Fibroids

Fibroids are the most common benign tumors in females and typically found during the middle and later reproductive years. While most fibroids are asymptomatic, they can grow and cause heavy and painful menstruation, painful sexual intercourse, and urinary frequency and urgency. Some fibroids may interfere with pregnancy although this appears to be very rare.

Treatment

Most fibroids do not require treatment unless they are causing symptoms. After menopause fibroids shrink and it is unusual for fibroids to cause problems.

Symptomatic uterine fibroids can be treated by:

• medication to control symptoms
• medication aimed at shrinking tumours
• ultrasound fibroid destruction
• various surgically aided methods to reduce blood supply of fibroids
• myomectomy
• hysterectomy
• treatment for infection and anemia
• embolisation

Myomectomy

Myomectomy is a surgery to remove one or more fibroids. It is usually recommended when more conservative treatment options fail for women who want fertility preserving surgery or who express desire to retain the uterus. This surgery is fertility preserving although in some circumstances subsequent pregnancies can be difficult or impossible.

There are three techniques types of myomectomy:

• In a hysteroscopic myomectomy, the fibroid is removed from inside the uterus by using a resectoscope, which is inserted through the vagina and cervix
• A laparoscopic (key hole) myomectomy is done through three small incisions in the tummy with a laparoscope. If the fibroids are quite large they can be morcellated and therefore, the procedure can still be done laparoscopically 
• Open Abdominal myomectomy is the most invasive surgical procedure to remove fibroids. An incision is made in the abdominal wall and the fibroids are removed from the uterus. Recovery time from this procedure is generally expected to be the same as for an abdominal hysterectomy, four to six weeks.