Fibroid: An in-depth report on the causes, diagnosis, treatment, and prevention of fibroid.

Fibroid: An in-depth report on the causes, diagnosis, treatment, and prevention of fibroid.

Fibroid

An in-depth report on the causes, diagnosis, treatment, and prevention of fibroid.

 

A healthy uterus

 Uterine fibroid, also called uterine leiomyomata or uterine myoma, benign tumour that originates from the smooth muscle wall of the uterus. It occurs sometimes as a single growth but most of the time, they appear in clusters.

For reasons unknown, African women and women who have not borne children between the ages of 30-45 are at risk the most to develop fibroid.

After menopause, new tumours rarely originate while existing ones usually degenerate but do not disappear.

 

In more than 99 percent of fibroid cases, the tumors are benign (non-cancerous). These tumors are not associated with cancer and do not increase a woman’s risk for uterine cancer. They may range in size, from the size of a pea to the size of a softball or small grapefruit.

 

The symptoms differ but depend mainly on the location and size of the tumour which include;

 

  • Heavy menstrual bleeding.
  • Menstrual periods lasting more than a week.
  • Pelvic pressure or pain.
  • Frequent urination.
  • Difficulty emptying the bladder.
  • Backache or leg pains.
  • Pains and even bleeding during intercourse
  • A firm mass, often located near the middle of the pelvis, which can be felt by the physician

In some cases, the heavy or prolonged menstrual periods, or the abnormal bleeding between periods, can lead to iron-deficiency anemia, which also requires treatment.

 

Uterine fibroids may contribute to infertility by interfering with egg implantation or by compressing the opening of the fallopian tubes so that the sperm cells are prevented from getting to the egg.

 

How are fibroids diagnosed?

Fibroids are most often found during a routine pelvic examination. This, along with an abdominal examination, may indicate a firm, irregular pelvic mass to the physician. In addition to a complete medical history and physical and pelvic and/or abdominal examination, diagnostic procedures for uterine fibroids may include:

  • Ultrasound: To confirm the diagnosis, doctors usually order an ultrasound. This is done by using sound waves to get a picture of the uterus to confirm the diagnosis and to map and measure the size(s) of the fibroid. A doctor or technician moves the ultrasound device (transducer) over the abdomen Transabdominal ultrasound or places it inside the vagina Transvaginal ultrasound (also called ultrasonography) to get images of the uterus.
  • Lab tests: If a patient has abnormal menstrual bleeding, the doctor may order other tests to investigate potential causes. These might include a complete blood count (CBC) to determine if there is anemia (iron-deficiency) because of chronic blood loss and other blood tests to rule out bleeding disorders or thyroid problems.
  • X-ray. Electromagnetic energy used to produce images of bones and internal organs onto film.
  • Magnetic Resonance Imaging (MRI): A non-invasive procedure that produces a two-dimensional view of an internal organ or structure.  This imaging test can show the size and location of fibroids, identify different types of tumors and help determine appropriate treatment options.
  • Hysterosonography: Also called a saline infusion sonogram is a sterile saline is used to expand the uterine cavity, making it easier to get images of submucosal fibroids and the endometrium.

Hysterosonography

  • Hysterosalpingography: Is an X-ray examination of the uterus and fallopian tubes that uses dye and is often performed to rule out tubal obstruction. Here, dye is injected into the uterine cavity to highlight it and fallopian tubes on X-ray images. This is usually recommended if infertility is a concern. In addition to revealing fibroids, it can help the doctor to determine if the fallopian tubes are open.

Hysterosalpingography

  • Hysteroscopy. This is Visual examination of the canal of the cervix and the interior of the uterus using a small lighted telescope (hysteroscope) inserted through the cervix into the uterus. The doctor injects saline into the uterus, expanding the uterine cavity and allowing the examination of the uterine walls and openings of the fallopian tubes.

 

Hysteroscopy

 

  • Endometrial biopsy. A procedure in which a sample of tissue is obtained through a tube which is inserted into the uterus.

Treatment for fibroids

Since most fibroids stop growing or may even shrink as a woman approaches menopause, the health care provider may simply suggest “watchful waiting.” With this approach, the health care provider monitors the woman’s symptoms carefully to ensure that there are no significant changes or developments and that the fibroids are not growing.

In women whose fibroids are large or are causing significant symptoms, treatment may be necessary. Treatment will be determined by your health care provider(s) based on:

  • Your overall health and medical history
  • Extent of the disease
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or preference
  • Your desire for pregnancy

In general, treatment for fibroids may include:

  • Hysterectomy. Hysterectomies involve the surgical removal of the entire uterus. Fibroids remain the number one reason for hysterectomies in the United States.
  • Conservative surgical therapy. Conservative surgical therapy uses a procedure called a myomectomy. With this approach, physicians will remove the fibroids, but leave the uterus intact to enable a future pregnancy.
  • Gonadotropin-releasing hormone agonists (GnRH agonists). This approach lowers levels of estrogen and triggers a “medical menopause.” Sometimes GnRH agonists are used to shrink the fibroid, making surgical treatment easier.
  • Anti-hormonal agents. Certain drugs oppose estrogen (such as progestin and Danazol), and appear effective in treating fibroids. Anti-progestins, which block the action of progesterone, are also sometimes used.
  • Uterine artery embolization. Also called uterine fibroid embolization, uterine artery embolization (UAE) is a newer minimally-invasive (without a large abdominal incision) technique. The arteries supplying blood to the fibroids are identified, then embolized (blocked off). The embolization cuts off the blood supply to the fibroids, thus shrinking them. Health care providers continue to evaluate the long-term implications of this procedure on fertility and regrowth of the fibroid tissue.
  • Anti-inflammatory painkillers. This type of drug is often effective for women who experience occasional pelvic pain or discomfort.

 

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Sources/Photo Credit: https://www.britannica.com/science/tumor

http://obgyn.ucla.edu/fibroids

http://www.mayoclinic.org/diseases-conditions/uterine-fibroids/diagnosis-treatment/diagnosis/dxc-20212528

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