An in-depth look at the challenges and medical procedures surrounding uterine fibroid tumors.
Fibroid tumors are an issue thousands of women deal with annually. While the majority of the cases of fibroids are non-life threatening they do impose a burden on most women that are diagnosed with them if that burden is nothing more than knowing they’re present Some fibroids lay dormant and pose little health challenges while some, after they’re removed insist upon returning time and time again. These are the ones the content of this post is aimed at.
Fibroids are muscular tumors composed of renegade muscle cells that come together to form a fibrous “knot” or “mass” within the uterus. Although all uterine fibroids are the same, they are categorized based on their location.
Submucosal fibroids that are located just under the uterine lining.
Intramural fibroids lie between the muscles of the uterine wall.
Subserol fibroids that extend from the uterine wall into the pelvic cavity.
Fibroids can be as small as an apple seed or as big as a grapefruit in size. In unusual cases, they can become very large.
Doctors say there is very little threat of most cases of fibroids being malignant. Because of the minuscule threat of malignancy attitudes toward fibroids from those that don’t suffer from them tend to be relaxed. But ask any woman who has been diagnosed with them and she’ll tell you there is nothing at all relaxed about having an uninvited intruder taking up residence inside your body.
Fibroids can be extremely problematic for some women depending upon their age and existing physical condition. For example, some of the symptoms alone pose daily challenges for some women.
Some experience pain and abnormal menstrual bleeding. Fibroids also can put pressure on the bladder, causing frequent urination, or the rectum, causing rectal pressure. Should the fibroids get very large, they can cause the abdomen (stomach area) to enlarge, making a woman look pregnant.
Two women that I talked to share experiences they had with recurring fibroids shredded light on living with fibroids. The frustration from repeated symptoms such as unexpected hemorrhaging, extreme pain, feelings of bloating and listlessness elevated their stress and anxiety levels to the point there were days they simply didn’t want to get out of bed.
One of the women elaborated on a period of time where she hemorrhaged off and on for weeks while doctors worked to find the offending fibroid that wouldn’t show up in images. This normally active woman was literally transformed into a reclusive introvert because of the confines these fibroid symptoms put around the quality of her life. The loss of blood at one point almost led her to have to have a transfusion. Every where she went she took a change of clothes and had conceded to wearing black clothes in case of sudden hemorrhaging. Menstrual cramps and pain were multiplied ten-fold coupled with weakness from diminished iron levels literally crippled her at times.
The other woman, in her thirties, grappled with some of the same symptoms coupled with an additional dilemma. She wanted desperately to have a child of her own however previous surgeries and recurring fibroids led her doctors to begin suggesting a hysterectomy. Doctors were willing to perform one more non hysterectomy procedure to remove the present fibroids. This would buy the woman some time to conceive and deliver before the fibroids grew back at which time a hysterectomy would be imminent.
Wanting to bring a child in the world the right way and under the best conditions and in the best environment possible, the woman was frustrated at the thought of “just going out and getting pregnant. Even more frustrating to her was the thought of having a hysterectomy before she could have her own child.
At the time of our interview with this woman she was seeking second opinions and had mapped out a time frame of four years to meet someone, cultivated a relationship that would blossom into love and commitment and marriage at which point she would become pregnant. If it sounds like she’s “under a gun” she is and she knows it. It’s another frustration thousands of childless women deal with as a result of extreme fibroid tumors.
There are several medical treatment options women with fibroids can pursue to manage or eliminate fibroids. The Achilles heel of some of these procedures is the affect they have on women that want to have children.
Fibroids can be surgically removed, the blood supply to fibroids can be cut off, the entire uterus can be removed, or medicine can temporarily shrink fibroids. The choice depends on the severity of the symptoms and whether the patient wants to preserve their fertility.
Here are some medical treatment options.
The Hysterectomy. If you’re not planning to have any (more) children and want uterine fibroid tumors out of your life for good this is one option you can consider. Do know however, there is a less damning version of the hysterectomy that leaves the ability to reproduce intact. It’s called the a supra cervical hysterectomy. [SOURCE]
“In a supra cervical hysterectomy you remove only the uterine cavity holding the fibroids and you do not touch the tubes, ovaries, cervix, orvagina, or any of the support muscles in the bladder or pelvis”
-Steve Goldstein, MD, Professor of Obstetrics and Gynecology at NYU Medical Center.
He also noted that patients don’t suffer any of the consequences linked to a traditional hysterectomy, including bladder
and sexual dysfunction, or instant menopause
Myomectomy. A myomectomy removes only the fibroid tumors, leaving the uterus and all other organs completely intact. The procedure involves a large incision on the abdomen, minimally invasive laparoscopic surgery done through pin hole-sized incisions, and, depending on the site of the fibroid, some can be done through hysteroscopy, a surgery done through the vagina. A Myomectomy removes the fibroids but does not guarantee they won’t grow back after a number of years.
Uterine Artery Embolization
A minimally invasive radiological procedure that blocks blood
flow to the fibroid, causing it to shrink and eventually die.
The procedure involves placing a catheter into the uterine arteries
through which tiny particles are injected that seal off the blood
supply to the tumor. Proceed with caution with this one. While it’s not life threating to women it could come back to haunt a future fetus. Studies show that obstetric complications are higher following this treatment, including a higher rate of preterm labor,
MRI-Guided Ultrasound –
This is an outpatient procedure where high focused ultrasound waves are converted to heat and destroy the tumor. The MRI is used to guide the radio waves to the tumor site. Sedated patients are put into an MRI machine and the procedure can take up to three hours to complete. Depending upon the success of the first treatment a second treatment may be necessary.
Fibroid Medical Therapy –
Fibroid tumors can be managed with medication, however, the patient has to understand they’re managing them not getting rid of them.
If a woman has been found to have fibroids without any of the severe symptoms noted in this post their doctor will more than likely take a wait and see approach. This approach involves regular pelvic exams to check on fibroid growth and symptoms. For women nearing menopause wait and see could be the literal God-given prescription to annihilate fibroids. After menopause, estrogen
levels drop, which causes most fibroids to shrink and symptoms to subside.
As common as they are fibroids are rarely a death sentence. They can compromise a woman’s quality of life to the level the residual stress from the symptoms can create more severe health issues for them. The largest group of women that find choosing a medical treatment for fibroids difficult are those that want to retain child bearing capabilities.
Those women are urged to request their healthcare practitioner to explore every pregnancy amiable treatment option available before resorting to the ones that may compromise or eliminate their ability to conceive.
This article was written to inform and encourage women dealing with fibroids. It also should encourage them to seek the treatment that they feel is conducive to their health, moral, social, and lifestyle contexts. Most importantly they should work closely with their doctor toward the right resolve.
Here is a video of Uterine Fibroids being surgically removed. CAUTION – It’s graphic.
Myomectomy. Large Fibroid Removal with Temporary Clipping of Uterine Arteries
Total Abdominal Hysterectomy
Frances’ Story – Focused Ultrasound for Uterine Fibroids