NCCRM has performed uterine fibroid surgery or myomectomies for many years to assist women so that they will have a healthy successful pregnancy. Uterine fibroids (also called myomas or leiomyomas) are benign (non-cancerous) tumors of muscle tissue that can enlarge and/or distort the uterus (womb) and sometimes the cervix. They start from the smooth muscle cells in the wall of the uterus.
Fibroids are benign tumors of the uterus. They are also called uterine leiomyomas, or simply myomas. They grow from the muscle cells of the uterus and may protrude from the inside or outside surface of the uterus or they may be contained within the muscular wall.
- Submucous fibroid – A fibroid which grows just under the uterine lining.
- Intracavitary fibroid – A fibroid which grows inside the uterine cavity.
- Intramural fibroid – A fibroid which grows in the muscular wall of the uterus.
- Subserosal fibroid – A fibroid which grows just mainly on the outer surface of the uterus.
- Pedunculated fibroid – A fibroid which is attached to the uterus by a thin “stalk”.
Fibroids are very common. About 25 percent of women in their childbearing years will have signs of fibroids that can be detected by a pelvic examination, although not all will experience symptoms.
Cause of uterine fibroids
Although the exact cause is unknown, the growth of fibroids seems to be related to a gene that controls cell growth. Fibroid growth is affected by the reproductive hormones estrogen and progesterone. When these hormone levels decrease at menopause, many of the symptoms of fibroids begin to resolve. However, it is not clear that the hormones actually cause the fibroids to occur. For example, women who have had high levels of both of these hormones as a result of pregnancy or birth control pills have a lower incidence of fibroids later in life.
Abnormalities in the blood vessels around the uterus may play a role in development of fibroids. Changes in chemicals in the body that cause tissue to grow may also be involved.
The majority of fibroids are small and do not cause any symptoms at all. But many women have significant problems that interfere with some aspect of their lives and want to be treated. Symptoms of fibroids are increased uterine bleeding, pelvic pain and pressure, infertility and miscarriage, and pregnancy complications.
At NCCRM, we typically perform saline-induced ultrasounds that allow the physicians to see fibroids on patients to evaluate their uteruses and determine the best course of action in your treatment plan.
Surgical Treatment Options
Myomectomy means removal of a fibroid. In an abdominal myomectomy, an incision is made through the abdomen to expose the uterus, and the fibroids are excised from the uterine muscle. This approach is most appropriate in women who want to maintain childbearing, and who have multiple fibroids or very large fibroids.
In this procedure, the fibroids are removed through laparoscopy. With laparoscopy, a fiberoptic telescope inserted through a tiny incision in or below the belly button, through which the surgeon can visualize the uterus. Additional tiny incisions are used to introduce long thin operating instruments which can be manipulated to remove the fibroids and repair the uterus afterward. Laparoscopy is most appropriate for women with one or two small to moderate sized fibroids that are located on the outer surface of the uterus.
As in the case of diagnosing fibroids, hysteroscopy involves placing a fiberoptic telescope through the vagina and cervix and into the uterine cavity. Long thin surgical instruments can be introduced into the uterus using an operative channel in the hysteroscope. Saline is used to keep the walls of the uterus separated. This procedure can only be done on fibroids that mostly located within the uterine cavity.