Understanding Uterine Fibroids

Uterine fibroids, noncancerous tumors, frequently develop within and on the uterus. They are also known as myomas, leiomyomas, or fibromyomas and are the most prevalent tumors in the female genital tract, affecting 20 to 40% of women in their childbearing years. The likelihood of developing fibroids is highest among women aged 30 to 50. Additionally, there is a considerably greater risk of fibroid development in overweight and obese women compared to those with a normal weight.

These growths vary in size, ranging from tiny to as large as an orange or more. In certain instances, they can lead to the enlargement of the uterus, resembling a pregnancy at the five-month mark or beyond.

While not all fibroids manifest symptoms, those that do may result in heavy menstrual bleeding, back pain, frequent urination, and discomfort during sexual activity. Treatment necessity varies; smaller fibroids often require no intervention, while larger ones need immediate medical attention.

Types of Uterine Fibroids

There are different types of uterine fibroids, and they are named depending on their location within the uterus, including:

• Intramural fibroids: They are the most common type and are located in the uterine wall. They may not exhibit symptoms unless they are large and can result in heavy bleeding.
• Submucosal fibroids: These fibroids grow inside the uterine muscle beneath the endometrium, they distort the uterine cavity, possibly leading to bleeding and infertility, even if small.
• Subserosal fibroids: This type of fibroid grows below the lining of the outer surface of the uterus, they can grow big, causing pressure on the bladder and rectum, resulting in urgent urination, constipation, and back pain.
• Cervical fibroids: They are the rarest form; these fibroids are connected to your uterus through a stalk or stem. In the cervix wall, they may cause infertility by blocking the cervical canal and difficulties in normal delivery.

Symptoms of Uterine Fibroids

Excessive and prolonged menstrual periods with occasional clots, potentially causing anemia.

• Pain in the lower abdomen, back, or legs.
• Bladder pressure results in a constant urge to urinate.
• Sensation of pressure or heaviness in the lower abdomen.
• Abnormal enlargement of the abdomen.
• Pressure on the bowel, resulting in constipation and bloating.

Diagnosis and Tests

Uterine fibroids are usually discovered during a gynecologic examination when symptoms like heavy bleeding arise. Diagnostic tests include the following:

• Ultrasonography
• MRI (Magnetic Resonance Imaging)
• CT Scan (Computed Tomography)
• Hysteroscopy
• Sonohysterography
• Laparoscopy
• Hysterosalpingography (HSG)

Causes of Uterine Fibroids

The exact causes of uterine fibroids are not fully known, but several factors may contribute to their development:

• Hormones: Estrogen and progesterone, hormones that regulate the menstrual cycle, may influence fibroid growth.
• Genetic predisposition: If your family members have a history of fibroids, you may be more susceptible.
• Age: Women in their reproductive years, particularly those in their 30s and 40s, are at a higher risk.
• Other growth factors:  Substances such as insulin-like growth factors, which play a role in tissue maintenance, could impact the development of fibroids.

It’s essential to note that while these factors are associated with a higher risk, many women with one or more risk factors do not develop fibroids, and the exact cause varies among individuals.

Possible Complications Of Uterine Fibroids

While uterine fibroids are generally not harmful, they can result in discomfort and potential complications, including:

• Anemia: Heavy menstrual bleeding and prolonged periods can lead to anemia.
• Urinary tract infections: If a fibroid puts pressure on the bladder and stops it from emptying fully.
• Pregnancy and labor complications: Fibroids generally don’t stop you from getting pregnant, but they could change the shape of your fallopian tubes or block them, thus increasing the risk of fertility issues, miscarriages, and complications during pregnancy and labor.
• Pelvic pain and pressure: Fibroids may cause discomfort and a feeling of pressure in the pelvic area.
• Bladder and bowel problems: Large fibroids may press against the bladder or rectum, causing frequent urination or constipation.
• Impact on quality of life: Symptoms such as pain and excessive bleeding can significantly affect a woman’s daily life and well-being.

It’s important to note that not all women with fibroids will experience complications, and the severity of complications can vary. Regular medical check-ups and discussions with a healthcare provider are crucial for monitoring and managing any potential complications.

Treatment Options for Uterine Fibroids

There isn’t one perfect way to treat uterine fibroids—there are many options.

