Fibroids

Fibroids removal specialist:

As a leading Gynecologist in the Washington DC area, Dr. Sikka offers women a variety of options for safe and convenient removal of fibroids from their body.

What are fibroids?

A fibroid is a benign tumor that arises from a muscle cell in the wall of the uterus. Fibroids are also called myomas, their size ranges widely from a small tumor that is the size of the pea to a large tumor almost the size of the uterus. Depending on the location where the fibroids are found, they are divided into following types:

Intramural: This type of fibroid grows inside the wall of the uterus
Serosal: This type of fibroid grows on the outer wall of the uterus
Submucosal: This type of fibroid grows inside the cavity of the uterus
Pedunculated: This type of fibroid hangs from a small stock from the outer wall of the uterus.

What type of symptoms can fibroids cause?

The size and position of the fibroids may lead to several symptoms like:

  • Heavy menstrual bleeding
  • Difficulty getting pregnant
  • Irregular bleeding between periods
  • Lower back pain
  • Pain during intercourse
  • Frequent urination
  • Lower abdomen-fullness and enlargement

How are fibroids diagnosed?

Larger fibroids can be diagnosed on pelvic and abdominal examination as the uterus is bigger on the exam. Small fibroids are usually diagnosed on ultrasound evaluation. In such cases ultrasound is usually done to evaluate the uterine cavity (the area where the baby grows) in women with abnormal bleeding or fertility issues.

How are fibroids treated?

The treatment of fibroids depends on the age, symptoms and location of fibroids. For example, patients may have a small fibroid which may be 1 or 2 cm in dimension but is located inside the cavity of the uterus and hence is causing problems with pregnancy or heavy bleeding. These fibroids can be easily removed through a procedure called hysteroscopic myomectomy which is done through the vagina in an outpatient fashion. Some patients may have 3-5 cm fibroids which are not causing any symptoms and can be watched with serial ultrasounds. Some patients may have several very large fibroids which can cause pressure symptoms and may need to be removed.

Treatment options-

  1. Hysteroscopic Myomectomy: Myomectomy is a surgical treatment which involves the removal of only fibroids thus enabling the patient to preserve the uterus for future fertility. Hysteroscopic Myomectomy can be performed by putting a small camera into the uterus through the vagina. Small fibroids in the cavity of the uterus (submucous fibroids) can be removed in this way. This procedure is called “hysteroscopic myomectomy”. This can significantly help patients with heavy bleeding or fertility issues.
    In a patient who wants to get pregnant, removing the fibroids with this technique is extremely helpful as it avoids making any incisions or cuts on the wall of the uterus. This does not delay future pregnancy and allows for a vaginal delivery at childbirth.

     

  2. Laparoscopic or robotic myomectomy-  This surgical option is used for larger fibroids which are involving the muscle of the uterus. In this procedure an incision is made on the uterus to remove the fibroid. The incision on the uterus is then stitched in several layers to maintain uterine integrity for future pregnancy. Many patients may need a cesarean section after removal of these type of fibroids. 
  3. Hysterectomy: This is a surgical treatment which involves removal of the uterus. This type of treatment is used for women who have large fibroids and have completed their family.