By Dr. Sonali N Tawde, Gynaecology

Uterine fibroids, also known as leiomyoma, are non-cancerous growths which develop in and around the uterus or the womb and form benign tumors in course of time. Though there are several types of uterine fibroids, they are all consistently similar in their genetic makeup. They are generally classified depending on their specific locations:

• Intramural fibroids
• Submucous fibroids
• Subserous fibroids
• Pedunculated fibroids

Signs and symptoms

In many cases, uterine fibroids display little or no symptoms at all. Therefore many women are caught unaware of the leiomyoma. When symptoms do show, however, they may include any one of the following:

1. Prolonged menstrual periods, usually for seven days or even longer
2. Increased frequency of menstrual periods
3. Heavy bleeding during periods
4. Pain during menses
5. Pain during intercourse

Treatment

Treatment depends upon size, location of fibroids and type, duration of symptoms of the patient

1. Non-surgical approach

(1) Watchful expectancy in cases where fibroids are asymptomatic, are diagnosed incidentally
(2) Anti fibrinolytics like Tranexamic acid, ethamsylate will help to reduce blood flow to some extent
(3) Anti spasmodics to relieve the pain
(4) Intrauterine device containing Levonorgestrel (LNG IUD) to help reduce heavy periods
(5) Iron supplements are helpful in substituting the blood loss caused by heavy menstruation
(6) Ulipristal will help in reducing the blood flow and pain for those cases where patients want to defer surgery or wish to go for fertility treatment before getting operated for fibroids. It may cause cessation of menses(amenorrhoea) which is reversible.

2.Surgical approach

i) Myomectomy

ii) Hysterectomy

These two procedures can be performed using several techniques like:

• Laparoscopy
• Laparotomy (Open abdominal surgery)
• Vaginal approach
• Hysteroscopic approach

iii) Uterine artery embolization (UAE) which reduces the blood flow and size of the fibroid.