Uterine Fibroids

About
  • Benign growths that are made up of the muscle and connective tissue of the uterine wall
  • May grow as a single nodule or in clusters and may range in size from 1 mm to more than 20 cm (8 inches) in diameter
  • They may grow within the wall of the uterus, project into the interior cavity or toward the outer surface of the uterus
  • In rare cases, they may grow on stems projecting from the surface of the uterus
  • Symptoms, size, location and number vary
  • Each fibroid is unique and one of a kind, which requires individualization of therapeutic options

Potential Causes
  • Unknown
  • Most fibroids occur in:
    • Women of reproductive age
    • Black women diagnosed 2-3x more frequently than white women
    • Seldom seen in young women who have not begun to menstruate
  • Increased risk with
    • Genetic link
    • Obesity
    • Not having children
    • Early onset of menstruation
    • Late age for menopause

Symptoms
  • Most fibroids do not cause any symptoms
  • Symptoms usually stabilize/dissipate post-menopause
  • Some women may have the following:
    • Excessive/painful bleeding during menstruation
    • Bleeding between periods
    • A feeling of fullness in the lower abdomen
    • Frequent urination resulting from a fibroid that compresses the bladder
    • Pain during sexual intercourse
    • Low back pain
    • Constipation
    • Chronic vaginal discharge
    • Inability to urinate
    • Severe menstrual cramps
    • Infertility

Diagnosis
  • Pelvic exam: To detect if the uterus is enlarged/irregularly shaped
  • Abdominal ultrasound: To get a picture of your uterus and to map and measure fibroids

Treatment
  • If asymptomatic, no treatment is necessary
  • Periodic pelvic examination and ultrasound depending on the size or symptoms of the fibroid/s
  • Type of treatment is determined by the number, size, location and symptoms
  • Laparotomy: Abdominal incision to remove all fibroids
    • More often used when there are a large number of fibroids
  • Uterine Fibroid Embolization (UFE): Minimally invasive procedure that uses a form of real-time x-ray called fluoroscopy to guide the delivery of embolic agents to the uterus and fibroids
    • These agents block the arteries that provide blood to the fibroids and cause them to shrink
    • Nearly 90% of women who undergo UFE experience significant/complete resolution of their fibroid-related symptoms