Uterine Fibroids: Symptoms, Causes, Risk Factors & Treatment

Fibroids are benign/non-cancerous tumors associated with the uterus. They are made up of dense fibrous tissue, which is where the fibroids come from. Fibroids are also known as leiomyoma or just myoma. Fibroids can grow as single tumor or these can be many of them in uterus. They can be as small as an apple seed or as big as grape fruit. In unusual cases they can became very large.

Fibroids are also very vascular, that means a strong and well developed blood vessel system to carry oxygen and nutrients to living tissue. The fact that fibroids are vascular means that surgically removing is often bloody and debilitating.

Fibroids are like weeds, they leave behind any roots (the fibroid- feeding blood vessels) and they usually grow back

TYPES:

  • SUB MUCOSAL FIBROIDS – these grow inside the uterine cavity. This is the space where a growing baby lives; large fibroid in this area can also enlarge the uterus to resemble extreme weight gain or a pregnancy type belly.
  • INTRA MURAL FIBROIDS: these grow with in the muscular wall of uterus, these is the muscular area that contracts while giving birth.
  • SUB SEROSAL FIBROIDS:  these can grow on outside wall of uterus, these fibroid produces symptoms like back pain and bladder pressure as growing fibroids press on nerve endings and/or other organs in the body.
  • PEDINCULLATED FIBROIDS: these are the fibroids that grow on stalks, like mushrooms. They can emerge from inside o0r outside uterine walls. A twisted or impeded stalk will cause severe pelvic pain.

RISK FACTORS:

  • Age: fibroids become more common especially during their 30’s and 40’s and up to menopause.
  • Family history: having a family member with fibroids increases your risk, if a women’s mother had a fibroids, her risk of having fibroids is above 3 times higher than average
  • Obesity: women who are overweight are at higher risk of fibroids, for very heavy women the risk is 2 to 3 times higher than average.
  • Diet:   foods which contain estrogen like yams, soy products, and red meat can cause fibroids to grow.

SYMPTOMS:

  • Heavy or prolonged periods.
  • Bleeding between periods
  • Pelvic pain and pressure
  • Frequent urination
  • Low back pain
  • Pain during intercourse
  • Difficulty in getting pregnant or infertility.
  • Complications during pregnancy and labor including a six-time greater risk of cesarean section.

DIAGNOSIS:

  • ULTRASONOGRAPHY:  Ultrasound is the most commonly used scan for fibroids. It uses

Sound waves to diagnose fibroids and involves frequencies much higher than what we hear.

  • MAGNETIC RESONANCE IMAGING (MRI):

This imaging uses magnets and radio waves to produce images. It allows doctor to gain a road map of the size, number and location of the fibroids. we can use MRI to confirm a diagnosis and help determine which treatments are best for you.

TREATMENT:

  • If you have fibroids and have mild symptoms, doctor may suggest taking medication.
  • If you have heavy menstrual bleeding, taking an iron supplement can keep you away from getting anemia.
  • 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 to grow and can help control heavy bleeding.
  • The same is true for progesterone-like injections (e.g.: DEPO-PROVERA).
  • An IUCD (intra uterine device) called MIRENA contains small amount of progesterone –like medication, which can be used to control heavy bleeding as well as for birth control.
  • Other drugs used to treat fibroids are gonadotropins releasing hormones agonists (GnRHa).the most commonly used one is LUPRON. These drugs can be given by injection, nasal spray, or implanted, can shrink fibroids.
  • Side effects of GnRH are hot flushes, depression, not being able to, decreased sex drive, and joint pain.

Most women do not get periods when taking GnRHas. This can be big relief to women who have heavy bleeding. It also allows women who have (heavy bleeding) Anemia to recover to a normal blood count.

SURGERY:

If you have fibroids with moderate to severe symptoms, surgery may be the best way to treat.

MYOMECTOMY: 

Surgery to remove fibroids without taking out healthy tissue of uterus. It can be performed in many ways like open surgery, laparoscopic. Women can become pregnant after myomectomy.

HYSTERECTOMY:

Surgery to remove the entire uterus, this surgery is only sure way to cure uterine fibroids. This surgery is used when women’s fibroids are large, if she has heavy bleeding, is either near or post menopause or doesn’t want children.

 UTERINE FIBROID EMBOLIZATION (UFE)

  • It is a non-surgical, minimal invasive treatment option for uterine fibroids.
  • Uterus remains preserved.
  • Lower complication rate with reductions in pain and blood loss.
  • Reduced surgery recovery time so most patients return home same day and return to normal activities within one week.
  • UFE is performed by an interventional radiologist who inserts a thin catheter into artery at the groin or wrist.
  • The radiologist guides the catheter to the fibroids blood supply where small particles, are released to float downstream and block small blood vessel and deprive the fibroids of nutrients.
  • This results in fibroid softening, bleeding less and shrinking in size.
  • Approximately 9 out of 10 patients who undergo uterine fibroid embolization will experience significant improvement or their symptoms will go away completely.
  • UFE is effective for multiple fibroids, and the reoccurrence of treated fibroids is very rare.

 UFE PROCEDURE: 

  • UFE is an angiographic procedure that is typically performed by using a unilateral femoral artery approach.
  • In almost all cases bilateral uterine artery catheterization and embolization are needed, since most of the fibroids receive blood supply from both uterine arteries.
  • It is also easier to catheterize across the aortic bifurcation to the opposite side technique that can reduce fluoroscopy time.
  • Under fluoroscopy, left iliac artery is accessed with catheter. Thereafter, many radiologists catheterize uterine artery with a micro catheter.
  • After uterine arteriography, embolic material is injected into uterine artery to occlude the vessels of fibroid.
  • This procedure is repeated in the contralateral uterine artery as well, since blood supply to a fibroid is rarely unilateral.
  • The goal is to occlude vessels of fibroid but not to completely occlude uterine artery.
  • Usually trisacryl gelatin microspheres or polyvinyl alcohol particles are used as embolizing materials.
  • Most patients will experience less pain after procedure.

Who is the best doctor for the treatment of Fibroids?

UFE is by far the best non-surgical treatment procedure for uterine fibroids. It is a painless process and does not have any major side-effects. It is usually performed as an outpatient procedure, you do not require hospitalization and can go back home on the same day.

Centre for UFE is the world-class medical institute for the treatment of uterine fibroids. It has all the latest medical equipment and the most experienced doctors for the best-in-class treatment of uterine fibroids for patients of all age groups.

Dr. Rajah V Koppala has over two decades of medical experience and specializes in the UFE treatment of fibroids. He has successfully treated thousands of women who have symptoms with fibroids.

If you experience discomfort from the uterine fibroids symptoms and/or are unable to grow your family, get in touch with Dr. Rajah V Koppala at Centre for UFE. We are here to help you bid a farewell to the fibroid pain and heavy bleeding, and be blessed with a healthy baby. Get in touch with us today!