These growths range in site, size and number. Some may have multiple pea-sized myomas that are almost undetectable with the naked eye while others have a single grapefruit-sized one that commonly distorts the shape of the uterus.
Uterine fibroids are very common, but many women are not aware they have these growths because
often there are no symptoms. If left undiagnosed and untreated, however, fibroids may cause
heavy bleeding, menstrual changes, fertility problems, pelvic pain and pregnancy
complications.
Because fibroids do not always cause symptoms, the most effective way to check for tumors is
through a routine and thorough pelvic and/or abdominal examination and a pelvic ultrasound
scan. (Sound waves are used to capture images of the uterus to detect and measure fibroids.
The probe can be passed over the abdomen or inserted vaginally)
Blood tests such as Full blood count (FBC) may be requested to determine if anaemia and heavy
menstrual bleeding are caused by fibroids, and not other bleeding disorders or thyroid conditions.
Most uterine fibroids have been observed to stop growing and even shrink after menopause. Some
symptoms are also unnoticeable and give little discomfort. This is the reason why gynaecologists
advise “watchful waiting”, whereby symptoms are only observed for significant changes.
For women who have developed multiple or large fibroids that cause severe symptoms, immediate
medical attention is required. Treatment options will depend on the patient’s overall health,
tolerance for prescribed medications and procedures, size and extent of the myoma, and desire for
future pregnancy.
For women who wish to retain the uterus and remove the fibroids which are causing them problems,
they can avail themselves of either laparoscopic or laparotomy myomectomy. The choice of key hole
versus ooen surgery would really depend on the site size and number of fibroids one wishes to
removed. Where a pregnancy is desired, closure of the uterus needs to be very secure and open
myomectomy may be preferred.
For those who choose a total hysterectomy, the procedure would render the woman instantly
menopausal. The operation can be done laparoscopically for less scarring and quicker recovery, or
via the traditional open method. If fibroids are present in the ovaries and cervix, these organs
may be removed as well. Hysterectomy is a major and permanent procedure, preventing any future
pregnancies through open surgery, depending on the size and location of the myoma.
Aside from hysterectomy and myomectomy, there is a minimally invasive procedure that can help to
destroy the fibroids instead of removing them through surgery. These are:
Anti-hormonal medications are also to control the unwanted symptoms caused by fibroids and a patient may opt for these if surgery is not possible or undesirable.
Dr Ann Tan is an established obstetrician and gynaecologist in Singapore who has devoted over 20 years to the care of women and couples struggling with infertility. She is accredited in both fetal and reproductive medicine, and was the former Medical Director of Mount Elizabeth Fertility Centre.
3 Mount Elizabeth #11-12
Mount Elizabeth Medical Centre,
Singapore 228510
Tel : +65 6734 8188
Fax : +65 6262 0330
Email : mail@dranntan.com
WhatsApp : +65 8318 9757 (for appointment booking)