Uterine fibroids are normally benign lumps that grow in or just outside a woman’s uterus (womb). They begin as normal uterus muscle cells that develop into a tumor.
Uterine fibroids are common in women, especially those in their 30s and 40s. Most never cause any problems, but others can become painful and cause bleeding. While there is no known cause for uterine fibroids, they tend to develop in younger women. It is theorized that estrogen plays a big role in the development of uterine fibroids.
Names for fibroid tumors, which can vary in size from microscopic to weighing as much as 10 pounds, are based on where they are located:
- Myometrial (intramural) fibroids - are located on the muscular wall of the uterus
- Submucosal fibroids - are located under the lining of the uterus
- Subserosal fibroids - are located outside the surface of the uterus and the most common type
Some Symptoms of Fibroid Tumors
- Heavy bleeding and longer periods lasting seven days or more
- Bloating or fullness in the belly
- Pain in the lower abdomen
- Constipation
- Pain during intercourse
Myomectomy and hysterectomy to remove fibroid tumors
When fibroid tumors become painful or disrupt a woman’s quality of life, they can be removed. If only the fibroids are removed, it is a procedure called myomectomy. If part or all of the uterus has to also be removed, it is done through hysterectomy.
Myomectomy is often performed using minimally invasive techniques – either laparoscopy or hysteroscopy. Since myomectomy removes the fibroids, leaving the uterus in place, it is often done in women of child bearing age.
The laparoscopic method involves a few small cuts in the abdomen. A tiny camera inserted into one of the incisions and is used to magnify the region on a TV screen. Gynecologist use the TV to find the fibroids then surgical instruments are used to remove them.
A less invasive procedure uses a hysteroscope. A long, thin lighted tube is inserted into the uterus through the vagina and cervix. Without any external cuts, the gynecologist can remove fibroids with a tool inserted through the hysteroscope. This procedure is best used to remove fibroids on the inner wall of the uterus that have not grown deep into the uterine wall.
If the submucosal fibroids require advanced hysteroscopy, the gynecologist uses a tiny wire to trim the fibroid until it is completely removed. Subserosal fibroids may be removed using either method.
If the patient has the removal done laparoscopically or hysteroscopically, she will normally be discharged the same day. Recovery time depends on the method used for the myomectomy. Some patients who undergo hysteroscopy may recover in a few days. Full recovery typically takes two weeks. Laparoscopy requires one to two weeks to recover.