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Fibroids — Diagnosis and Treatment
A fibroid is a benign growth arising from the muscle of the uterus. They are common and most cause no symptoms at all. Treatment is decided not by their presence but by their size, position and the symptoms they produce.
Symptoms
- Heavy and prolonged menstrual bleeding
- Tiredness from anaemia
- Pressure, fullness or a sense of enlargement in the pelvis
- Frequent passing of urine, constipation
- Pain during intercourse
- In certain positions, difficulty conceiving or pregnancy loss
Diagnosis
Diagnosis is usually made by examination and ultrasound. Hysteroscopy may be used for fibroids growing into the cavity, and MRI may be requested to plan surgery where fibroids are numerous or large. In women with bleeding, a blood count assesses anaemia.
Treatment options
- No symptoms: periodic observation
- Medical treatment: control of bleeding and pain, correction of anaemia
- Hysteroscopy: keyhole removal of fibroids within the cavity
- Laparoscopic or open myomectomy: removal with preservation of the uterus
- Hysterectomy: removal of the uterus in selected cases
If pregnancy is planned
For women wishing to conceive, preserving the uterus is the priority. The decision takes account of the position of the fibroid, whether it distorts the cavity, and how many there are; not every fibroid needs surgery.