FIBROID UTERUS

The Fibroid is a commonest benign tumor in females. It is seen in 20% of women. Most of them do not show any symptoms highest incidence is between the ages of 35-45 years.

Development of fibroid has a positive family history and also sense genetic abnormalities also have a role in the development of fibroids. The rate of growth of fibroid is slow and it takes about 3-5years for the fibroid to grow sufficiently to be felt per abdomen.
Risk factors for the development of fibroid are :

  1. Nulliparity
  2. Obesity
  3. Hyperoestrogenic state
  4. Blacks

Fibroids are been less frequently in multiparous women. Fibroids grow rapidly during pregnancy or also among oral contraceptive pill users. The most common type of fibroid is the intramural type

Symptoms – 75% of women are asymptomatic.

  1. Excessive bleeding during menses
  2. Frequent menstrual cycles
  3. Dysmenorrhea
  4. infertility – scan in 30% of women having fibroids.

During pregnancy, it can cause abortion, preterm labor and also growth restriction in the fetus. it can also cause.

Postpartum Hemorrhage

If the fibroid size is very big and impacted it can cause pressure symptoms like constipation, retention of urine. Fibroids can be treated medically and surgically. Patients with fibroid uterus can be given medications for reducing the amount of bleeding and antispasmodics to relieve pain and dysmenorrhea. GnRH against are also prior to surgery in cases of huge and multiple fibroids.

Newer modalities of medical therapy are LNG-IUS which is the levonorgestrel-releasing intrauterine system. It is a hormone-releasing device like copper-t. This reduces uterine size and bleeding. Ulipristal acetate is the newest drug available in the market for fibroid uterus. this is given for a continuous period of 3months which shrinks the size of fibroids.

Surgically only fibroids can be removed which is called a myomectomy. This surgery is fertility of uterus-preserving surgery done in the younger age group of females. If family completed and elderly women hysterectomy can be done.

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