Uterine Fibroids

Fibroids (non-cancerous tumors that grow in the walls of the uterus) are the most common type of tumor found in women. Growths can range in size from miniscule seedlings to large masses or clusters.

The cause of the condition is unclear, though fibroids appear to be related to the production of the female hormones estrogen and progesterone. Heredity may also play a role.

Many women are unaware they have uterine fibroids because symptoms are often non-existent. For others, the condition may cause heavy or prolonged bleeding, lower back pain, pressure in the lower abdomen, frequent urination, constipation, abdominal swelling or pain during intercourse. About three percent of infertility cases are traceable to uterine fibroids.

Treatment Options

Fibroids usually do not require treatment, but for women contemplating pregnancy, periodic monitoring is important. If fibroids need to be removed, all options require careful consideration and discussion with a specialist.

Uterine Fibroid Embolization (UFE)

A relatively new procedure to remove fibroids is known as uterine fibroid embolization (UFE). Performed by an X-ray technique, this minimally invasive treatment blocks the blood supply to the fibroids, causing them to shrink. UFE is not an option for women who are planning to become pregnant.

Minimally Invasive Surgery

Until recently, 70 to 80 percent of these procedures were performed with a traditional abdominal incision requiring several weeks of recuperation. This type of surgery is more painful and leaves a larger scar than the new laparoscopic fibroid surgery. In some cases, surgeons may perform a procedure called a laparoscopic myomectomy to treat uterine fibroids.

Women who have a laparoscopic myomectomy generally experience shorter hospital stays,less pain and faster recovery times with a quicker return to normal activities than women who have traditional surgery.

Since a myomectomy may result in a build up of scar tissue, fertility may be impaired even though infertility is sometimes helped with the procedure.

Surgeons take advantage of the latest advances in robotics to perform a laparoscopic myomectomy instead of a traditional abdominal incision with the goal of a more precise removal of the fibroids.

Both the laparoscopic myomectomy and traditional surgery are performed with the intention of enabling a woman to preserve her uterus giving her the opportunity to bear children in the future, although sometimes fibroid removal may leave a woman's ability to conceive and bear children impaired. Either procedure may resolve infertility problems since there appears to be a close relationship between uterine fibroids and infertility.

If a hysterectomy is required, many patients, even those with large fibroids, are candidates for a laparoscopic hysterectomy. It usually offers the same benefits of less pain, fewer complications, faster recovery and less scarring than traditional surgery.

Resources at Cedars-Sinai


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