Fibroid Tumors

Non-cancerous tumors that grow within the wall of the uterus are called fibroids.  They come in all sizes and their fibrous tissue is composed of smooth muscle cells.  Danger to health or cause for concern is dependent upon the size and location of these tumors.  Fibroids can place pressure on organs adjacent to the uterus, cause abnormal vaginal bleeding, infertility, and complicate pregnancy.  Heavy bleeding is a common and often alarming symptom of fibroids. Sometimes, fibroids can turn cancerous. Fortunately, this is rare. 

Many women experience fibroid tumors in their lifetimes.  In fact, they can be found in 40% of women between the ages of 35 and 55 years.  For unknown reasons, fibroids affect 50% of African-American women. While specific causes of fibroids have not yet been determined, we do know that they are dependent upon estrogen and that their rate of growth can be affected by hormone levels.

The traditional approach is to recommend a hysterectomy in patients with large fibroids or who experience excessive bleeding, pelvic pain or a sudden growth spurt in the size of the fibroids, suggesting a possible cancerous degeneration.  Except in infertility patients, a myomectomy where only the tumor is removed is usually not recommended because of the potential for excessive bleeding during surgery. 

Recent advances in surgical techniques and equipment now make laparoscopic myomectomies possible. However, since most patients with fibroids have multiple tumors, the removal of some would leave still others in place and the patient's problems would continue. Now we offer patients a supracervical hysterectomy where the body of the uterus with the fibroids is removed without disturbing the cervix where the nerves and ligaments supporting the pelvic floor are. In some cases this can even be done laparoscopically. 

Uterine Artery Embolization (UAE)
This is an investigational technique used in women with large symtomatic fibroids and who suffer from major contraindications to surgery. Tiny plastic pellets are injected into the uterine arteries blocking blood flow to the fibroids, causing cell death and eventual shrinkage. Side effects include significant pain and occasional premature menopause (because the blood flow to the ovaries was also blocked). 

We do not recommend this for the average patient with fibroids because this procedure goes against one of the basic tenets of surgery: namely that any tumor operated upon should be examined by the pathologist to rule out a cancerous condition. As noted above, a small percentage of fibroids are cancerous and if left untreated, will continue to grow and spread, compromising future treatment of the patient.  

Photographs of actual surgery to remove fibroid tumors can be viewed in our Surgery Gallery.

The health-related information on this website is provided as a courtesy to our patients and visitors.  This information is not intended as a substitute for medical advice of physicians. A patient or visitor to this website should regularly consult a physician in matters relating to his or her health and particularly with respect to any symptoms that may require diagnosis or medical attention.