Fibroids are extremely common affecting around 40% of ladies over forty in the UK. They are benign tumours (very rarely malignant) composed of smooth muscle and fibrous tissue and, in the main, cause no symptoms at all. If symptoms do occur they are either heavy periods, pressure effects on the bladder or bowel or sometimes pain. You may also feel a lump arising from the pelvis if the fibroids are relatively large.
Fibroids are classified according to where they are in relation to the womb (see picture). Those sticking into the cavity are called submucous and these tend to cause period problems such as heavy periods or bleeding between periods. If they need treating they can usually be removed hysteroscopically (from down below) as a relatively minor procedure.
Fibroids buried within the muscle of the womb are called intramural fibroids. These can cause heavy bleeding or pressure symptoms and if they need removal this is called a myomectomy. This is an operation through the abdomen and can be done either as an open operation or laparoscopically (keyhole). In cases where a lady has finished her family it is often preferable, both from the easy of surgery and to reduce the risk of recurrence, to have a hysterectomy. Depending on the size of the womb this may be done laparoscopically (keyhole) or, if the womb is too large, as an open operation.
Fibroids protruding from the outside of the womb are called subserous fibroids. These tend to cause pressure symptoms rather than bleeding problems and if they need removing this can be done laparoscopically (keyhole) or as an open procedure.
In addition to surgery, there are other options for treatment of fibroids including a medication known as Ryeqo and an interventional radiological option of fibroid embolisation. Ryeqo is a once daily tablet that causes fibroids to reduce in size and often stops periods.
Fibroid embolisation is a procedure carried out by interventional radiologists, who block the blood supply to the fibroids. If this is a suitable option for you Mr Carpenter will refer you to an interventional radiologist who undertakes these procedures