Fibroids are muscle tumours of the uterine wall.

Fibroids are typically non-cancerous growths of the uterine wall commonly found in women during their childbearing years. Fibroids may be classified according to their location within the uterus as:

1. Subserous fibroids which grow in the outer wall of the uterus
2. Intramural fibroids which grow within the inner wall of the uterus
3. Submucosal fibroids which protrude into the cavity of the uterus

Depending on the location of the fibroids and size of the fibroids, there may be different symptoms. Submucous fibroids protruding or pressing into the cavity of the uterus may cause heavy or prolonged menstrual bleeding. Large subserous fibroids or large intramural fibroids may exert pelvic pressure or pain. Fibroids lying close to the bladder may cause frequent urination, or difficulty emptying the bladder. Fibroids lying at the back of the uterus close to the bowels may cause difficulty with defaecation or emptying of the bowels.

Occasionally, women may not have symptoms from fibroids and may be found to have fibroids only incidentally on physical examination when a large abdominal mass is detected.

Treatment of fibroids

Based on the results, further treatment may be recommended. Methods of treating pre- cancerous changes of the cervix include laser vapourization, LEEP and cone biopsy. LEEP or cone biopsy are minor surgical procedures that involve removal of a cylindrical or cone-shaped piece of cervix in which abnormal cells are located by using a heated electrical loop wire or with a laser, diathermy or knife respectively.

• the nature of the symptoms e.g. severity of pain or heavy menstrual flow caused by fibroids
• the desire for fertility (usually done to prepare for IVF treatment).
• the size of the lesion
• the risk for cancerous changes

Options for fibroids include:

• Observation of fibroids
  An ultrasound scan is usually useful for the diagnosis of fibroids and monitoring the size of fibroids.
• Medication for symptoms caused by fibroids
  Medication may also be prescribed to reduce menstrual pain and also to reduce the amount of menstrual flow due to the fibroids.
• Surgery to remove fibroids
  
  • Myomectomy
    Myomectomy refers to surgery to remove the fibroids alone, leaving the uterus in place to allow you to bear children. With myomectomy, as opposed to a hysterectomy, there is a risk of fibroid recurrence. The surgical approach to a myomectomy depends on the size and location of the fibroids. Fibroids may be removed by laparoscopy (minimally- invasive or key-hole method) or laparotomy (open abdominal approach).
  • Hysterectomy
    Surgery to remove the uterus is the permanent solution for fibroids but ends your ability for childbearing. Hysterectomy may also be performed by laparoscopy or laparotomy.