Medical Q&As

Fibroids - alternatives to hysterectomy?

I have fibroids in the womb and would like to know if it is possible to have them treated without undergoing surgery?

Fibroids are non-cancerous growths in the wall of the womb. They occur in up to 50 percent of women. The real incidence isn\'t known, because most fibroids don\'t cause any symptoms. If fibroids are present, but not causing serious symptoms, no therapy is needed. They are not themselves an indication for surgery. It is also possible for fibroids to shrink after the menopause, thereby eliminating the need for any treatment. However, they may cause pain, cramping, and chronic bleeding and are the most common cause of non-emergency uterine bleeding. Hysterectomy has been the traditional treatment for fibroids but it is now possible to surgically remove the fibroid without removing the womb. This procedure is known as a myomectomy. It is also possible to shrink fibroids with special hormone injections. The drugs used are called GRH analogues and they suppress oestrogen release from the ovaries and this lack of oestrogen causes the fibroids to shrink. Essentially these drugs induce a chemical menopause. It is sometimes possible to remove fibroids with the aid of a hysteroscope, which is a special scope that enables the gynaecologist to see inside the womb. Using this instrument the gynaecologist is able to scrape away the lining of the womb and remove any fibroids that may be close to the lining of the womb. However, not all fibroids can be removed in this way. Fibroids can also be eliminated by burning them or freezing them via laparoscopic surgery. There is a new technique available for treating fibroids that is called uterine artery embolisation but I am not aware if this technique is yet available in Ireland. This procedure involves the insertion of a tiny tube or catheter into the femoral artery. The catheter is then guided into the uterine artery, which is the principal artery supplying blood to the womb. A dye is injected into the artery, which enables the radiologist to map the arteries supplying the fibroids. A special agent is then injected into these blood vessels that blocks the blood supply to the fibroids thereby depriving them of oxygen and nutrients and this causes them to shrink.