Uterine Fibroids
 I have fibroids. I declined surgery because I was afraid of a hysterectomy becoming necessary, and I want children. I am 33 years old. Can you advise?
 Fibroids are smooth muscle balls that grow predominantly in the uterus, and for the vast majority are benign tumors. They interfere with the blood flow in and through the uterus, and often cause disturbances in menstrual flow, making it heavy. They can interfere with fertility, and occasionally may cause the loss of a pregnancy.
Fibroids vary in size from barely detectable, peanut-size tumors to some as large as a soccer ball. When large, they may cause pressure and pain as well as abdominal distension. But recent advances have enabled gynecologists and interventional radiologists to utilize a new range of approaches to fibroids.
Many women carry successful pregnancies despite fibroids, though a pregnancy can be associated with the rapid growth of fibroids and a degeneration of the center of the fibroid called “red degeneration,” which can be quite painful.
Small fibroids that may hang within the cavity of the uterus or just beneath the endometrial (lining) surface may sometimes be removed through the use of a hysteroscope, which is a small telescope inserted through the cervix.
When surgery is envisioned to remove fibroids in a procedure called a myomactomy, the patient is always cautioned that a hysterectomy could become urgently required. This is because on rare occasions bleeding can be difficult to control, or the fibroids may be so numerous that there is little uterus to reconstruct back to normal.
In practice, however, because the use of vasopressin solutions injected around the fibroid can minimize bleeding, and because fibroids are generally detected while smaller, the risk of a hysterectomy being needed is much less. Perhaps at age 33, one of the larger dangers to your having children is the rapid passage of time and your declining fertility.
I advise that you attempt pregnancy as soon as appropriate to your situation. Problems of fertility require urgent identification. If the fibroids are felt to be the cause of infertility, you must seriously consider their removal. Many women, or their doctors, procrastinate only to find age has left them childless. We recommend you seek care from a concerned and involved gynecologist who takes your aspirations for motherhood very seriously.
Allan R. Handysides, M.B., Ch.B., F.R.C.P.(C) is director of the General Conference Health Ministries Department; Peter N. Landless, M.B., B.Ch., M.Med., F.C.P.(SA), F.A.C.C. is ICPA executive director and associate director of Health Ministries.
While this column is provided as a service to our readers, Drs. Landless and Handysides unfortunately cannot enter into personal and private communication with our readers. We recommend that you consult with your personal physician on all matters of your health. |