• Watchful waiting: If you have no symptoms, just keeping an eye on things might be the best choice. Fibroids are not cancers.
• Medications: They can ease mild symptoms but don’t cure the fibroids.
• Non-surgical options:
• Uterine artery embolization
• HIFU (High-Intensity Focused Ultrasound)
• Surgical options:
• Hysterectomy
• Myomectomy

Medications for Uterine Fibroids

Medicines for uterine fibroids focus on the hormones that control your periods. They help with symptoms like heavy bleeding and pelvic pressure but don’t get rid of the fibroids. There are two types of medicines:

• Gonadotropin-releasing hormone (GnRH) agonists: These make your natural hormones, estrogen and progesterone, drop temporarily, putting you in a state like post-menopause. Many women get strong hot flashes with this medicine.
• Androgens: Similar to the male hormone testosterone, this drug can stop periods and fix anemia. But it’s not commonly used due to side effects like, feeling down or anxious, headaches, acne, weight gain, extra hair growth, and a deeper voice, which make some women hesitant to take it.

Non-Surgical Treatments for Fibroid in India

Uterine Fibroid Embolization (UFE) or Uterine Artery Embolization

UFE is extremely effective as it treats all uterine fibroids at the same time. This is a minimally invasive procedure done by an interventional radiologist. It needs only a small cut in the skin, and you won’t feel pain as it’s done with sedation and local anesthesia. Usually, you stay in the hospital for just one night. Many women can go back to light activities within a few days, and most return to normal routines within a week. UFE treats all fibroids at once, making it very effective.

The Best Candidates for Uterine Fibroid Embolization treatment in India:

• Has one or more fibroids
• Wants to keep her uterus
• Prefers not to have surgery
• Experiences symptoms because of the fibroids
• Doesn’t have cancer
• Faces challenges with surgery

During the procedure, a tiny cut is made in the skin at the groin, and a catheter is inserted. The interventional radiologist identifies the uterine artery using contrast media. Then, they inject tiny particles that block the vessels supplying all the fibroids. This cuts off the blood supply to the fibroids, making them shrink over a few weeks. Most patients see a significant improvement in symptoms like bleeding and pain, with 85% to 95% experiencing resolution.

Uterine Artery Embolization is used for various reasons:

• Single or multiple uterine fibroids.
• Adenomyosis.
• Postpartum hemorrhage.
• Bleeding from cancer of the cervix and uterus.
• Fibroids return after a myomectomy or if the myomectomy didn’t work.
• Patients at high risk for surgery, like those who are overweight, anemic, or have chronic renal failure.
• Before surgery on the uterus to reduce bleeding during the procedure.

Side Effects of Uterine Artery Embolization:

• There is around a 1% chance of infection, usually causing fever and a specific smell from the vagina. Treatable with antibiotics.
• Mild fever, controlled with oral paracetamol.
• Mild pelvic pain for 1-2 days, easily managed with simple pain medication.
• Women with fibroids always have fertility risks, but many have successful pregnancies after embolization.
• About half a percent of women may experience short-term menopause, but they usually resume normal periods later.

Pros & Cons of Non-Surgical Treatments for fibroid in India:

• High success rate of about 96-98%, unlike other fibroid treatments.
• This is the only method for treating multiple fibroids at once.
• There were no scars or blood loss during the procedure.
• Requires just daycare or 24-hour hospitalization.
• Short recovery time, usually 1-4 days.
• Addresses fibroids and adenomyosis simultaneously.

Advantages of Uterine Artery Embolization (UAE) treatment in India:

• Treats all fibroids at once, unlike myomectomy.
• It is uncommon for treated fibroids to grow back.
• Involves minimal blood loss or the risk of blood transfusion.
• Performed under local anesthesia, not general anesthesia.
• It requires only a small cut in the skin and no surgical incision in the abdomen.
• Shorter recovery time compared to hysterectomy or open myomectomy.
• There is virtually no formation of adhesions, which are common in surgery.
• If excessive vaginal bleeding was the issue, 87-90% of cases see resolution within 24 hours.
• Emotionally, financially, and physically, embolization can be an overall advantage over other procedures since the uterus is not removed.

