What to know before opting for fibroid surgery

Any woman of childbearing age knows the chills that run down the spine whenever the word 'fibroid' is mentioned. Scientists say fibroid is a physical growth in the uterus (womb) that sometimes present without symptoms, though it may sometimes result in painful cramps and abnormal bleeding that will have to be tackled surgically.

Other symptoms, where presented at all, include prolonged menstrual periods that may last for seven days or more, pelvic pressure or pain, frequent urination, difficulty emptying the bladder, constipation, back ache or leg pains and pain during sex.

Talking about symptoms, Professor of Human Anatomy, Oladapo Ashiru, warns that fibroids only cause symptoms in approximately one out of every four women of reproductive age. In other words, someone may have the tumour and be blissfully unaware!

Worse still, experts lament, even after surgical removal of these growths, they may still grow back, subjecting the victim to unending rounds of physical and mental torture.

Consultant Radiologist, Dr. Abiodun Kuti, says this obnoxious growth is more common than many women may be willing to admit, what with the fact that four out of every five women have it, even when some victims have no symptoms and may not need any treatment — especially if it has not been diagnosed as being responsible for any infertility problem.

The fibroids that grow inside the lining of the womb (uterus) are medically known as uterine fibroids. Beyond the nomenclature, one worrisome trend about this growth, experts say, is that by the time a woman hits age 50, her chances of developing fibroids jump up.

Kuti warns that fibroids range in size — from seedling's size to bulky masses that can distort the shape of the womb and enlarge it, making the woman to look pregnant. Ashiru says they can be single or multiple; and that in extreme cases, they can expand the size of the womb so much so that it reaches the rib cage!

“Fibroids can be as small as an apple seed or as big as a grapefruit. In unusual cases, they can become very large,” Ashiru warns.

Fibroid and pregnancy
Ashiru says if fibroids are located in the muscle of the womb and are not bigger than four centimeters, a woman may not worry much, as they're very unlikely to prevent pregnancy from happening.

However, he warns, if the growth is located inside the womb where the baby is supposed to develop and it is bigger than four centimeters, the woman may have to undergo surgical removal in order to be able to conceive and carry pregnancy to term.

“Most women who have fibroids will achieve pregnancy without much hassle, and they will carry the pregnancy to term and have the baby. But where fibroid has been diagnosed as being present in the womb, especially where the woman is trying for a child, then you have to be pragmatic about it,” Ashiru submits.

But then, experts say, fibroids can result in complications during pregnancy! “A woman who has fibroids can experience complications during pregnancy and labour, and she stands six-time greater risk of undergoing cesarean section during delivery,” the experts warn.

Age, weight, family history
The experts say between 20 and 80 per cent of women develop fibroids before age 50, and that after age 50 when menopause is likely to set in, the fibroids may begin to shrink where present.

“Fibroids become more common as women age, especially during the 30s and 40s through menopause. After menopause, fibroids usually shrink,” Ashiru says.

The Medical Director of Nordica Fertility Clinic, Dr. Abayomi Ajayi, also adds that fibroids can run in families! “If a woman's mother had fibroids, her risk of having them is about three times higher than average,” Ajayi says.

Again, the experts warn, women who are overweight are at higher risk of developing fibroids. “For very heavy women, the risk is two to three times greater than average, and that is why people are consistently advised to maintain sound dietary habits, such as eating less fatty foods and eating more fruits and vegetables. Eating plenty of green vegetables seems to protect women from developing fibroids,” says the Nutritionist at Mayr Clinics, Mrs. Idowu Ashiru.

The way out
Sad to say, many women who have fibroids are sometimes ill-informed about the options of the treatment they have, or how the growth affects their reproductive health, for that matter.

However, physicians say that with the deployment of high-tech equipment, women who wish to undergo surgery for fibroid removal can heave a sigh of relief.

Consultant obstetrician/gynaecologist at the Medical Assisted Reproductive Technology Centre, Lagos, Dr. Lateef Akinola, says the hospital deploys Hysteroscopic Morcelator, which skilled physicians use in fertility treatment such as fibroid removal and in performing key-hole surgery (hysteroscopy).

Akinola says, “With the use of this equipment, which is the first of its kind in West Africa, clients can have minimally invasive surgeries that last for 30 minutes on the average and with little incision.

“So, unlike the surgeries of yore that left deep gash on the abdomen, what you now have is a key-hole size that heals beautifully.”

Ashiru, who also doubles as the Director of the MART Group of Health Services, says, “When used for fibroid removal, the morcelator 'melts' off the fibroid without leaving tissues floating in the uterine cavity; and where such a client also needs to undergo IVF treatment, it makes for double assurance that the process will be successful, unlike the failure rate that would be recorded should the uterus become scarred if old procedures were employed.”

Ashiru adds, “The beautiful thing here is that this sort of procedure is done without taking out the healthy tissue of the uterus. It is best for women who wish to have children after treatment for their fibroids or who wish to keep their uterus for other reasons. You can become pregnant afterwards.”

source: http://www.punchng.com