Uterine Fibroids

These are lumps or tumours arising from the muscle of the uterus


Uterine fibroids are very common and rarely develop into cancer (although the risk is 1:1000). Fibroids may be small as a seed or as big as an orange or even larger. They give you symptoms depending on their size and place in the uterus. For example:

Although the cause for developing fibroids is not known, estrogens (childbearing age) and genetic causes (fibroids may be common in certain families) may be responsible for the fibroids.

Fibroids may be suspected or diagnosed through an internal examination by your Doctor. Other tests like a pelvic ultrasound may be needed as well. Assessment of your pelvis by laparoscopy (keyhole surgery) or by hysteroscopy (thin telescope to assess the uterine cavity) may also reveal you have fibroids. Treatment for fibroids should be individualized - depends on the size of the fibroids, degree of symptoms, your need for a future pregnancy, your age, rate of growth of the fibroids, etc.

Treatment for fibroids

Management of fibroids is by either observation (if they are not giving symptoms or are very small) or surgery. Surgical options are as follows:

There are 3 Types of Hysterectomy

  1. Abdominal hysterectomy

    This operation is indicated where there is significant pathology and especially when the uterus is significantly enlarged and therefore removal of the uterus through the vagina becomes too technically difficult. An incision, which is usually 15 cm in length, is done in the lower abdomen to remove the uterus. The operation takes 1 to 2 hours. You are likely to need pain relief by narcotics/injections and the stitches or clips are removed on day 5 after your operation. A full recovery may take 2 months.

  2. Vaginal hysterectomy

    The uterus is removed through the vagina without a cut or punctures in the abdominal wall. This conventionally has a good reputation with a minimal degree of postoperative pain. It is suitable for those ladies in whom prolapse is a major indication for surgery and when the uterus is reasonably normal sized, and there is no reason to suspect any other intra-abdominal problem particularly relating to the ovaries requiring inspection and/or operation. The operation takes 1 to 1.5 hours or longer if a pelvic floor repair is needed. A thorough examination of your pelvis is not possible and the removal of the ovaries may be difficult or impossible.

  3. Laparoscopic hysterectomy

    This is an innovative procedure as the first laparoscopic hysterectomy in the world was performed only in 1988. A thin telescope connected to a camera is placed through a small incision in the navel. Three or four other incisions are made to enable other instruments to be used. The largest incision is only 10 mm long. This operation takes 2-2.5 hours. The advantage of this operation is that the degree of pain is very minimal requiring pain relief not by injection but rather by tablets. There is therefore a substantial reduction in the use of narcotics. The expected duration of stay in hospital after the operation should be of the order of 2 days and the woman undergoing this procedure should be able to return to work in 2 weeks. The disadvantage of this innovative procedure is that it is more expensive.
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