Focused Ultrasound Surgery (FUS)

MRI-guided focused ultrasound surgery (FUS) is a noninvasive option for treating uterine fibroids while keeping the uterus intact. This procedure takes place inside a specially designed MRI scanner, enabling doctors to see your anatomy, locate, and destroy fibroids without any incisions. High-frequency, high-energy sound waves are directed at the fibroids to eliminate them. Typically, one or two treatment sessions, lasting several hours, are conducted intermittently.

As it’s a newer technology, ongoing research is exploring the long-term safety and effectiveness of FUS. Current data suggests that FUS for uterine fibroids is safe and highly effective.

Surgical Treatment Options for Uterine Fibroids

Hysterectomy (Removal Of The Uterus)

A hysterectomy is the surgical removal of the uterus, and it’s done by a gynecologist. There are two types:

• Total (removing the whole uterus with the cervix)
• Partial (removing the uterus and keeping the cervix)

Sometimes, they also remove the ovaries. It’s a big surgery that needs anesthesia, and the size of the scar depends on the uterus. The cut can be done on the belly, vagina, or with small tools. Side effects are common, like bleeding that requires a blood transfusion. Long-term issues are more common under 45 years due to hormonal effects. About 35% of women have another surgery within 2 years. Ureteral (urinary tube) injuries happen in 2.2% to 3% of cases. Hospital stay is 2 to 5 days or more, and full recovery takes a long time, 3 to 12 months. Everyday activities are limited for at least 4 months. It stops you from having kids, and if ovaries are removed, menopause starts, and you might consider hormone therapy.

Myomectomy (Removal Of The Fibroid)

Myomectomy is the removal of fibroids, done by a gynecologist. It’s a major surgery, and it can be open or laparoscopic, and sometimes it is done by hysteroscope.

The surgery needs general anesthesia, and a cut is made in the lower belly. The size of the scar depends on how big the fibroid is. The cut can be on the belly or done with a laparoscope.

Side effects include a lot of blood loss. Fibroids make new blood vessels, so during myomectomy, doctors have to be careful to avoid too much bleeding. Scar tissue can also form, leading to issues like blocked fallopian tubes or trapped intestines.

New fibroids may grow even after myomectomy, and if they come back, more treatment might be needed. If the cut during myomectomy is deep, it can weaken the uterus for future childbirth, and a cesarean delivery might be recommended.

Hospital stay is 2 to 5 days or more, and full recovery takes a few months.

The Best Choice for Treating Fibroids in India; Non-Surgical Treatment, Uterine Artery Embolization (UAE)

During this procedure, an interventional radiologist uses a catheter to send tiny particles that block the blood supply to the fibroids. When used specifically for uterine fibroids, it’s called Uterine Fibroid Embolization (UFE). This approach doesn’t involve surgery, letting the uterus stay in place. It provides relief from symptoms, and patients recover quickly, getting back to their daily activities soon after.

Benefits of Non-Surgical Fibroid Treatment in India:

• Done under local anesthesia, not general anesthesia.
• Treats all fibroids at once, unlike myomectomy.
• It is uncommon for treated fibroids to grow back.
• There was only a tiny cut in the skin and no surgical incision in the abdomen.
• Involves minimal blood loss or the risk of blood transfusion.
• Quicker recovery compared to hysterectomy or open myomectomy.
• Rarely forms adhesions, unlike common occurrences in surgery.
• If excessive vaginal bleeding was an issue, 87-90% of cases see resolution within 24 hours.
• Emotionally, financially, and physically advantageous over other procedures, as the uterus is not removed.

Exploring Non-Surgical Uterine Fibroid Treatment in India

If you’re seeking effective uterine fibroid treatment without surgery in India, then the country offers advanced and reliable non-surgical uterine fibroid treatments, providing a comprehensive solution for patients. With state-of-the-art medical facilities and skilled interventional radiologists, the non-surgical uterine fibroid treatment in India is renowned for its success. Uterine fibroid treatment cost in India are also competitive, making it an affordable option for international patients.

Choosing India for uterine fibroid treatment ensures access to cutting-edge medical technologies, experienced doctors, and a holistic approach to women’s health. Embrace the non-surgical advancements in uterine fibroid treatment in India, where quality meets affordability for a comprehensive healthcare experience.