Fibroids

Fibroids are benign growths that can cause painful, heavy periods and fertility problems. Mr Thomas Ind can operate to remove fibroids or control the symptoms they cause.


Fibroids are growths that can be found in the wombs of around half of all women of reproductive age. They are non-cancerous and are made up of muscle and fibrous tissue. Fibroids can vary a great deal in size, from little swellings the size of a walnut to enormous, baby-sized growths that can take over the whole abdomen.

Small fibroids are common and most women with these have no symptoms. Bigger fibroids are much more likely to cause problems with pain, heavy periods and fertility issues. If your fibroids are causing difficulties, surgery by an experienced gynaecologist can make a real difference to your health and wellbeing.

Mr Thomas Ind is skilled gynaecological surgeon, operating in the NHS and in some of London’s top private clinics. He leads a caring, multi-disciplinary team of health- professionals working with the most up-to-date equipment. Together they will diagnose your fibroids, help you through your operation and support your safe recovery.


What are fibroids?

Whether they’re called fibroids, leiomyomas or myomas, they’re all the same thing. They are growths of uterine muscular or fibrous tissues. They develop in different parts of the womb; their name and symptoms depend on the part of the womb from which they originate.

  • Subserous: These fibroids develop on the outside of the womb and grow out into the pelvis. They can expand to an enormous size.
  • Intramural: These fibroids grow within the muscular wall of the uterus.
  • Submucosal: These fibroids develop on the inside wall of the womb and grow into the cavity of the uterus.

Why have I developed fibroids?

Any woman of reproductive age can develop fibroids. Their growth is driven by the female hormone, oestrogen, so they can appear any time from puberty until the menopause. However, they become more common with increasing age. Fibroids are also more likely to affect women of African-Caribbean origin and women who are overweight, because they tend to have higher oestrogen levels.


What are the signs and symptoms of fibroids?

The majority of fibroids cause no problems, but a third of women can have troubling symptoms. Problems are related to the position and size of the fibroids. Some can press on other structures in the pelvis or increase the surface area of the inside of the womb leading to heavy bleeding. Look out for:

  • Heavy bleeding during periods. You may also pass clots and suffer crampy pain.
  • Abdominal pain or lower back ache. If the fibroid twists or hasn’t got a big enough blood supply, this pain can suddenly become much sharper and more intense.
  • A need to pass water more often because of pressure on the bladder.
  • Constipation
  • Deep pelvic pain during sexual intercourse.
  • Miscarriage or fertility problems. Fibroids can interfere with fertilized eggs implanting or affect the healthy growth of the developing baby. This is a particular problem with fibroids that grow within the uterine walls or ones on the inside of the womb.

Fibroids usually develop slowly, but high oestrogen levels can speed up the growth. This can happen just before the menopause or in early pregnancy. Fibroids are benign growths but rarely they can become cancerous, this happens in between one in five hundred and one in two thousand women.


Investigations for fibroids

Mr Thomas Ind will ask about all your symptoms so that he can assess how much your condition is affecting your life. He will then perform a careful examination. If the fibroids are large, they can be felt on examination of the abdomen or pelvis and the womb may feel distended on vaginal examination.

Often, however, fibroids are discovered almost by accident, often on a scan that was arranged for a separate problem.

Thomas Ind may organise an ultrasound scan to assess the size and position of the fibroids. This can be done using a probe on the abdomen or through the vagina to get a better view of the womb and the fibroids. Sometimes, an MRI scan may also be arranged, if further information is needed. Blood tests may also be performed to check that heavy periods haven’t caused anaemia.


The treatment of fibroids?

The best treatment for your fibroids will depend on your symptoms, how much of a problem they are for you and whether you are trying for a baby or have completed your family. Mr Ind will discuss the potential treatment options, so that you can consider the pros and cons of each method and make the right decision for you.

If the fibroids aren’t causing problems and were just an incidental finding on a scan, it may be safe to leave them and monitor their growth. Medication can help ease pain and control heavy bleeding. Hormonal treatments can also decrease the oestrogen levels, reduce fibroid growth and decrease bleeding and pain.

If your fibroids need surgical treatment, Mr Ind can operate to remove problematic growths, shrink the fibroids or perform a hysterectomy if necessary. He is an experienced surgeon, with expertise in minimally invasive surgery. This means that you can have a shorter stay in hospital, less scarring and a much quicker recovery.


The treatments include:

Hysteroscopy

This is a minimally invasive procedure to examine the inside of your womb. A small camera is inserted through the vagina so that fibroids within the wall or the uterine cavity can be identified and biopsies taken.

Laparoscopy

Laparoscopy is a form of keyhole surgery. A camera is inserted through a small cut near the tummy button to examine the abdomen and pelvis and identify fibroids. Mr Ind is an experienced laparoscopic surgeon, with extensive experience operating on women with fibroids.  Depending on the size, location and position of your fibroids and whether you want to have babies in the future, Mr Ind can either remove specific fibroids or operate to remove the whole womb.

Myomectomy

Myomectomy is surgery to remove fibroids, leaving your womb in place. It may be done through a cut in your abdomen or it may be possible for Mr Ind to remove the fibroid by a keyhole or laparoscopic operation.

Myomectomy is performed under general anaesthetic, so you will be asleep during the procedure. 
You may be offered a myomectomy if you would like the option to become pregnant in the future. However, as your womb isn't removed there’s a chance that more fibroids will grow. This means that you may need to have further treatment in time.

Uterine Artery Embolization

Uterine artery embolization is procedure in which the blood supply to the fibroid is blocked, making it shrink. Under local anaesthetic, a fine tube is introduced via a blood vessel in the leg and guided to the womb. A chemical is then injected that blocks the blood vessel feeding the fibroid. This method may relieve symptoms for as much as two years, although problems can return and the full impact on future fertility is not fully understood.

Hysterectomy

Hysterectomy is a major operation to remove your womb. Mr Thomas Ind prefers to perform this operation as a minimally invasive procedure through the laparoscope. This is associated with less pain, fewer complications and a speedier recovery. It is not possible to carry a baby after a hysterectomy.

Endometrial Ablation

Endometrial ablation is a procedure in which the lining of the womb is removed. Energy from microwaves or a heat source is used to destroy the cells, which results in decreased vaginal bleeding. Some women may get pregnant following this procedure, so make sure you discuss contraception with Mr Ind or your GP. However, it is not suitable if you’ve not finished your family, because it is associated with an increased risk of pregnancy complications and miscarriage.


To arrange a consultation with Mr Ind or to discuss your options, please contact us.