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Uterine Fibroids |
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Definition
Uterine fibroids are non-cancerous tumors that develop
within or attach to the wall of the uterus, a female
reproductive organ. This is not a cancer, and is
extremely common.
Causes
Symptoms
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Many women do not have any
symptoms.
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Sometimes, it can cause frequent
urination (because it pushes against the bladder),
difficulty with passing stool (if it pushes on the
intestines), irregular or heavy periods.
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If it becomes large, it can push
against other organs in the stomach, or it can cause
the stomach to get bigger/distended.
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Sometimes, the blood supply to
the fibroid is suddenly cut off, and this can be
very painful.
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Some women with fibroids may have
problems becoming pregnant.
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In women with fibroids who do
become pregnant, they may have a
Miscarriage, premature
labor, pain during the pregnancy, or may not be able
to deliver the baby through the vagina if there is a
fibroid in the way. Also, some may have a lot of
bleeding after delivery.
Screening and
Diagnostics
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The most common way to make the
diagnosis is by an ultrasound.
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An MRI (magnetic resonance
imaging) scan can also be done.
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If necessary, a hysteroscopy (in
which a camera is used to look into the uterus) or
hysterography (in which a dye is injected into the
uterus and X-Rays
are taken) can be done.
Treatment
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No treatment is necessary if the
woman does not show any symptoms, but she needs to
be checked every 6 months by her doctor.
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If the fibroid's blood supply is
cut off, then the woman will have a lot of pain.
This is an emergency and needs immediate medical
attention. Emergency surgery may need to be done.
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For heavy bleeding, medicines,
such as Medroxyprogesterone or Danazol, can be used
to help decrease the bleeding.
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If the woman is severely anemic
(low blood count), this needs to be treated before
any surgery is done.
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Surgery to remove the fibroid
needs to be done if it is getting bigger quickly, if
it is causing symptoms, or if there is too much
bleeding.
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Fibroids that are near the cervix
or go through the cervix (the connection between the
uterus and the vagina) need to be removed.
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The smaller the fibroids, the
less risky the surgery. Therefore, when possible,
women are given medicines such as Leuprolide or
Nafarelin for two to three months before surgery.
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The following medicines help to
shrink the fibroids:
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Surgery to remove either the
individual fibroids or the entire uterus is the
main treatment.
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In women who are pregnant or
want to become pregnant, the fibroids can be
surgically removed and the uterus is left intact.
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In others, the entire uterus is
removed. This can be done through the stomach
(abdominal hysterectomy), through the vagina
(vaginal hysterectomy), or by
Laparoscopy-assisted
vaginal hysterectomy (a camera is used to help
with the surgery).
Once surgery is done, the
person is cured.
Although women can still become
pregnant if the uterus is left in place, they may
have to have a C-section.
Complications
Fibroids may cause infertility. They may also cause
premature delivery.
Severe pain or excessively heavy bleeding with
fibroids may require emergency surgery.
In rare cases, cancerous changes may occur. These
usually take place after menopause. The most common
warning sign is rapid growing of a fibroid. A
definite diagnosis is usually not made until the time
of surgery.
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