Uterine Fibroids and Hysterectomy - Complications

Highlights	Complications	Other Procedures
Introduction	Diagnosis	Hysterectomy
Causes	Lifestyle Changes	Resources
Symptoms	Medications	References
Risk Factors	Surgery

Complications

Effect on Fertility. The effect of fibroids on fertility is controversial. A 2002 analysis suggested that they may account for infertility in only 1% to 2.4% of women who are having trouble conceiving. Large fibroids may cause infertility by:

Impairing the uterine lining.
Blocking the fallopian tubes.
Distorting the shape of the uterine cavity.
Altering the position of the cervix and preventing sperm from reaching the uterus.

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Some evidence suggests that even small fibroids may reduce the chances of pregnancy in women who are undergoing assisted reproductive techniques. Treatments to reduce fibroids may be helpful in such women, although there has been little research on this subject.

Effect on Pregnancy.

A cesarean section may be required in cases where multiple fibroids, particularly those located in the lower part of the uterus, block the vagina during pregnancy. This, however, is a rare occurrence.
Multiple fibroids can increase the risk for miscarriage. In one 2001 study the presence of intramural fibroids halved the chances for a successful pregnancy. (The largest fibroid observed in the study was less than an inch.)
Fibroids canbreak downduring pregnancy causing pain and, possibly,premature labor.

Anemia

Anemiadue toiron deficiency can develop if fibroids cause excessive bleeding. Oddly enough, smaller fibroids, usually submucous, are more likely to cause abnormally heavy bleeding than larger ones.

Most cases of anemia are mild. Mild anemia can cause weakness and fatigue. Moderate to severe anemia cancause shortness of breath, rapid heart rate, lightheadedness, headaches, ringing in the ears (tinnitus), irritability, pale skin, restless legs syndrome, and mental confusion. Heart problems can occur if prolonged and severe anemia is not treated. Pregnant women who are anemic, particularly in the first trimester, have an increased risk for a poor pregnancy outcome.

Urinary Tract Infection

Large fibroids that press against the bladder occasionally result in urinary tract infections. Pressure on the ureters may cause urinary obstruction and kidney damage.

The female and male urinary tracts are relatively the same except for the length of the urethra.

Severe Pain

Fibroids can cause cramping during a period, which can be quite intense at times.

Pain can also develop if the blood supply is cut off from the fibroid tissue. In such cases, the cells blacken and die (called necrosis) from lack of oxygen. This event may occur under the following circumstances:

A very large fibroid outgrows its own blood supply.
A pedunculated fibroid (one that grows on a stem from the uterine wall) becomes twisted, thus cutting off its blood supply.
Pregnancy occurs, in which the risk for fibroid cell degeneration and necrosis increases.