Imagine having a softball-size growth in your uterus. That's a real threat for the one in four American women in their reproductive years who have fibroids—benign muscular masses on the inner or outer uterine walls.
Fibroids can number from one to hundreds and range in size from a speck to a melon.
Though not cancerous, fibroid tumors can cause intense pelvic pain, constipation, incontinence and prolonged menstrual periods. The tumors typically shrink after menopause, but some symptoms may continue. Fibroid sufferers-even those who are symptom-free-are at increased risk for infertility, miscarriage and premature labor. Some fibroid patients bleed so heavily that they develop anemia and/or require a blood transfusion. In some cases, fibroids can be life-threatening if untreated.
Diagnosis can be made during a pelvic exam and confirmed with ultrasound. Hysterectomy (surgical removal of the uterus) is the only way to guarantee that no new fibroids will form. Fortunately, less drastic treatments-some quite new-can reduce the symptoms of and risks for fibroids.
Note: All fibroid treatments carry a risk for impaired fertility.
Focused ultrasound (FUS). High-intensity ultrasound waves are directed at individual fibroids to destroy them. FUS involves no incisions or hospital stay and requires one to four days of recovery. Though fibroids may return, symptom relief usually lasts up to 24 months FUS is FDA-approved, but some insurers label it "experimental and so do not cover it.
Myolysis and cryomyolysis. A probe is inserted into the fibroid and heat (myolysis) or cold (cryomyolysis) destroys the mass. Both outpatient procedures are usually done laparoscopically, so incisions are small-but they work only for fibroids on the outer surface of the uterus. Recovery takes about two weeks.
Uterine artery embolization (UAE). Tiny bead-like particles are injected into the uterine artery to block the blood supply to the fibroids. Tumors soften over time, easing pain and reducing menstrual bleeding.
Myomectomy. This technique removes individual fibroids with a laser, electrical current and/or scalpel. Depending on the location of the fibroids and the surgical procedure used, recovery may take from several days to several weeks. Though fibroids may grow back within 10 years, half of patients get sustained relief.
Important: Among fibroid treatment options, myomectomy is most likely to preserve fertility.
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