Introduction
A uterine fibroid (myoma) is a benign tumor consisting of muscle tissue which originates in the uterine wall. Fibroids are often found in women at their 4th -5th decades of life and are likely to grow until the time of menopause when their growth usually ceases due to the drop in plasma estrogen levels.
Quite commonly, multiple uterine fibroids can be found in the same women, a condition called 'fibroid uterus'.
Fibroids may interfere with uterine contraction during menstrual periods, resulting in increased bleeding and even anemia. An enlarged fibroid uterus might have a mass effect uppon neighboring pelvic and abdominal structures including the urinary and gastrointestinal organs.
This may manifest with abdominal bloating, urinary tract obstruction and gastrointestinal symptoms.
Diagnosis and follow up of uterine fibroids is usually performed by serial pelvic physical and sonographic examinations. Treatment of this condition varies and is largely dependent on women's age, menopausal status, the number and size of uterine fibroids, the amount of uterine bleeding, severity of anemia and the degree of pressure exercised by the uterus upon other pelvic organs.
While mild cases can be managed conservatively, severe cases may require surgical intervention including excision of the fibroids or removal of the uterus. These interventions are preferably carried out using minimally invasive techniques, such as laparoscopy or hysteroscopy.
These techniques are associated with faster recovery and lower complication rates than open techniques. Nonetheless, if the uterus is extremely enlarged, open surgery (laparotomy) is inevitable.