Uterine Fibroids: Symptoms, Treatment, and Surgery Options

Q: Uterine Fibroids: Symptoms, Treatment, and Surgery Options

Hello： If you are considering surgery, you should discuss in detail with your attending physician the surgical procedure, potential complications, and the physiological and reproductive impacts post-surgery. <br>It's important to understand that surgery may not necessarily resolv

Uterine fibroids

Hello doctor, today I went to Cathay for an examination.
The doctor checked a six-centimeter and a three-centimeter mass.
The previous doctor I saw couldn't determine how large they were, and since I have a lot of excess fat, the Cathay doctor referred me to another physician for laparoscopic surgery.
He mentioned that the incision would be small, but he also suggested that I should consider having children first.
He told me that if I become pregnant after the surgery, I would need a cesarean section.

I informed the doctor that I experience either urinary tract infections or ovulatory bleeding every month.
He said that this is unrelated to the fibroids, which I understand.
The doctor told me that even after surgery, I might still experience urinary tract infections and bleeding.
However, I have been taking medication without improvement, and it's very frustrating.
Additionally, the odor during my menstrual period is quite unpleasant, and it fills the entire room.
In winter, the smell isn't as strong, but every time I come in with severe pain, I refrain from taking painkillers.
I used to buy them at the pharmacy, but even after taking them, the pain persisted and seemed to worsen.
Currently, I am constantly vomiting; anything I drink comes back up, and I can't keep food down, leading to dry heaving.
Before going to Cathay, I was considering the worst-case scenario of having the masses removed because my menstrual cycle severely affects me.
My family often sees me applying heat packs, which sometimes cause blisters, and they tell me to stop, but the pain is unbearable.

Doctor, I previously underwent a colonoscopy; should I inform my physician about this? Because after the colonoscopy, I developed urinary tract infections, whereas I had no issues before the procedure.
If I need laparoscopic surgery, what should I be aware of? I am genuinely concerned about many issues, and I am taking medication all the time.
Sometimes I take antibiotics, and other times I take medication to regulate my menstrual cycle.
I also have a cold but am hesitant to see a doctor, so I keep taking medication.
I've been on antibiotics to the point where my lower back hurts for no apparent reason.
Sometimes, just walking requires me to use heat packs, or I can't sleep.
The gynecologist here says it's a fibroid issue.

Bing hen jiu, 30~39 year old female. Ask Date: 2014/02/06

Dr. Dong Yuhong reply Obstetrics and Gynecology

Hello: If you are considering surgery, you should discuss in detail with your attending physician the surgical procedure, potential complications, and the physiological and reproductive impacts post-surgery.
It's important to understand that surgery may not necessarily resolve your abdominal pain 100%.
Regarding your previous examinations and any related concerns you have, you should inform your attending physician, as this will aid in the preoperative assessment.
The issues you mentioned in your online consultation can also be discussed with your attending physician.
Thank you!

Reply Date: 2014/02/06

More Info

Understanding uterine fibroids, also known as leiomyomas, is crucial for women experiencing symptoms related to these benign tumors. Fibroids can vary in size, number, and location within the uterus, and they can lead to a range of symptoms that significantly impact a woman's quality of life.

Symptoms of Uterine Fibroids
Common symptoms associated with uterine fibroids include:
1. Heavy Menstrual Bleeding: Many women report excessively heavy periods, which can lead to anemia.

2. Pelvic Pain or Pressure: Fibroids can cause discomfort or pain in the pelvic region, particularly if they are large or located in certain areas.

3. Frequent Urination: If fibroids press against the bladder, they can cause an increased need to urinate.

4. Pain During Intercourse: Some women experience pain during sexual activity due to the presence of fibroids.

5. Backache or Leg Pain: Depending on their size and location, fibroids can also lead to discomfort in the lower back or legs.

In your case, the symptoms you are experiencing, such as severe menstrual pain, frequent urinary issues, and nausea, could indeed be related to the presence of fibroids. It is essential to communicate all your symptoms to your healthcare provider, as they can help determine the best course of action.

Treatment Options
When it comes to treating uterine fibroids, several options are available, depending on the severity of symptoms, the size and location of the fibroids, and whether you wish to preserve your fertility. Here are some common treatment options:
1. Medication: Hormonal treatments, such as birth control pills or GnRH agonists, can help manage symptoms by regulating menstrual cycles and reducing bleeding. However, these medications may not eliminate fibroids.

2. Minimally Invasive Procedures:
- Uterine Artery Embolization (UAE): This procedure blocks blood flow to the fibroids, causing them to shrink.

- Laparoscopic Myomectomy: This is a minimally invasive surgery to remove fibroids while preserving the uterus, which is an option for women who wish to maintain fertility.

3. Surgical Options:
- Hysterectomy: In cases where fibroids are large or causing significant problems, a hysterectomy (removal of the uterus) may be recommended. This is a definitive solution for fibroids but eliminates the possibility of future pregnancies.

- Open Myomectomy: For larger fibroids or multiple fibroids, an open surgical approach may be necessary.

Considerations Before Surgery
If you are considering surgery, such as a laparoscopic approach, it is essential to discuss the following with your healthcare provider:
- Risks and Benefits: Understand the potential risks associated with surgery, including infection, bleeding, and the possibility of needing additional procedures in the future.

- Recovery Time: Inquire about the expected recovery time and any limitations you may face post-surgery.

- Impact on Fertility: If you are considering future pregnancies, discuss how the surgery may affect your fertility and any necessary precautions.

Managing Pain and Symptoms
Given your current symptoms, including severe pain and nausea, it is crucial to manage these effectively. Here are some strategies:
- Pain Management: Over-the-counter pain relievers may help, but if they are ineffective, discuss stronger pain management options with your doctor.

- Hydration and Nutrition: Staying hydrated and eating small, frequent meals may help manage nausea.

- Heat Therapy: Applying heat to the abdomen can provide relief from menstrual cramps and pelvic pain.

Conclusion
Uterine fibroids can significantly impact a woman's health and well-being. It is essential to work closely with your healthcare provider to explore all treatment options and find a solution that best fits your needs. If you are experiencing severe symptoms, do not hesitate to seek immediate medical attention. Your health and comfort are paramount, and there are effective treatments available to help manage your condition.

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