Odysseys of George

If you missed the article then read this first After the Holiday

Wah, my friends are so smart, Bernard and Eve.

Yes the swelling that looks like a scene from egghead is a uterine fibroid. Incidentally her anterior abdominal muscles are very weak which caused the large swelling to bulge with every cough but became suspicious on examination as nobody could feel the muscular defect.

Well as I am not a gynaecologist, I will just write briefly on fibroid.

Uterine fibroids are non-cancerous growths that develop within or attach to the wall of the uterus, a female reproductive organ.

Sites where fibroids can form:

Uterine fibroids are the most common pelvic growth.

The cause of uterine fibroid tumors is unknown. Oral contraceptives and pregnancy lower the risk of developing new fibroid tumors.

Fibroids may be present in 15 - 20% of women in their reproductive years. Fibroids may affect 30 - 40% of women over age 30.

The growth of a fibroid seems to depend on the hormone estrogen. As long as a woman with fibroids is menstruating, the fibroids will probably continue to grow, usually slowly.Fibroids rarely affect females younger than 20 or who are postmenopausal.

Fibroids normally grow very slowly except during pregnancy where its’ size can increase. It will usually resume its normal size once the baby is delivered. However, they can also grow very big. They may fill the entire uterus, and may weigh several pounds. Although it is possible for just one fibroid to develop, usually there is more than one. Sometimes, a fibroid hangs from a long stalk, which is attached to the outside of the uterus. Such a fibroid is called a pedunculated fibroid. It can become twisted and cause a kink in blood vessels feeding the tumor. This type of fibroid may require surgery.

Symptoms
* None
* Sensation of fullness or pressure in lower abdomen
* Pelvic cramping or pain with periods
* Abdominal fullness, gas
* Increase in urinary frequency
* Heavy menstrual bleeding (menorrhagia), sometimes with the passage of blood clots
* Sudden, severe pain due to a pedunculated fibroid

A good pelvic bimanual examination and an Ulltrasound whether per abdomen or per vaginal will be able to reveal this diagnosis

Treatment can either be of a surgical or medical treatment

Treatment depends on the severity of symptoms, the patient’s age, whether or not she is pregnant, the desire for future pregnancies, her general health, and characteristics of the fibroids. Some women may just require monitoring of the fibroid.

Analgesics like nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended for women who have cramps or pain with menstruation. Birth control pills (oral contraceptives) may be used to help control heavy periods and to stop the fibroid from growing. Iron supplements may be given to prevent anemia in women with heavy periods.

In some cases, hormonal therapy is prescribed to shrink the fibroids. This medicine reduces the production of the hormones estrogen and progesterone. The hormones create a situation in the body that is very similar to menopause. Side effects can be severe and may include hot flashes, vaginal dryness, and loss of bone density.

Hormone treatment may last several months. Fibroids will begin to grown as soon as treatment stops. In some cases, hormone therapy is used for a short period of time before surgery or when the woman is expected to reach menopause soon.

Hysteroscopic resection of fibroids (an outpatient surgical procedure) may be needed for women with fibroids growing inside the uterine cavity. In this procedure, a small camera and instruments are inserted through the cervix into the uterus to remove the fibroid tumors.

Surgery:

A myomectomy is a surgical procedure to remove just the fibroids. It is frequently the chosen treatment for premenopausal women who want to have children, because it usually can preserve fertility. Another advantage of a myomectomy is that it controls pain or excessive bleeding that some women with uterine fibroids have.

Hysterectomy is another surgical procedure for women who have completed their family or if the size is increasing rapidly or excessive bleeding

Uterine artery embolization is a new procedure aimed at preventing the need for major surgery. The method stops the blood supply that makes fibroids grow. The long-term effects of this procedure are still unknown

Complications

1. possible infertility but rare
2. premature delivery
3. severe pain
4. excessive bleeding
5. potential to become cancerous.

Any gynaecologist willing to add?

This entry was posted on Tuesday, December 12th, 2006 at 9:39 pm and is filed under Medical, Health. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.