Fibroids are most often benign tumors of the uterus that occur during the reproductive age. The identification of the site fibroids will change their management. Fibroids grow either under the lining of the uterus (submucosal) in the uterine wall (intramural) or at the exterior part of the uterus (subserosal). The incidence of fibroids is high. Almost 1 in 4 women have got fibroids. The risk of malignancy is small (2.1 in 1000 fibroids that end to have surgery).

How are fibroids created?

The most prevalent theory suggests that fibroids grow from a single muscle cell from the uterine wall.

What are the symptoms of Fibroids?

Fibroids might not cause any problems for the patient. However, they can have severe clinical manifestations that can affect a woman’s social and personal life. Their presence might be related to infertility, miscarriage, or premature birth. The symptoms they cause depends on their location and size. The picture below depicts different types of fibroids that can occur.

Submucosal fibroids add to long and heavy periods, abnormal bleeding between periods, abdominal pain, pain during intercourse, feeling of pelvic pressure, increased frequency in passing urine, constipation, difficulty conceiving, etc.

Diagnosis of Fibroids

The diagnosis is easily made through pelvic ultrasound, and a pelvic MRI will assist the surgeon about the number, size, and location of the fibroids. When causing anemia (due to substantial blood loss), infertility, miscarriages, or pain, patients should receive treatment.

Treatment of Fibroids

The treatment varies depending on the size and location, the symptoms they cause, and the woman’s age and family planning. They can be treated conservatively through medication or surgically (usually with robotic surgery or hysteroscopy). In some cases, removal of the whole uterus (total hysterectomy) is advised. After a total hysterectomy, a woman will not have periods any more, but since her ovaries can be preserved, she will not experience any symptoms of menopause.

The removal of fibroids with uterus preservation is called myomectomy. Since fibroids can extend up to several centimeters and form masses that occupy the whole pelvis, the chance of completing such procedures through minimally invasive techniques rather than open laparotomies increases through the use of the surgical robots.

Surgeons dedicated to performing minimally invasive procedures are committed to personalized treatment for every individual patient. Robotic-assisted procedures are considered safe and effective. It is appropriate for most patients, but not for all.
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