With the Gynaecology Practice available at Spire Dunedin Hospital, Fibroids and Myomectomy surgery is now available under consultant Mr Alex Swanton. Patients are provided with leading private consultation and surgery at Dunedin Hospital, Reading, Berkshire.
Fibroids are benign (non-cancerous) tumours that grow in or around the womb (uterus). The growths are made up of muscle and fibrous tissue and can vary in size. Fibroids are sometimes known as uterine myomas or fibromyomas.
Fibroids usually develop during a woman’s reproductive years (from approximately 16 to 50 years of age). They are linked to the production of oestrogen, which is the female reproductive hormone.
Types of fibroids
Fibroids can grow anywhere in the womb. The five main types of fibroids are described below.
- Intramural fibroids develop in the muscle wall of the womb and they are the most common type of fibroids found in women.
- Subserosal fibroids grow outside the wall of the womb into the pelvis and can become very large.
- Submucosal fibroids develop in the muscle beneath the inner lining of the womb wall and they grow into the middle of the womb.
- Pedunculated fibroids grow from the outside wall of the womb and are attached to the womb wall by a narrow stalk.
- Cervical fibroids develop in the wall of the cervix (the neck of the womb).
What can be done about fibroids?
In many cases, fibroids do not cause symptoms and treatment is not required. Over time, fibroids will often shrink and disappear without any treatment.
However, sometimes fibroids can cause symptoms, such as pain or heavy bleeding. In such cases, medication may be prescribed. If this proves ineffective, surgical or non-surgical techniques may be recommended.
What is a Myomectomy?
A myomectomy is the surgical removal of fibroids from the wall of the uterus, without the removal of the uterus itself. This is done via a low horizontal (bikini line) incision of the abdomen or a midline incision (vertically) if the fibroids are very large.
A myomectomy is usually performed for one of the following reasons:
- heavy periods (menorrhagia)
- infertility - Women with very large fibroids may have difficulty in getting pregnant. Women may be advised to have fibroids removed before having assisted conception.
- pressure symptoms and discomfort due to an enlarged womb - Fibroids may press on the bladder causing the need to pass urine frequently. If very large they can cause the abdomen to swell and feel uncomfortable.
The procedure can now be performed laparoscopic (keyhole surgery).
Are there any side effects or possible complications?
The chances of complications of a myomectomy vary slightly with how it is performed, but generally they include;
- Hysterectomy (removing the womb)
This is uncommon (1 in 100 cases) and is only performed in life-threatening situations in order to stop the bleeding.
Excessive bleeding may occur and it may be necessary to give you some blood during or after the procedure.
This may require treatment with antibiotics.
- Injury to adjacent organs
Depending on the injury, further surgery may be required and may result in a longer recovery.
- Developing clots in your leg or your lungs
This is not common and you will be advised to mobilise as soon as you are comfortable after your surgery. You may also be given compression stockings to wear and may receive an injection (heparin) to thin the blood whilst you are in hospital.
- Adhesion formation
Scar tissue may occur both in the pelvis and inside the womb following this type of surgery. The chance depends on the type of surgery and the size and number of fibroids that are removed.
- Recurrent fibroids
The chance of new fibroids growing may be as high as 60% over five years. These may be picked up on an ultrasound scan, but are only significant if they are causing problems. Any future surgery may be more difficult because of the scar tissue that may have formed after the myomectomy.