In women, tumors of the uterus (fibroids) are regarded as main causes of the problems of the health. Moreover, uterine fibroids are the main culprits, causing infertility in females. About 15 to 20% among women are having this ailment. Fibroids’ incidence is more in women who is above 35 years of age. Fibroids of the uterus are also called as-Leomyomas, Myomas and Fibromyomas.
Source of occurrence: They form either from- walls of the uterus or from the blood vessels pertaining to the uterus.
Appearance: Usually, they are very hard in nature and pinkish white in color.
They are formed with fine cells and appear usually in round shape and are from few millimeters to centimeter in size and in weight from peas to watermelon (a few grams to kgs). Some fibroids are like pedicles (elongated and twisted) or formed with polyps.
Names of the fibroids, depending on the site of development:
1. Intra-mural or interstitial tumors:
They form only in the myometrium, which is a part in the uterine wall and their incidence is 75% of all the tumors that occur in the uterus.
2. Sub-serous tumors:
These tumors growing gradually come out from the walls of the uterus, and their incidence is up to 10%.
3. Parasitic fibroids:
Sometimes the fibroids grow bigger in size and look like pedicles in shape and get separated themselves from the uterus and grow with the support of the organs which are around the uterus.
4. Sub-mucous fibroids:
Due to the movements of the uterus, the fibroids are thrown into the cavity of the uterus and remain there.
5. Sub-mucous myomatous polyps or wandering tumors (fibroids).
The fibroids which slip from the uterus and go into the vagina and change into the form of pedicles are known by this name.
Age and incidence: Between 15-45 years of age and it is estimated 5-20% of them are having these fibroids.
Signs and symptoms:
1. Excessive bleeding either during monthly cycles 2 or 3 times in a month.
2. Pain in the lower abdomen either before or during menstruation is felt.
3. If the fibroid is very big in size, pulling of the uterus to down side is felt and patient feels that there is stone in the abdomen.
4. Increase in frequency of urination or difficult to pass urine is there and also constipation is present.
5. History of infertility or abortions is present.
6. Anemia, weakness, etc. are present.
Tests for fibroids:
1. It is better to have scanning once in a year to know the progress of the fibroid. (Usually fibroid decreases itself in size after 40 years of age).
2. Other blood tests to be done.
Management (treatment) of the case: It depends on the-size, site, pain and other troubles caused by the fibroids.
1. Drugs:
1. New type ‘’GNRI analogues’’ injections are now available and they make the fibroid to decrease in size. The injections are costly and cannot be given for more than six months. So it is more useful in women who are going to attain menopause in short time.
2. “Miphipristone’’ tablets also make the fibroids to shrink in size.
3. Recent procedure: The blood vessel which supplies blood to the fibroid is closed and as there is no blood supply to the tumor, it gradually decreases in size and later disappears. It is becoming popular now and there is no necessity to remove the uterus.
2. Surgery:
- Myomectomy: Only fibroid is removed, keeping the uterus intact, especially in women of reproductive age so that the women after marriage get pregnancy and have children.
- Hysterectomy:Uterus is removed in this type of operation procedure, when other methods of treatments are failed. It is more useful in women of post menopausal stage.
