Uterine fibroids are balls of smooth msucle, the same msucle that makes up the walls of the uterus, which form into discrete “tumours”, most commonly in the uterus itself. The location within the uterus (under the lining of the cavity, within the wall or on the outside) and their overall size and number determine whether they present as heavy bleeding, pain, pressure symptoms or are completely asymptomatic.
Treatment is therefore;
1. Do nothing - they are rarely malignant and if causing no problems may not need treatment at all
2. Medical therapy - some medications may shrink fibroids temporarily however this is done only to facillitate easier removal at a later date as this medication has side effects and can only be used for 6 months maximum after which time the fibroids will commence growth again
3. Intereventional radiology - so called Fibroid embolization
4. Magnetic Resonance guided focussed ultrasound - mRGFUs
5. Surgical removal of the fibroids - this can be done
a. Hysteroscopically - a camera insrted via the cervix to resect or remove fibroids that are predominantly within the uterine cavity, usually for heavy bleeding or fertility problems
b. Laparoscopically - Keyhole or Robotic surgery to remove fibroids on the outer side of the uterus causing pain, pressure or fertility issues
c. Some surgeons still prefer open surgery (laparotomy) with a large adbominal incision for removal of fibroids
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