Uterine Fibroids

(Information provided by UpToDate)

Fibroids are growths of the uterus, or womb. They are also called uterine leiomyomas or myomas. Fibroids grow from the muscle cells of the uterus.  Fibroids are not cancerous or pre-cancerous.

Fibroids are very common. At least 25 percent of women have signs of fibroids that can be detected by a pelvic examination or ultrasound; not all of these women have symptoms of their fibroids.

FIBROID CAUSES — Although the exact cause of fibroids is unknown, fibroid growth seems to be related to the hormones estrogen and progesterone. When these hormone levels decline at menopause, many fibroid-related symptoms begin to resolve. However, it is not clear that hormones actually cause the fibroids.

The majority of fibroids are small and do not cause any symptoms at all. However, many women with fibroids have significant bleeding and/or pelvic pain that interfere with some aspect of their lives.

The severity of symptoms is related to the number, size, and location of the fibroids. Fibroid symptoms fall into three main groups: increased uterine bleeding, pelvic pressure and pain, and problems related to pregnancy and fertility. Fibroid symptoms tend to decrease at the time of menopause.

FIBROID TREATMENT-Birth control pills can be helpful in decreasing heavy menstrual bleeding associated with fibroids. The birth control pill does not shrink the fibroid, thus it is not an effective treatment for women with fibroids who have pelvic pressure, pain, or infertility.

Levonorgestrel intrauterine device — The levonorgestrel intrauterine device (IUD), available in the United States as Mirena®, is another possible option for women with fibroids who have heavy menstrual bleeding.  It can significantly reduce menstrual bleeding and provide an effective long-term (up to 5 years) form of birth control.

Progestin is a hormone that works to decrease the thickness of the uterine lining, thereby decreasing menstrual bleeding. It can be taken as a daily pill, an injection given every 12 weeks, or as an implant that is inserted and left under the skin for up to 3 years (Implanon). Progestin treatments do not decrease the size of fibroids but can decrease fibroid-associated heavy bleeding.
 

Surgical fibroid treatment — Surgical fibroid treatment may be recommended for longer-term relief of fibroid symptoms such as bleeding and pain. In other cases, surgical fibroid procedures are done in an attempt to treat infertility. A number of surgical fibroid treatments are available.

Hysterectomy is the surgical removal of the uterus through the abdomen or vagina. It may be the treatment of choice for women who have completed childbearing, those who are not interested in other surgical treatments, and those with severe symptoms or recurrent symptoms after less invasive surgery.

Myomectomy is the surgical removal of a fibroid. It may be done by making an incision in the abdomen and removing the fibroids (called abdominal myomectomy) or by making multiple small incisions in the abdomen and using a thin narrow tube with a camera (laparoscope) to remove the fibroids (called laparoscopic myomectomy). If the fibroids are inside the uterus, a procedure called hysteroscopic myomectomy may be recommended.  There is a significant risk that fibroids will recur after myomectomy; between 10 and 25 percent of women who have myomectomy will require a second fibroid surgery.

In this procedure, the lining of the uterus is destroyed with heat by inserting a scope through the vagina and cervix and into the uterus. It can be done in combination with other treatments, such as hysteroscopic myomectomy or myolysis (explained below). Endometrial ablation does not shrink the fibroid(s), but can help to decrease heavy menstrual bleeding caused by fibroids.

In uterine artery embolization (UAE or UFE), a small catheter is inserted into a large blood vessel in the groin and threaded up to blood vessels near a fibroid. Tiny particles are injected into the blood vessel, which stops blood flow to the fibroid. This causes the fibroid to rapidly soften and decrease in size within weeks to several months after the procedure.

Dr. Scott is available to discuss fibroids and treatment options.  Call us for an appointment at (770) 405-0391.

Conditions Treated
  • Menopause
  • Leaking Bladder
  • Uterine Fibroids
  • Genital Prolapse
  • Painful Menses
  • Chronic Pelvic Pain
  • Endometriosis
  • Polycystic Ovaries
  • Osteoporosis 

SCOTT GYNECOLOGY & PELVIC SURGERY - Dr. Vincent S. Scott   (770) 405-0391
5041 Dallas Highway, Powder Springs, GA 30127    drscott@scottgynecology.com

Copyright © 2009 SCOTT GYNECOLOGY & PELVIC SURGERY. All Rights Reserved.

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