Most Leiomyomas are non-cancerous tumor growths of the muscles and tissue of the uterus. A small percentage of fibroids become cancerous. Fibroids may occur as a single growth or in clusters. They can also vary in size. They can be located on the inner (sub mucosal) or outer (serial) surface of the uterus as well as with in (intramural) the uterine wall. Approximately 25-50% of women get fibroids, most commonly over of 35.
SymptomsMost of fibroids produce no symptoms. However, when symptoms do occur they many cause:
- Changes in menstruation - Heavy bleeding, bleeding between periods, longer periods
- Pelvic pressure- May cause frequent urinating, difficult bowel movements
- Pain - Low adnominal or lower back pain, painful intercourse
- Infertility - Difficult getting pregnant, may increase risk for miscarriage or preterm labor
- Enlarged abdomen
- Ultrasound - Sound waves create a picture of the pelvic organs
- Hysteroscopy - A slender camera is inserted through the cervix and the inning of the uterus can be visualized
- Laparoscopy - Small incisions are made in the abdomen and camera may see fibroids on the outer uterus.
- MRI and CPT Scans- Imaging test that can sometimes see pelvic organs, but usually an ultrasound is adequate.
Treatment OptionsNo treatment is necessary if the fibroids do not cause any symptoms
- Medications - Sometimes hormonal treatments such as birth control may control symptoms. In addition, drugs such as gonadotropin-releasing hormone (GnRH) agonists may used before surgery to shrink fibroids.
- Myomectomy - Surgical removal of the fibroids while keeping the uterus in place. This is an option that maintains a woman's ability to bear children after surgery. Depending on size and location a myomectomy may be performed by:
- Hysterectomy - That uterus is removed along with fibroids. This may be done with laparotomy, laparoscopy, robotic surgery, or through the vagina.
- Uterine Artery Embolization - A procedure performed by a radiologist that blocks the blood flow that permits the fibroids to grow.