Frequently Asked Questions
What are fibroids?
Uterine fibroids are noncancerous, benign, growths of the uterus that often appear during childbearing years from the age of 20-55 years. Also called leiomyomas (lie-o-my-O-muhs) or myomas, uterine fibroids aren’t associated with an increased risk of uterine cancer and almost never develop into cancer.
Uterine fibroids develop from the smooth muscular tissue of the uterus (myometrium). A single cell divides repeatedly, eventually creating a firm, rubbery mass distinct from nearby tissue. The growth patterns of uterine fibroids vary — they may grow slowly or rapidly, or they may remain the same size. Some fibroids go through growth spurts, and some may shrink on their own. Many fibroids that have been present during pregnancy shrink or disappear after pregnancy, as the uterus goes back to a normal size.
Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. They can be single or multiple, in extreme cases expanding the uterus so much that it reaches the rib cage.
Why do people get fibroids?
While doctors still don’t know the cause of uterine fibroids, research and clinical experience point to the following factors:
- Genetic changes: Many fibroids contain changes in genes that differ from those in normal uterine muscle cells. There’s also some evidence that fibroids run in families and that identical twins are more likely to both have fibroids than nonidentical twins.
- Hormones: Estrogen and progesterone, two hormones that stimulate development of the uterine lining during each menstrual cycle in preparation for pregnancy, appear to promote the growth of fibroids. Fibroids contain more estrogen and progesterone receptors than normal uterine muscle cells do. Fibroids tend to shrink after menopause due to a decrease in hormone production.
- Other growth factors: Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth. Fibroid growth has not been linked to diet.
Although researchers continue to study the causes of fibroid tumors, little scientific evidence is available on how to prevent them. Preventing uterine fibroids may not be possible, but only a small percentage of these growths require treatment.
How do I know if I have fibroids?
Your doctor can often detect fibroids during a bimanual exam. The doctor or gynaecologist usually performs an ultrasound scan to confirm the presence and location of fibroids.
The most common symptoms of uterine fibroids include:
- Heavy menstrual bleeding
- Prolonged menstrual periods — seven days or more of menstrual bleeding
- Pelvic pressure or pain
- Frequent urination
- Difficulty emptying your bladder
- Constipation
- Backache or leg pains
How do you check for fibroids?
Fibroids are diagnosed through a variety of tests. Some fibroids masses may be deductible from a pelvic exam by a doctor. Usually, the doctor will require further testing to confirm the presence of fibroids. An ultrasound or MRI may be required to see the fibroid and extent of it. If a person is experiencing symptoms such as prolonged menstrual bleeding, excessive menstrual bleeding, pain during sex and pelvic pain, consult a doctor to determine if fibroids could be the reason.
Can you leave fibroids untreated?
Asymptomatic fibroids can be left untreated and often do as many women are not even aware they have fibroids due to the lack of symptoms. Women with symptoms may also go without treatment if the symptoms are manageable for them. The need for treatment arises when fibroids cause debilitating symptoms such as prolonged menstrual bleeding and immense pain and discomfort. When the quality of life is being compromised, fibroids should be addressed promptly and efficiently to restore a woman’s health.
At what age can you have a hysterectomy?
A hysterectomy can be performed at almost any age though it is avoided by medical specialists in the case of younger women. Due to the irreversible nature of a hysterectomy, women need to be made aware that they will be unable to carry children if they undergo the procedure. Most often, medical specialists will consider all other options before resorting to a hysterectomy, though in the case of cancer or major fear of cancer there is often little else that can be done. There are alternatives to a hysterectomy.
Is Uterine Fibroid Embolisation a new procedure?
Uterine Fibroid Embolisation as a technique was pioneered in 1974 by Dr.Jean-Jacques Merland. As of this writing, the efficacy of UFE for treatment of uterine fibroids has been confirmed by numerous institutional and multi-center studies for well over a decade.
Can I still have children after UFE?
The simple and short answer is “yes”; you can have children after embolisation.
However, fertility is a complex subject and successful conception requires a number of factors to align namely; functioning ovaries, open tubes and viable and healthy sperm.
Many patients are told “Treat your fibroids before trying to get pregnant” or ” Your fibroids are preventing you from having kids”. Both of these statements are myths. Many ladies have successful pregnancies despite having multiple fibroids! Also, fibroids usually don’t interfere with conception and pregnancy.
By far the most common issues associated with fertility problems are those related to blocked tubes (fallopian tubes), poor sperm health, advanced age of the female wanting to conceive and poorly functioning ovaries.
Our advice is very simple when it comes to fertility wishes….. as the patient you need to decide what is more important….. your desire to have a baby or the need to get bothersome, life-distressing/disturbing symptoms due to the fibroids under control.
We always assess our patients individually, but below is the principle we apply as a guide to explaining natural conception.
For ladies who are under 40 years of age we say the following: as long as the tubes are open, the sperm is healthy and the ovaries are working, then natural conception after embolisation remains possible.
For ladies who are over the age of 40 years, we say the following; natural conception is inherently compromised due to your age. As the ovaries age, so the chances of having a healthy egg in place for the sperm to impregnate decreases.
Will I be cured after UFE?
Uterine Fibroid Embolisation enjoys a solid reputation for relief of major symptoms of fibroids. The research shows that upwards of 90% of women find relief. The chances of recurrence are much lower than with myomectomy. Recurrence rates after myomectomy are reported to be as high as 60% while the recurrence with embolisation is less than 5-10%.
Embolisation is an excellent treatment alternative for patients who have already had a myomectomy and are now experiencing recurrent fibroids and symptoms. A repeat myomectomy is technically difficult because of the scarring in the abdomen. Embolization does not involve surgery and thereby does not have the risks associated with it that repeat surgery does.
How much is Fibroids Treatment?
Fibroid removal surgery cost will vary based on the type of surgical treatment a patient receives. The exact figure of treatment will depend on a range of factors including hospital fees, surgeon fees, anaesthetist fees as well as any other relevant charges. On average a myomectomy, which is the surgical removal of fibroids, costs around 30% more than uterine fibroid embolisation. The cost of a hysterectomy, which is surgical removal of the womb, is significantly higher. Almost all medical aids will cover the procedure costs of UFE/UAE in South Africa.
Need Information on Fibroids Treatment?
At Fibroid Care, we specialise in uterine fibroid embolisation(UFE), a safe minimally invasive alternative to surgery.
We are available to guide you through the process, answer your questions and help you make an informed decision.
Reach out to today for expert advice, or book a consultation to discuss the symptoms and treatment in more detail.