What are fibroids?

Commonly referred to as “Rasauli” in Hindi, fibroids are non-cancerous growths in the uterus. We may say when the normal tissue of uterus overgrows at one particular site then we call them as fibroids.  

How many women are diagnosed with fibroids?

 If we do an ultrasound in 100 women then approximately 50 of them will be diagnosed with fibroids. So just an incidental diagnosis of fibroids is not a very troublesome condition because most of the time fibroids do not pose any problem. But, if there are symptoms of excessive bleeding or pain during periods, irregular bleeding or pain in lower abdomen etc, then you should consult a gynaecologist. 

 How serious is the condition with fibroids?

If fibroids are small in size e.g. 1-2cm and there is no symptoms of pain, bleeding etc; then there is nothing to worry as such. In cases, where a couple is finding difficulty in conceiving then we need to see if these small fibroids are close to uterine cavity or away from the uterine cavity (where a baby grows inside the uterus).  

What do we need to do when we are diagnosed with fibroids?

There is nothing to get panicky about. But do visit a gynaec to be assured if any immediate intervention is needed or not.In case, fibroids are not posing any problem like pain, bleeding etc then we just need to follow them up in regular ultrasounds at an interval of 6-12months. All fibroids usually regress after menopause. If the size of fibroids is approximately same, then there is no need of surgery as such. In cases there is a dramatic increase in sizes, then it's better to consult a gynaec to find out if immediate surgery is needed or not. 

What are treatment options available in cases of fibroids?

Even if fibroids are causing symptoms like bleeding, pain etc; surgery is not required in all cases. A woman in her 40s, having excessive bleeding, can be easily managed with medicines, injections etc.

There is an option of Mirena (hormone-releasing copperT kind of a thing), which is put inside the uterus and helps in controlling bleeding, pain etc problems associated with fibroids.

Surgery is required in a small subset of patients e.g. who have had previous miscarriages, who are unable to conceive even after trying for 1-2 yrs, in whom fibroids are increasing in size continuously, who are having fibroids inside the uterine cavity as polyps etc

Open vs Laparoscopic surgery: With the advancement of medicine and technology, nowadays many large size fibroids can be removed laparoscopically. Patient has to be hospitalized only for 1 or 2 days. There are only 3-4 sutures of very small size (0.5-1 cm ).There is hardly any need of doing open surgery (involving 8-10 sutures and total scar length of 8-10cm). In last10yrs, we have done just one open surgery for fibroids that too because there were many large size fibroids and uterus was just like a pregnancy of 8month.We usually do laparoscopic surgeries for all fibroids and these are almost scarless and minimally invasive surgeries. There is a recent recommendation for usage of the bag for morcellation of fibroids. It needs expertise and exposure to recent advances. This bag avoids spillage of cells inside the abdominal cavity. This way our patients go home comfortably, within 1 or 2 days of surgery.