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- Patient Comments: Uterine Growths - Symptoms
- Patient Comments: Uterine Growths - Treatments
- Patient Comments: Uterine Growths - Polyps
- Patient Comments: Uterine Growths - Adenomyosis
- Find a local Obstetrician-Gynecologist in your town
- What are uterine growths?
- What are uterine fibroids?
- What are the signs and symptoms of uterine fibroids and what do they look like?
- How are uterine fibroids diagnosed?
- What is the treatment for uterine fibroids?
- Surgery for uterine fibroids
- What other medical treatments are available for uterine fibroids?
- What is adenomyosis?
- What are the symptoms of adenomyosis and what does it look like?
- How is adenomyosis diagnosed?
- How is adenomyosis treated?
- What are uterine polyps?
- What are the symptoms of uterine polyps and what do they look like?
- How are uterine polyps diagnosed and treated?
Quick GuideUterine Fibroid Pictures: Anatomy Diagrams, Pictures of Fibroids, Tests, Treatments, and More
What are the signs and symptoms of uterine fibroids and what do they look like?
Most women with uterine fibroids have no symptoms. However, fibroids can cause a number of symptoms depending on their size, location within the uterus, and how close they are to adjacent pelvic organs. Large fibroids can cause:
- Pelvic pain
- Pressure on the bladder with frequent or even obstructed urination
- Pain during intercourse
- Reproductive difficulties such as infertility, miscarriage, or premature labor
- Pressure on the rectum with pain during defecation.
Abnormal uterine bleeding is the most common symptom of a fibroid. If the tumors are near the uterine lining, or interfere with the blood flow to the lining, they can cause heavy periods, painful periods, prolonged periods or spotting between menses. Uterine fibroids that are deteriorating can sometimes cause severe, localized pain.
If uterine fibroids are benign, why are they the reason for so many hysterectomies (surgeries performed to remove the uterus)?
The main answer is that uterine fibroids can cause bleeding. This bleeding can sometimes be significant and lead to anemia. Fibroids can also lead to complications as discussed in the next section. Fortunately, there are also many non-surgical means available to treat fibroids.
How are uterine fibroids diagnosed?
Fibroids are diagnosed by performing a manual pelvic examination (bimanual examination) and confirmed by ultrasound. Ultrasound is harmless and does not involve radiation exposure. This test is similar to the one performed in pregnant women to view the developing fetus inside the uterus. Rarely, more complex imaging is used, but only in cases wherein the doctor cannot determine the exact nature of the mass found on the physical exam or ultrasound.
What is the treatment for uterine fibroids?
Reasons for surgical removal of uterine fibroids
Some of the reasons for surgical removal of uterine fibroids include:
- If there is still concern that the uterine growth could be cancer: In these cases, the doctor is not certain that the growth is actually a benign fibroid. Unusually rapid growth is a sign that a uterine growth may be cancerous. The growth must be removed and examined by a pathologist for signs of more dangerous conditions.
- If other pelvic surgery is already being done: There are other reasons for pelvic surgery, such as ovarian disease.
- If all medical treatments have failed to stop bleeding or other complications.
Surgery for uterine fibroids
There are three major categories of surgery for fibroids.
- Hysterectomy: Removal of the uterus is called a hysterectomy. Fibroids are the most common reason that hysterectomies are performed in the United States. Advantages are that: (1) the fibroids never return (the only "cure" for fibroids); (2) the woman will never have another menstrual period (which some, but not all women, find to be an advantage); and (3) contraception is no longer a concern. It is easy to understand, therefore, that the best candidates for hysterectomy have already finished their childbearing.
- Myomectomy (Local Resection): This surgery involves the removal of the fibroids themselves without removal of the whole uterus. Myomectomy is not permanent in the sense that fibroids can grow back after the procedure. The fibroids grow back in about 25% to 50% of women, and about 10% of women will need a second surgery. Although myomectomy is a sure temporary measure, it is less guaranteed to be a permanent solution. Thus, this procedure is often used to "buy time" if the woman is planning to become pregnant in the next few years. The advantages of this surgery are that it preserves the uterus for childbearing and involves less extensive surgery, which implies less extensive recovery periods. Certainly, in the short term, bleeding tends to be much improved after myomectomy (in about 80% of women).
- Embolization: Another technique for treating fibroids is known as uterine artery embolization (UAE). This technique uses small beads of a compound called polyvinyl alcohol, which are injected through a catheter into the arteries that supply the fibroid. These beads obstruct the blood supply to the fibroid and starve it of blood and oxygen. Uterine artery occlusion (UAO), which involves clamping the involved uterine arteries as opposed to injecting the polyvinyl alcohol beads, has also been used as a way to interrupt blood supply to the fibroid.
- Other Procedures: Some treatments have involved boring holes into the fibroid with laser fibers, freezing probes (cryosurgery), and other destructive techniques that do not actually remove the tissue but try to destroy it in place.
Complications of uterine fibroid surgery
It might seem very appealing to a woman to just have the uterus removed, however, as with any surgery, complications can include a risk (though extremely low) of dying or having complications from the general anesthesia. There are also risks of bleeding and infection, although these risks are fairly low. However, a hysterectomy is actually a more significant procedure than many women realize in that it does require substantial recovery time.