Uterine fibroids are common, non-cancerous growths that develop in or on the uterus. While many fibroids cause no symptoms, larger fibroids can lead to heavy menstrual bleeding, pelvic pain, and other symptoms that significantly impact quality of life.

Most fibroids are benign and treatable. With expert assessment and personalized treatment, the majority of women experience substantial improvement in symptoms and overall wellbeing.

Many fibroids are small and cause no symptoms. However, larger fibroids may cause:

• Heavy or prolonged menstrual bleeding
• Bleeding between periods
• Pelvic pain or pressure
• A feeling of fullness in the lower abdomen or bloating
• Frequent urination (when a fibroid presses on the bladder)
• Pain during intercourse
• Lower back pain
• Constipation
• Chronic vaginal discharge
• Difficulty emptying the bladder completely
• Abdominal enlargement

If you experience persistent heavy bleeding, pelvic pain, or other symptoms that affect your daily life, seek medical assessment. Symptoms usually stabilize or improve after menopause as hormone levels decline.

Fibroids are often discovered during routine pelvic examinations or imaging for other conditions. When fibroids are suspected, diagnostic tests may include:

• Pelvic examination to assess uterine size and shape
• Transvaginal or transabdominal ultrasound to visualize fibroids and determine their size and location
• MRI scan for detailed imaging of fibroid size, number, and position
• CT scan when additional imaging is needed
• Hysteroscopy — examination inside the uterus using a thin camera to visualize fibroids in the uterine cavity
• Diagnostic laparoscopy — keyhole surgery to assess fibroids on the outside of the uterus

These tests confirm the diagnosis and help plan the most appropriate treatment approach.

Treatment depends on the size, number, and location of fibroids, the severity of symptoms, age, and your personal circumstances. Options include:

Observation:

Small, asymptomatic fibroids often require no treatment, only regular monitoring by your consultant.

Medical Management:

• Over-the-counter pain relief medications
• Iron supplements for anaemia caused by heavy bleeding
• Hormonal treatments to help control heavy bleeding and reduce fibroid growth
• Medications that work by temporarily shrinking fibroids before surgery

Medical therapy can help manage symptoms, particularly for smaller fibroids or when surgery is not immediately desired.

Surgical Treatment:

• Myomectomy — surgical removal of fibroids while preserving the uterus. This can be performed using open surgery, laparoscopic (keyhole) techniques, or robotic surgery depending on fibroid size and location
• Hysterectomy — removal of the uterus, which permanently resolves fibroid symptoms. This can be performed using minimally invasive approaches including vaginal, laparoscopic, or robotic techniques
• Uterine fibroid embolization — a procedure performed by an interventional radiologist that blocks blood flow to fibroids, causing them to shrink

The choice of treatment depends on your symptoms, the characteristics of your fibroids, and whether you plan to have children in the future. Your consultant will discuss all options and help you make an informed decision.

Fibroids are very common, affecting approximately 40-80% of women. Many women have fibroids without realizing it because they cause no symptoms. Fibroids are almost always benign — it's extremely rare (1 in 350 cases) for a fibroid to become cancerous. However, rapid fibroid growth or growth after menopause should be evaluated promptly.

Dr Mohamed Otify is a Consultant Gynaecological Surgeon with expertise in minimally invasive and robotic surgery for fibroids. He provides comprehensive assessment and personalized treatment plans tailored to individual circumstances.

His approach prioritizes:

• Thorough diagnostic assessment to determine the best treatment approach
• Advanced surgical techniques including robotic and laparoscopic myomectomy
• Minimally invasive hysterectomy when appropriate
• Organ-preserving surgery when desired and medically suitable
• Clear communication about all treatment options
• Personalized care focused on symptom relief and quality of life

If you're experiencing symptoms of fibroids such as heavy bleeding or pelvic pain, or have been diagnosed with fibroids and seek expert treatment, book a consultation for comprehensive assessment and personalized treatment planning.