Uterine Fibroid Surgery Singapore

What Are Uterine Fibroids?

Fibroids are muscle tumours of the uterine wall.

Fibroids are typically non-cancerous growths of the uterine wall commonly found in women during their childbearing years. Fibroids may be classified according to their location within the uterus as:

1. Subserous fibroids which grow in the outer wall of the uterus
2. Intramural fibroids which grow within the inner wall of the uterus
3. Submucosal fibroids which protrude into the cavity of the uterus

Depending on the location of the fibroids and size of the fibroids, there may be different symptoms. Submucous fibroids protruding or pressing into the cavity of the uterus may cause heavy or prolonged menstrual bleeding. Large subserous fibroids or large intramural fibroids may exert pelvic pressure or pain. Fibroids lying close to the bladder may cause frequent urination, or difficulty emptying the bladder. Fibroids lying at the back of the uterus close to the bowels may cause difficulty with defaecation or emptying of the bowels.

Occasionally, women may not have symptoms from fibroids and may be found to have fibroids only incidentally on physical examination when a large abdominal mass is detected.

What Are the Signs & Symptoms of Fibroids?

Many fibroids are asymptomatic, with some resolving on their own. However, depending on the size and location, signs and symptoms may include:

• Heavy vaginal bleeding or a painful period
• Prolonged menstruation
• Discomfort or heaviness in the pelvis
• Pain in the lower back
• Pain while having sex
• Bladder problems such as frequent urination
• Spotting or bleeding between periods

Treatment will vary depending on the severity of symptoms, ranging from observation to uterine fibroid surgery in Singapore.

What are the Causes of Fibroids Development?

What exactly causes fibroids is still unknown. However, there are risk factors that can contribute to its development. These include:

• Genetic predisposition: Individuals with family members diagnosed with fibroids have a higher chance of developing one and may require fibroid surgery.
• Hormones: Oestrogen is a female sex hormones that thickens the lining of the uterus during menstruation. This hormone can also promote fibroid growth. During the menopausal period, fibroid tumours shrink as the body produces fewer hormones.
• Obesity: Fat cells in the body release oestrogen which may contribute to the growth of fibroids
• Having no previous pregnancies has been associated with an increased risk of fibroids
• Vitamin D deficiency has also been linked to an increased risk of fibroids

Which Size of Fibroids Is Dangerous?

Fibroids in Singapore vary in size, and women with larger fibroids typically experience more serious symptoms. For instance, fibroids that measure 4 to 5 cm or more and develop inside the uterus can distort the womb’s shape and potentially block the fallopian tube. On the other hand, if it grows outside the uterus, it can press onto nearby organs and cause pain or discomfort.

Here are some factors that determine the type of uterine fibroids treatment needed:

• the nature of the symptoms e.g. severity of pain or heavy menstrual flow caused by fibroids
• the desire for fertility (usually done to prepare for IVF treatment).
• the size of the lesion
• the risk for cancerous changes in the fibroid

What are the Treatments Available for Uterine Fibroids?

• Observation of fibroids
  An ultrasound scan is usually useful for the diagnosis of fibroids and monitoring the size of fibroids.
• Medication for symptoms caused by fibroids
  Medication may also be prescribed to reduce menstrual pain and also to reduce the amount of menstrual flow due to the fibroids.
• Surgery to remove fibroids
  • Myomectomy
    Myomectomy refers to surgery to remove the fibroids alone, leaving the uterus in place to allow you to bear children. With myomectomy, as opposed to a hysterectomy, there is a risk of fibroid recurrence.The surgical approach to a myomectomy depends on the size and location of the fibroids as well as risk of cancerous change. Fibroids may be removed by laparoscopy (minimally-invasive or key-hole method) or laparotomy (open abdominal approach).
  • Hysterectomy
    Surgery to remove the uterus is the permanent solution for fibroids but ends your ability for childbearing. Hysterectomy may also be performed by laparoscopy or laparotomy.

FAQs

What is the most effective treatment for fibroids?

Treatment for fibroids include medical and surgical management. If the fibroids are large or symptomatic, surgical removal may be recommended. In such cases, a myomectomy is usually preferred – it removes the fibroids while leaving the uterus intact.

What size fibroids need surgery?

There isn’t a specific fibroid size that automatically necessitates removal; your doctor will determine the need for surgery based on the severity of your symptoms.

How are uterine fibroids diagnosed?

Two types of ultrasound scans can help diagnose fibroids:

• Abdominal Ultrasound: The ultrasound probe is moved over the outside of the abdomen.
• Transvaginal Ultrasound: A small ultrasound probe is inserted into the vagina for a closer view of the uterus.
• Blood Tests: In some cases of irregular menstrual bleeding, a blood test may be performed to check for anaemia due to blood loss.

Can you have fibroids without symptoms?

Many women with fibroids may not experience any symptoms, and they are often discovered during a routine exam. Fibroids can also shrink and become asymptomatic in some women who have undergone menopause.

Can fibroids affect fertility?

Fibroid size and location can sometimes affect fertility, especially large ones or those that are located in areas that block the fallopian tubes or blocks a fertilised egg from implanting.

Can fibroids shrink and go away on their own?

Small and asymptomatic fibroids may not require any treatment; and some fibroids may shrink after menopause due to a decrease in oestrogen levels.