By Dr Sridhar Reddy Baddam
Senior Consultant Vascular & Oncointerventional Specialist
Published on 06/10/2022
Nowadays, infertility is the most common problem in young couples. The reasons are the altered lifestyle, food habits, and work-related stress pertaining to the existing factors. Symptomatic Uterine Fibroids are most commonly noted in young females of 20+ years.
The number of couples experiencing infertility problems has increased over the past years, and male and female factors contribute to it. More particularly in women, several factors play a significant role in affecting the ability to get pregnant.
Nowadays, the most common problem is uterine fibroids, even in younger age groups. These fibroids are noncancerous (benign) growths of the uterus. And these can potentially cause infertility by blocking the fallopian tubes or preventing a fertilized egg from implanting in the uterus. Furthermore, large fibroids may prevent a fetus from fully developing. Fibroids can increase the risk of placental abruption, leading to premature birth or miscarriage.
There are four primary types of fibroids based on the location:
- Subserosal fibroids
- Intramural fibroids
- Submucosal fibroids
- Pedunculated fibroids
Possible Causes And Risk Factors:
Although the exact reason for uterine fibroids is unknown, clinical studies point to the following factors:
- Hormones: Estrogen hormone significantly appears to promote the growth of uterine fibroids.
- Heredity: Uterine fibroids seem to run in families.
- Obesity: Two to three times greater in obese women due to higher estrogen levels.
- Unhealthy food habits and lifestyle
Symptoms Of Uterine Fibroids:
Some women may not have any symptoms. The symptoms can be influenced by the location, size, and the number of fibroids in those who have them. The most common signs and symptoms of uterine fibroids are as follows:
- Heavy and prolonged menstrual bleeding.
- Irregular bleeding between menstrual periods.
- Frequent and incomplete urination.
- Back pain, lower abdominal pain, and leg pain
- Bloating / distended abdomen
Complications Caused By Uterine Fibroids:
If uterine fibroids continue to grow and become larger, they can cause various complications, including impaired fertility, severe pelvic pain, and heavy bleeding leading to anemia. Especially, untreated fibroids in pregnant women might lead to:
- Preterm delivery
- Fetal malpresentation is described as the wrong fetal body position.
- Heavy bleeding after giving birth (postpartum hemorrhage).
Diagnosis Of Uterine Fibroids:
Treatment Of Uterine Fibroids:
It is determined by location, size, presenting symptoms, and individual conditions. The treatment methods are:
- Medications for treating symptoms. However, medicines do not eliminate fibroids.
- Surgeries to remove fibroids are either hysterectomy or selective fibroid removal known as myomectomy which is an open surgery/laparoscopy.
- In uterine fibroid embolization, a non-surgical, daycare angiography method is done where no surgical cutting / no suturing / no opening / no anesthesia is required; hence no blood loss, infections, or complications are observed. More importantly faster recovery and shorter hospital stays allow patients to return to regular activities more quickly.
- The patients get admitted on the day of the procedure, get it done, and may leave by the end of the day or the next day. The symptoms will get relieved within a few days to weeks. However, the size of the fibroid will take a few weeks to 2-3 months to significantly reduce in size.
Frequently Asked Questions:
An IV cannula tube is placed in the groin, and a tube is selectively passed into the uterus via blood vessels. Some particle-like medications are injected into the fibroid selectively, cutting off the blood supply to the fibroid and causing it to shrink over time.
Patients can plan for a family with a minimum period of 6-month post-procedure.
After uterine fibroid embolization procedure it is rare for treated fibroids to regrow or form new fibroids.
Fibroids number and size do not matter in this treatment method; any number and size can be treated in one sitting.
It is not at all a surgical procedure. It is just a simple angiography procedure with an IV cannula line in the groin or hand where the patient is awake with no pain and can see what's happening on the monitor throughout the procedure.
It usually takes not more than 30 minutes for the procedure to get over.
The fibroid usually shrinks inside the body over time or sometimes gets discharged as waste products through the vagina.
Hysterectomy is not recommended as it is not worth removing the complete uterus when the fibroid is just a benign growth. The uterus has other vital hormonal functions in the body such as to maintain hormonal balance and keep the pregnancy option open, at least during the childbearing age. In case of myomectomy a surgical/minimal surgical procedure is performed.
There may be a menstrual cycle disturbance for a month or two, which gets normalized gradually.
There are no significant complications other than fever or pain symptoms for a day or two.
They are present in almost 1 in every 3 women, whether symptomatic or non-symptomatic. But in symptomatic women, it needs to be attended and treated to prevent anemia, pregnancy complications, and infertility.