Frequently Asked Questions on Fibroids and Fibroid Embolisation

Here we have listed some of the questions we are often asked at Mercia Fibroid Clinic.

We hope these answers will be useful for you, but if you’re still looking for information you can get in touch with us

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Fibroids or uterine leiomyomas are benign, noncancerous growths inside the uterus or in its muscular wall.

Fibroids can vary enormously in size, from that of a pea to that of a melon. Between 20% and 40% of women over 35 years of age have fibroids. However, for Afro-Caribbean women they are two-three times more common and also tend to be larger and more numerous.

Multiple growths may be present at the same time, anywhere in the uterus. They are classified according to their location.

What are fibroids?   -  Who gets fibroids?   -  Where can fibroids grow?
What types of fibroids?   -  Are uterine fibroids dangerous?

Intramural fibroids, the most common, grow in the wall of the uterus.

Subserosal fibroids grow on the outside of the uterus. ...

Submucosal fibroids grow just underneath the uterine lining and can crowd into the uterus cavity and lead to heavy bleeding and other more serious complications.

Pedunculated uterine fibroids occur when a fibroid grows on a stalk, resulting in pedunculated submucosal or subserosal fibroids

Types of Fibroids
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What are the most common symptoms?   -  Can uterine fibroids cause back pain?
What are the symptoms of fibroids in the womb?

Symptoms vary, but most common symptoms are:

Regular, heavy menstrual bleeding

Pain in the pelvic area

Heaviness, cramps and swelling of the abdomen

Pain during urination or bowel movement

Infertility

Such symptoms do not necessarily mean that fibroids are present, which can only be confirmed by pelvic examination, possibly including an ultrasound scan or a magnetic resonance imaging (MRI) examination.

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How are fibroids treated?   -  How do you remove fibroids?

Most fibroids are asymptomatic and do not cause any particular problem. If this is the case, treatment in unnecessary. Treatments fall into one of three categories: medical therapy (drugs), surgery and embolization.

Drugs: anti-haemorrhagics or anti-inflammatories can be used to treat the patient's symptoms. Certain hormones can also be beneficial. However, the efficacy of drugs and hormones is usually limited and their effects temporary. Moreover, side effects may limit the duration of the course of treatment.

Surgical removal: various surgical techniques can be used, depending on the size, number and location of the fibroids:
Myomectomy involves the individual removal of each leiomyoma. Different approaches can be used, including laparoscopy , hysteroscopy or abdominal incision, but all entail a hospital stay of several days followed by a one to six week convalescence period. Myomectomy can complicate subsequent pregnancies because it causes scarring of the uterine muscle tissue.
Hysterectomy involves the removal of the entire uterus by coelioscopy  or surgery (either abdominal surgery or via a vaginal approach). This treatment modality definitively eliminates the fibroids but both hospital stay and convalescence period are longer. And of course, hysterectomy abolishes the possibility of later pregnancy.

Embolisation: This uterus-sparing procedure is performed with mild local anaesthesia and can be performed as a day case procedure. Postoperative pain is managed with various drugs or by means of a small pump device with which the patient herself can control the dose administered according to her degree of pain. With a fast recovery, normal lifestyle can be resumed within one to two weeks.

Embolisation does not compromise fertility although the procedure is not at this time licensed for the correction of leiomyoma-related infertility.

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What does Fibroid Embolisation involve?

Before the embolisation procedure, you will be given a comprehensive medical checkup.

A full physical and gynaecological examination carried out by your gynaecologist.

Imaging to assess the number, size and location of the fibroids, carried out by a radiologist.

A pre-treatment consultation is required in order to determine the most suitable
anaesthesia and pain management modalities.

During the procedure: The  embolisation procedure is carried out by an interventional radiologist who is specially trained in navigating  through vessels and treatment via a radiological approach. You will be given drugs to control pain, but you will remain conscious throughout the procedure. The radiologist will insert a small plastic tube, known as a catheter, into an artery in the groin or wrist . With X-ray monitoring, the catheter is advanced until it reaches the uterine artery where small particles, each the size of a grain of sand, are injected into the vessels supplying the fibroids. This blocks the blood supply so that the fibroids shrink and the symptoms are controlled, this can take up to 3 months.

After the procedure:  If performed as a day case you will be discharged a few hours after the procedure with pain killers and advice on how to be re admitted should you require further pain control. There is the option of an overnight stay with pain killers though the vein.

You will be able to return to work after 7 to 10 days. You may experience a mild  fever and fatigue in the days following the procedure. Bleeding may also occur in the following months. The fibroids may be expelled spontaneously, although this is rare.

Your interventional radiologist and gynaecologist will be working closely together to follow up with you after the procedure. Follow-up details vary, but you will be asked to return for checkups one and six months after embolisation.

An MRI examination will be completed between three and six months following embolisation treatment.

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© 2018 Mercia Fibroid Clinic LLP - c/o Nuffield Hospital, Stoke on Trent, Clayton Road, Newcastle under Lyme. ST5 4DB - Company Partnership Number OC418016

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Royal Stoke University Hospital
Newcastle Road,
Stoke-on-Trent,
Staffordshire,
ST4 6QG

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Nuffield Hospital
Stoke on Trent,
Clayton Road,
Newcastle under Lyme,
ST5 4DB

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Email: info@merciafibroidclinic.com

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