Hear from the Experts: All You Need to Know About Fibroids

Fibroids are some of the most common reproductive systems tumours women experience. They are also known as uterine myomas, leiomyomas, and fibromas. On average, 20-50% of women between the ages of 13 and 50 have fibroids. However, not all large enough to be detected during a physical examination.

Below are some of the common questions my patients ask me about fibroids:

What Are Fibroids?

Fibroids are smooth muscle tumours arising from the muscular wall of the uterus.

How are they Diagnosed?

A woman may feel a lump in her abdomen, heavy menstrual cycle, or experience pressure-like symptoms such as frequent passing of urine and bloating. Fibroids are hormone-dependent and found in women between the ages 30 and 40. They can be diagnosed by a physical examination, an ultrasonography, or an MRI.

How are Fibroids Treated?

Smaller non-symptomatic fibroids could be observed with regular follow-ups, but fibroids symptoms need to be managed. Medical management with oral or injectable medicines could give temporary relief but may have undesired side-effects like bone loss.

Surgical removal of fibroids used to be done with a large cut in the abdomen, but now can it be achieved laparoscopically. In fact, laparoscopic removal is now a gold standard and has the following advantages:

Magnified well-lit high definition visuals
Precise and accurate surgical technique
Lesser pain with minimal tissue handling and scarring
Decreased blood loss
Shorter convalescence and quick recovery
Increased chances of fertility

How is Laparoscopic Myomectomy Performed?

During laparoscopic myomectomy, the patient is given general anaesthesia. Two to three tiny half centimetre cuts are made over the abdomen. A one-centimetre telescope with an attached camera gives the visual and thin long instruments are used to perform surgery.

The fibroids are shelled out from a capsule and incisions stitched to reconstruct the uterus. The fibroids are then removed by cutting them into thin long strips through the keyhole cuts. Due to minimal handling of the surrounding tissues the risk of scarring decreases and the fertility outcomes improve.

Do Fibroids Recur After Treatment?

There is a 10% chance of recurrence in younger patients with well-functioning ovaries. The risk is more with a woman having multiple fibroids as compared to a single fibroid. Blocking the blood supply to fibroids can decrease the risk but is still being evaluated.

Recurrence could also have a possible genetic role. In case of recurrence after a few years, a laparoscopy can be performed skilfully with lesser trauma than with an open conventional procedure.

Can a Patient with Fibroids Avoid Removing the Uterus?

Yes, fibroids can be removed, and the uterus reconstructed for fertility. However, if a patient does not wish to have any more children, a hysterectomy can be done. Laparoscopy can be done with previous open surgeries or caesarean section. Women who are perimenopausal and have multiple recurrent fibroids may do well with removal of the uterus.

Can Fibroids be removed by Robotic Technology?

Removing fibroids using technically advanced and precise robotic technology fine-tunes the procedure to give superior results. Here the surgeon operates the console and the robotic arms perform challenging movements with greater accuracy.

Laparoscopic surgery for fibroids has revolutionized the removal, making the procedure patient-friendly while reserving and improving fertility outcomes. Laparoscopic removal of uterus for large fibroids is possible with lesser pain, minimal blood loss, and early recovery.

Laparoscopic myomectomy is possible with advanced technological equipment and expertise that includes a skilled surgical and anaesthesia team. Comfortable anaesthesia, overnight hospital stays, safety, lesser complication, shorter convalescence, and early return to work with better fertility outcomes make this procedure a gold standard.