Uterine fibroids

Another advantage of a myomectomy is that it controls pain or excessive bleeding that some women with uterine fibroids experience. However, a myomectomy often cannot remove very small fibroids that may grow and cause symptoms in the future.

A total hysterectomy, which involves removal of the uterus, is a curative option that is often chosen by older women.

Expectations (prognosis):

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Prior to menopause, fibroids are likely to grow slowly. Women with known fibroids who choose to have children may be advised to become pregnant in early adulthood.

As a general rule, fibroids don't interfere with fertility. However, a tumor sometimes blocks the fallopian tubes and prevents sperm from reaching and fertilizing eggs. In some cases, fibroids may prevent a fertilized egg from implanting in the uterine lining. However, proper treatment may restore fertility.

After a pregnancy is established, existing fibroids may grow due to the increased blood flow and estrogen levels. These usually return to their original size after the baby has been delivered.

Most women are able to carry their babies to term, but some of them end up delivering prematurely because there is not enough room in the uterus to sustain full term.

Cesarean section may be needed for delivery since fibroid tumors can occasionally block the birth canal or cause the baby to be positioned abnormally. After menopause, new fibroids rarely develop and those already present usually shrink.

Complications:

Fibroids may cause infertility because they can interfere with conception or implantation. They may cause premature delivery because of decreased area within the uterus. Severe pain or excessively heavy bleeding with fibroids may necessitate emergency surgery.

Rarely, malignant changes may occur. These usually take place in postmenopausal women. The most common warning sign is rapid enlargement of a fibroid and definitive diagnosis is usually not made until the time of surgery.

Calling your health care provider:

Call your health care provider if gradual changes in your menstrual pattern occur (heavier flow, increased cramping, bleeding between periods), or if fullness or heaviness develops in your lower abdomen. Frequently there is associated pressure or discomfort and occasionally interference with normal urination frequency.