Uterine Fibroids

An Information Sheet

A Fibroid is an abnormal growth of muscular tissue within the uterus. It is not a cancer and usually does not require treatment. In some women, due to the fibroid's size or location, it may cause problems requiring treatment.

Some of the symptoms women with fibroids may experience include:

Fibroids can been found in up to 40% of women. Most of these women will not experience any symptoms.

When a clinical history or examination suggests fibroids, an ultrasound will be organised to confirm the diagnosis. Other investigations, such as hysteroscopy (video imagining of the uterine cavity which is done in hospital), CT scan or MRI (performed at radiology departments) may be required.

Fibroids grow at a very slow rate and will often have been present for many years before they are diagnosed. They will continue to grow slowly until the menopause after which they usually shrink in size.

Hormone therapy is safe and will not usually increase the size of fibroids. However fibroids have been reported to grow in women using hormone patches, so these should be avoided.

The role of fibroids in causing infertility is controversial. There is some evidence to suggest that large fibroids may impair fertility and increase the risk of miscarriage, preterm labour and the need for a caesarean delivery. Removal of large fibroids may therefore be considered prior to pregnancy and in the management of some cases of infertility. The benefits will always need to be weighed up against the risks of surgery and you should discuss all options with your doctor.

Very occasionally cancer can occur in a fibroid (sarcoma). Although rare it should be suspected in women who are postmenopausal, who are bleeding and have a rapidly growing uterus.

Treatment of Fibroids

A myomectomy is an operation that removes a fibroid from the uterus. It involves the wall of the uterus being cut open to expose the fibroid. The fibroid is then "shelled" out from the surrounding normal uterine muscle. Following the removal of one or more fibroids the defect in the uterus is repaired. The operation usually requires a laparotomy (abdominal operation) but can occasionally be performed using keyhole techniques.

The risks of the operation include:

Due to these and other possible pregnancy complications it may be recommended to avoid surgery until after your family is completed. However, the benefits may be thought to outweigh the risks if you have large fibroids that may be impairing your fertility or causing significant symptoms.

After a myomectomy, fibroids may recur in 25% of women.

Other treatments include:

No one treatment is best for all women. Please discuss the alternatives with your doctor.

WHAT TO EXPECT AFTER YOUR MYOMECTOMY (REMOVAL OF FIBROIDS)

LAPAROSCOPIC MYOMECTOMY

Length of Hospital Stay You will usually go home within 3 days of surgery.
Post operative pain Within a day of laparoscopic myomectomy most patients require only oral pain medication.
Mobility Showering and walking short distances within 24 hours
Return to work Patients can return to non-strenuous employment within a few weeks of surgery. (Usually 3-4 weeks). Light duties can be started within 2 weeks.

ABDOMINAL MYOMECTOMY

Length of Hospital Stay You will usually go home within 3-5 days.
Post operative pain Patients usually require 48 hours of injections (i.e pethidine, morphine) given either intravenously, subcutaneously or intramuscularly for pain relief.
Mobility Showering and walking short distances within 24-36 hours
Return to work Patients can return to non-strenuous employment within 4-6 weeks of surgery. Light duties can be started within 2 weeks.

WHAT TO EXPECT FROM YOUR HOSPITAL STAY

COMMON ISSUES

Vaginal Bleeding and Discharge - A small amount of vaginal bleeding is common after this surgery and it may persist for 6 weeks. Have some ultrathin sanitary pads on hand - best to avoid tampons.

Please report any discharge that is offensive or becomes heavier than a period.

Return to normal activity:

Pelvic floor exercises - These should be commenced when they can be done comfortably, usually within a week or two of surgery.

Copyright © 2003 Dr M Ritossa, Dr D Munday and Dr J Semmler; updated Jan 2005

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