Fibroids are benign tumours affecting the uterus (womb). They are also sometimes called uterine leiomyomas, fibromyomas or myomas. They are found in over half of all women, and in some women will cause significant symptoms. They are the commonest benign (non-cancerous) tumours of the womb. These symptoms can include heavy menstrual bleeding, painful periods, and effects on the bladder or on the bowels (such as constipation or bloating sensations). Fibroids may also affect fertility and sometimes women may be referred for removal of their fibroids before starting fertility treatment.
There are three types of fibroids:
1. Submucosal fibroids, which develop within the inner layer of the womb, often growing out into the cavity of the womb.
2. Intramural Fibroids, which develop in the middle layer of the womb.
3. Subserosal Fibroids, which develop on the outer layer of the womb.
The Treatment of fibroids
Often some medications such as Tranexamic acid, Mefanamic acid, or hormones such as Norethisterone or the contraceptive pill can successfully manage the symptoms associated with fibroids. Often an Intrauterine system (e.g. the Mirena Coil) can be an effective way of controlling fibroid symptoms.
Transcervical resection of fibroids (TCRF)
Hysteroscopic resection of fibroids or TCRF is an operation to remove fibroid tissue from the inside of the womb (within the uterine cavity) when the fibroids are causing heavy bleeding. This operation is usually performed under general anaesthetic in the day surgery unit. It rarely requires an over-night stay. A thin telescope in passed in the cavity of the womb via the neck of the womb (the cervix). If a fibroid is found, it may be cut using a heated loop. Occasionally a second operation may be required to remove larger fibroids.
Radiofrequency Ablation of Uterine Fibroids
The Sonata™ System uses radiofrequency energy to ablate uterine fibroids under intrauterine ultrasound guidance. Mr Quinn at Imperial College was the first gynaecologist in the UK to perform fibroid treatment using this device and to date has performed over 30 cases.
For more information visit: https://gynesonics.com/us/sonata-system/
This operation involves the removal of the lining of the womb in order to reduce monthly menstrual bleeding. This treatment can be very effective for women who have completed their families and wish to avoid more invasive surgery.
Removal of larger fibroids from the uterus may be done using key-hole (laparoscopic) surgery or by a larger cut on the abdomen (open) depending on the size and position of the fibroids. This operation is often preferred in women aiming to have children, or when the fibroids are very large. These operations involve a general anaesthetic and a stay in hospital.
For some women, removal of the womb by hysterectomy may be the most effective way of treating their symptoms. This operation, like myomectomy may be performed by key-hole or open techniques depending on the size of the fibroids. The type of surgery would be discussed with you at your consultation.
Uterine Fibroid Embolisation (UFE)
UFE (also known as uterine artery embolisation (UAE)) is a procedure to block the blood supply to the fibroids. Following UFE it is hoped that the fibroids will shrink in size (although not completely disappear), and that symptoms such as heavy bleeding and pain will improve. This procedure is often recommended in women with multiple fibroids causing symptoms who wish to avoid surgery (myomectomy or hysterectomy).