I am Dr. Puja Sharma, Gynaecologist. Today I will discuss a very common problem i.e. fibroid uterus. If you are at a reproductive age group then you must know about this. What are fibroids? What can happen if they are left untreated? What are the diagnostic techniques and finally the treatment? This is the most common tumors happens in the muscles of the uterus. This is the most common benign tumors. Benign means are non-cancerous. Who can have them or what are the risk factors? It is most commonly seen in women who had a family history of fibroids, who are nulliparous, who have early menarche or late menopause and obesity? These are the few risk factors. What are the symptoms? How can a lady think that she is having fibroids?
The fibroids mostly present with menstrual disturbances like abnormal uterine bleeding, mostly in the form of excessive and frequent uterine bleeding. It can also present as lower back pain, pelvic pain, pain during passing stools, pain during urination. Some fibroids can also cause infertility. We need to give certain extra precautions during pregnancy and after pregnancy. How can we diagnose them? In some cases, fibroids can be found while doing an ultrasound or pelvic examination otherwise for diagnosing it we need to a transvaginal ultrasound. However, in some cases, transabdominal ultrasound or MRI can be needed in rare cases. In most of the cases, it can be done through ultrasonography only. Now, coming to the treatment. Treatment depends upon the symptoms. Management of fibroid should be tailored according to the size of the fibroid, location of the fibroid, patient's age and desire for fertility. Now a lady who is having multiple small fibroids, in such cases, no treatments are required, if the lady is around in the premenopausal group or lady is about to have menopause in a few years, no treatment is required. If the lady desirous of fertility and having big fibroids then we can offer her myomectomy which means the removal of just fibroid, not the uterus.
If the lady has completed her family and still desires to remain the uterus and she is having fibroids which can be removed then also we can do myomectomy. But this does not mean that fibroid cannot recur. It can. Now the lady who is having multiple fibroids and completed their family, in such case, the main treatment is hysterectomy which means complete removal of the uterus. And this surgery should be done with the minimal invasive possible. So, nowadays it can be done by laparoscopy, ultrasonic energy, open surgery. I would like to mention if you are in the reproductive age group and you are not having a menstrual complaint, back pain, then please seek medical advice. At least meet your Dr and get yourself examined. So, your problem can be detected and treated early.