risks, like any medical procedure.
● Pain and bleeding post-surgery
● Risks related to anaesthesia
● Regrowth of fibroids
● In rare cases, surgery may not fully resolve symptoms
● Damages to the uterus or surrounding organs
● Infections
Remember, not everyone who undergoes a fibroid removal surgery will suffer from these complications. The complications can vary from person to person depending on the type of surgery, location and size of the fibroid.
When it comes to surgically removing fibroids, you have the following options:
This surgery helps remove the fibroids without causing any damage to the uterus, thus retaining the possibility of pregnancy in the future. Though the fibroids will not grow back in the same location, they can start growing in other locations. Some women require a repeat procedure to get rid of the new fibroids.
● Hysteroscopy - A very effective procedure for those small fibroids that grow in the cavity of the uterus or near the cavity. The doctor first fills the uterus with a liquid and then cuts the fibroids. The fibroid fragments are flushed out along with the fluid.
● Laparoscopy – Two small incisions are made in the belly. The fibroids are cut into smaller pieces and removed through these 2 incisions.
● Laparotomy – The fibroid is removed through one large incision.
A safe and effective procedure for smaller fibroids in women who have not yet attained menopause.
A minimally invasive procedure to remove small fibroids that are located inside of the uterus or near the cavity of the uterus. This procedure will destroy the endometrial lining, effectively reduce heavy bleeding, and also remove the fibroids.
A procedure that injects small particles into the uterine artery to block the blood flow to the fibroids. The fibroids will shrink in size, and symptoms can improve.
A partial or complete removal of the uterus to get rid of the fibroids for good. This procedure is suitable for women who are not planning to get pregnant in the future. If the fibroids are too big or are giving too much trouble, the doctor may suggest removing the uterus using different methods.
Magnetic Resonance-guided Focused Ultrasound heats and destroys the fibroids using ultrasound. This is a good option for women who want to conceive in the future, as the ultrasound will target only the fibroids and will not cause any harm to the uterus and surrounding areas.
In this procedure, the doctor will shrink the fibroids before removing them through tiny incisions in the belly. This is a fairly risky procedure. If the fibroid is cancerous, this procedure can spread the cancer.
One of the biggest concerns regarding fibroid removal surgery is its impact on future pregnancies. Procedures like embolisation, morcellation, and radiofrequency ablation can affect a woman’s fertility but may not necessarily prevent pregnancy. However, pregnancy after a hysterectomy or an endometrial ablation is not possible.
Your doctor may not suggest a fibroid removal surgery unless they are giving you too much trouble or are unresponsive to other treatments. Removing the fibroids surgically can provide immense relief and improve your quality of life. Discuss in detail with your doctor, understand the pros and cons, and make a well-informed choice.
Fibroids can be removed using various surgeries such as Myomectomy, Radiofrequency Ablation, Endometrial Ablation, Fibroid embolisation, Hysterectomy, MRgFUS, and Morcellation. The type of surgery will depend on the size, location and impact of the fibroids.
In most cases, doctors will first try to shrink the fibroids using hormonal contraceptives or by cutting the blood supply to the fibroids. Next, they will try medications and treatments to alleviate the symptoms caused by the fibroids. If none of these work, they will suggest surgery. Not having the surgery may extend your suffering, such as heavy bleeding during periods, prolonged periods, risk of infertility, anaemia and other complications.
Once you consult your doctor regarding your symptoms, they will check for similarities between your symptoms and those of fibroids. If there are similarities, they will perform a pelvic examination and also ask for imaging tests. These images can help them confirm fibroids and also understand their size and location.
