Uterine Fibroids

What are uterine fibroids?

Every organ in your body has different tissue types. Each tissue type within a given organ can develop its own set of tumors, benign or malignant. 

The uterus is a muscular organ and therefore, makes muscle tumors. We refer to them as myomas (“myo” means muscle; “oma” means new growth or tumor). Sometimes you will see the term leiomyoma, which refers to the fact that it is the “smooth” muscle of an organ as opposed to the “striated” muscle of the skeleton.

“Fibroids” are muscle tumors. There is nothing “fibrous” about fibroids.  (A bit of a misnomer…)

These myomas become malignant in less than half of 1% of cases.  But, when removing any fibroid, precautions are taken to contain the tissue, in the unlikely event of malignancy.  This is to prevent spreading malignant tissue to different areas of the abdomen. 

Fibroids can be deep within the uterine wall (Intramural), expand from inside the uterine cavity, through the uterine wall to the outside of the uterus (Transmural). They might also be mostly on the outside of the uterus (Subserosal) or mostly on the inside aspect of the uterine cavity (Mucosal).

Fibroids can be safely removed with minimally invasive surgery. Our goal is to manage the uterine fibroids safely with minimally invasive surgery and preserve fertility whenever possible. 

Indications to Intervene on Uterine Fibroids

Uterine fibroids can cause pelvic pressure, back/hip/leg pain, urinary frequency and/or urinary incontinence or defecatory dysfunction.  The bony pelvis is a fixed amount of space, and the uterine muscle tumors are solid and relatively heavy, so that normal organs (bowels, bladder, and ureters) can be pressed upon.  When a person with fibroids has debilitating pain, then we consider the possibility of an additional cause for pain, such as endometriosis or degeneration of the fibroid.

There are several indications to intervene on uterine fibroids: 

1. Discomfort/Pain
2. Heavy bleeding 
3. Uterine size such that the fibroid tumors may press on other organs, causing organ dysfunction (example: bowel and/or bladder)
4. Rapid uterine growth
5. Associated infertility