Management of Fibroids
Fibroids are extremely common and most cause no trouble at all. Treatment is for the ones that do: heavy bleeding, pressure on the bladder, pain, or difficulty conceiving. A fibroid found by chance on a scan is usually best left alone.
- Treated for symptoms, not for existing
- Medical treatment tried first
- Keyhole removal where suitable
- Fertility preserved where that matters
Stay
Outpatient to 3 days
Duration
Varies with the treatment
Anaesthesia
General for surgery
About Management of Fibroids
What matters is size, position and symptoms rather than the number seen on a scan. A small fibroid inside the cavity can cause more bleeding than a large one on the outside. Treatment ranges from medication and a hormonal coil, through hysteroscopic removal for cavity fibroids, to laparoscopic myomectomy or hysterectomy where family is complete.
- Position matters more than size for symptoms
- Fibroids found by chance usually need no treatment
- Myomectomy preserves the uterus where fertility matters
- Fibroids typically shrink after menopause
Before you read on
Everything here is general information about management of fibroids. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest management of fibroids.
- Heavy or prolonged periods due to fibroids
- Pelvic pressure, bloating or urinary frequency
- Pain from fibroid degeneration
- Fibroids affecting fertility or causing miscarriage
- Rapidly enlarging fibroids
- Anaemia from fibroid-related bleeding
Procedure details
The usual sequence, from first consultation through to follow-up.
Assessment
Symptoms, examination and a pelvic ultrasound to map the size, number and position of the fibroids.
Medical treatment
Tranexamic acid, hormonal treatment or a hormonal coil control bleeding for many women without any surgery.
Surgical options
Hysteroscopic removal for fibroids in the cavity, laparoscopic myomectomy to preserve the uterus, or hysterectomy where family is complete.
Follow-up
Symptoms and blood count are reviewed, and recurrence monitored, as new fibroids can develop after myomectomy.
How to prepare
What to sort out before you come in.
- Bring all previous scans, as change in size over time is informative
- Keep a record of bleeding heaviness and cycle pattern
- Be clear about your plans for future pregnancy, as it changes the recommendation
- Anaemia is often corrected with iron before surgery
- Discuss what should happen if unexpected findings arise during surgery
Recovery
What to expect afterwards, and roughly when.
- Medical treatment shows an effect over one to three cycles
- After hysteroscopic removal, most women go home the same day
- After laparoscopic myomectomy, expect one to two days in hospital and two to four weeks off work
- Pregnancy is usually advised to wait several months after myomectomy
- New fibroids can develop after myomectomy, so symptoms are monitored
Why choose Humayun for fibroid treatment
Fibroids are treated for what they are doing, not for appearing on a scan.
- Treatment based on symptoms rather than on size alone
- Medical options offered properly before surgery is discussed
- Myomectomy available to preserve the uterus where future pregnancy matters
- Keyhole approach used wherever the fibroids allow, which halves the recovery
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