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Fibroids

Fibroids are tissue growths that develop from the muscular wall of the uterus/womb. They can be found in the wall itself, under the external lining of the wall, or they can bulge into the cavity of the uterus/womb. They can grow and shrink under the influence of female hormones, usually becoming smaller after the menopause.

Fibroids can present in many ways depending on the number and site of the fibroids. Many women are unaware that they have fibroids because they do not have any symptoms. The most common symptoms of fibroids are heavy periods, painful periods or irregular periods. They may also cause discomfort through pressure on the bowel or the bladder since both these organs lie close to the uterus.

Investigations
You will be initially seen by the Consultant who will take a full history and perform an internal examination. You may then be referred for an ultrasound in order to determine the number, site and size of the fibroids. Please see the information section for further details on ultrasound scans.

Myomectomy
What is it?

This procedure is the removal of fibroids whilst leaving the uterus behind. The operation generally involves an incision in the abdominal wall (laparotomy). On some occasions it may be possible to remove fibroids with keyhole surgery.

The length of stay
The hospital stay after an abdominal operation is generally 4-6 days. The time taken to full recovery can take 6-8 weeks. Keyhole surgery has the advantage of a shorter hospital stay and quicker recovery.

Risks of the procedure
The main risks are bleeding and infection. The uterus has a very strong blood supply and hence removing fibroids can result in significant bleeding. Whilst precautions are undertaken to minimize any potential bleeding, on very rare occasions (1:200) a hysterectomy may have to be performed to prevent life-threatening blood loss. The risks of infection are reduced by giving antibiotics during and after the operation.

Other immediate risks of surgery include clots in the legs (Deep vein thrombosis, DVT), bruising of the wound and damage to bowel or bladder. Later risks include adhesions to the scars on the uterus which can cause abdominal pain in later years.

Fibroids can recur – the chances of this occurring are 10-20% over the 5-10 years after a myomectomy.

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