Q.
1. What are fibroids and why are they formed?
Fibroids are benign (non-malignant) tumors arising from the uterus. They would be seen in as many as 1 in 5 women after the age of forty, if all were to undergo an ultrasound of the lower abdomen. Even after extensive research, we have not been able to ascertain why fibroids are formed but genetic and environmental factors are suspected to be partly responsible.
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2. What problems can occur due to fibroids?
Fibroids often do not cause any problems and are picked up incidentally on scans done for some other purpose. Sometimes, especially when encroaching on the uterine cavity, fibroids can cause heavy menstrual bleeding and painful periods. Occasionally large sized fibroids may present as a hard lump in the lower tummy or with pressure symptoms on the bladder (frequent, scanty urination) or rectum.
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3. Do all fibroids need an operation?
Most fibroids do not need an operation just because they are there. Large fibroids felt on the tummy, fibroids causing heavy menstrual bleeding and pain not responding to medicines are most to need an operation for removal.
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4. Can fibroids turn to ‘cancer’?
Rarely about 3 to 4 in 1000 fibroids may turn malignant. For all practical purposes, all fibroids are benign.
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5. What happens to fibroids in the long run?
Some small fibroids may spontaneously disappear with time. Many stay the same size throughout and shrink once menopause sets in. Some fibroids (~ 20%) have a propensity to grow and multiply.
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6. Can a fibroid cause infertility?
Fibroids are often not the cause of infertility and some other associated factor should always be investigated. Some fibroids may however block fallopian tubes or impede with implantation and may need to be removed before infertility treatment is commenced.
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7. What problems in pregnancy can a fibroid cause?
Most often fibroids do not interfere with pregnancy. Occasionally they may result in severe pain following degeneration needing treatment. In advanced pregnancy they may be responsible for abnormal positions of the baby, cause interference with delivery of the baby and result in increased bleeding after delivery.
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8. What operations are done for fibroids?
Operations for fibroids essentially involve removing just the tumor(s) from the uterus or removing the uterus and tumor together. These operations may be done using the laparoscopic approach or by the conventional open surgery route. Contrary to WHAT some believe most fibroids can be removed entirely by a laparoscopic operation. The success of the procedure depends on the skill of the surgeon, the number of fibroids and the facilities available. Alternately, blood supply to fibroids, may be cut off by blocking supplying blood vessels.
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9. Are medicines available for treating fibroids?
Unfortunately medicines are not yet available to dissolve fibroids or make them vanish! GnRH injections may however be used to shrink fibroids either before surgery or to temporarily reduce symptoms.
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10. Can fibroid formation be prevented?
Unfortunately fibroid formation cannot be prevented as far as research available today suggests.