Fibroids are simple non-cancerous growth of uterine cells which get worse with age. Every journey of the female patient is full of twists & turns, and silence over the issues further complicates the matter. One such problem is uterine fibroids. It is commonly encountered, making it practically important to know the basics of this problem.
Uterine fibroids are lumps or tumours that develop within the uterine walls of women. Although they are the most common tumours of the female genital tract, they are, thankfully, almost always benign Fibroids are most frequently encountered in 30-40-yr olds and during the childbearing and reproductive phase of their lives.
Chances of fibroids being Cancerous are very rare but they can be problematic in other ways. From mildly troublesome to being the cause of very heavy & painful periods to being detrimental to fertility and childbearing. Very often a combination of the last 4 conditions.
The size and location of the tumour decide the severity of the symptoms. Uterine fibroid sizes can range from a tiny seed to as large as a melon. Fibroids may grow just as a single cell or in clusters and range in size from 1 mm to 20 cm. A very large fibroid can put pressure on the uterus to enlarge, which is equivalent to 3rd-trimester pregnancy. Fibroids there fuse as a single unit or can be as clusters.
The size of a fibroid is the first sign in deciding the nature of the treatment. A woman’s uterus is tentatively 3 inches long and is of pear shape. Smaller fibroids may not cause any symptoms, so remain undetected. In contrast, larger fibroids can cause your uterus to enlarge, thus invite other changes in your body.
As fibroids increase in size, their impact on the body becomes more obvious & significant. They can take up space, which is meant for other organs and can cause discomfort or pain. Below are a few effects that can arise when fibroids grow.
Fibroids can cause swelling of the abdomen, unusual but significant weight gain, and pain in the pelvis and lower back, increased urination. These are just a few possible signs of a larger fibroid.
The location of Fibroids is an equally important & deciding factor in treatment.
Fibroids are usually found in or around the uterus but sometimes occur in the cervix too. Fibroids within the uterus can be divided into Subserosal fibroids (are located in the outer wall of the uterus (55%). • Intramural are found in the muscular layers of the uterine wall (40%). • Sub-mucosal fibroids protrude into the uterine cavity (5%).
Big fibroids put pressure on the ureters & effectively cause kidney damage if the fibroids are not removed. Fibroids in the lower uterus put pressure on the large bowel and rectum, which results in painful bowel movements, constipation, and haemorrhoids of different grades.
Fibroids are a matter of great concern to married couples as they may cause infertility or difficulties in conceiving.
Achieving pregnancy in women with infertility is often more challenging in women with fibroids than in women without fibroids or those who had their fibroids removed.
Treatment for fibroids may range from no action required to surgery or even removal of the uterus.
An interesting and typical case in point – Mrs. Kritika was fighting a fibroid problem, without even knowing it. 30-year-old old was a professional Bharatnatyam dancer. Her daily routine is performing for up to 5 hrs. Recently, however, she was experiencing exhaustion and heavy bleeding with abdominal pain during her menses. She also had lower back pain, bloating, and cramping. This was making it very difficult for her to continue her rigorous daily routine and her performance was suffering.
On testing, she was detected with uterine fibroids and anaemia due to the blood loss owing to the fibroids. Her consultant at Pearl Women’s Hospital advised her to undergo a myomectomy (surgical removal of fibroids). She was even toying with the idea of a hysterectomy (removal of the uterus). The consultant explained to her that
- At such a young age this would be detrimental to her overall health
- It would rule out another pregnancy (she already had one child)
- It wasn’t necessary. Advanced Laparoscopic techniques can handle even large and multiple fibroids and the woman can easily resume her normal routine quickly. The procedure is practically scar-free, recovery is quick and hospitalization is barely 2 days. The procedure is also covered under insurance.
She followed this advice & underwent a Laparoscopic myomectomy that required just 2-day hospitalization. Her major concern that as a dancer she needed to wear outfits that could expose surgical scars was also taken care of. The surgery was practically scar-free. Within a week she was happily back to normal. She is now pain-free and the heavy bleeding has stopped. Consequently, her anaemia has been managed and she has returned to her strenuous dance routine.
Early diagnosis goes a long way in less invasive treatment & faster relief from fibroids. Ultrasound scanning will be required to confirm the presence, shape, size, numbers, and location of the fibroids.
There are different approaches to removing fibroids, depending upon their size, numbers, and location. Dr Chaitanya Ganapule is an expert in Laparoscopic as well as open surgical removal of fibroids. Removal of large fibroids laparoscopically is his forte and he is considered the top Gynaecologist in Pune for this procedure.
He has a diploma in Gynae Endoscopy from France, a diploma in Pelvic Endoscopy from Germany, and has recently attended & successfully completed the Indian Workshop of the Franco-European Multidisciplinary Endometriosis Institute at France, in 2022.