What are fibroids?
Fibroids are common benign tumours of the wall of the uterus (the muscle). As many as 1 in 4 women will have a fibroid. Most of these will be small, around a few centimeters.
Fibroids in the wall of the uterus (intramural fibroids) or outside of the uterus (subserosal fibroids) may cause symptoms if they grow to a large size (more than 5cm). They may put pressure on structures around the uterus such as the bladder or bowel, causing frequent urination or constipation.
Occasionally they cause pain. This is generally caused by the fibroid outgrowing its blood supply and starting to degenerate. Some fibroids may be pedunculated, or on a stalk. These can twist and cause pain.
Most fibroids will not cause any issues. Fibroids impacting on the inside of the uterus (submucous fibroids) may cause heavy menstrual bleeding. These fibroids can also cause infertility or miscarriage.
Fibroids have a 0.1% (1 in a 1000) risk of turning in to a cancer (leiomyosarcoma). Fibroids that are very large, rapidly growing, or in women having undergone radiotherapy are more at risk of this. Large fibroids in women in the menopause are also at greater risk.
Many fibroids do not require treatment. When treatment is required, the fibroids may be removed through the cervix (hysteroscopic fibroid resection), laparoscopically (laparoscopic myometomy), or through a laparotomy (horizontal incision on the abdomen).