Advanced Endometriosis Center NJ

Advanced Endometriosis Center NJ is one of the leading endometriosis treatment place in NJ areas.

What, exactly, are fibroids?

Fibroids, technically, are “tumors,” which is a generic medical word meaning a growth. The actual medical term for a fibroid is “leiomyoma,” which means smooth muscle growth. It is mainly made up of muscle and fibrous tissue in swirls that make them resemble balls of tough tissue.

Before you panic, know that tumors can be either malignant or benign, that is, cancerous or non-cancerous, so the word, “tumor” is not necessarily a life-threatening thing. This is important to know, since fibroids are often called “fibroid tumors,” and as such, should not be misinterpreted as cancer or life-threatening like cancer might.

Are fibroid tumors malignant?

No. These are the non-cancer variety of “tumor.” There are very rare cases in which they have been associated with cancer, but many researchers think this type of cancer isn’t actually from the fibroid, but in addition to it. The bottom line is that you shouldn’t worry about cancer from a fibroid itself or even many fibroids.

Nevertheless, fibroids—although common—are abnormal growths in that they interfere with the normal function of a very important organ, your uterus.

What is your uterus?

Your uterus is your “womb,” the organ that experiences your entire menstrual cycle, i.e., building up tissue in preparation for implantation of a fertilized egg in early pregnancy or, if pregnancy (conception) does not occur, shedding that lining as your menstrual period every month.

Its smooth muscle is the tissue that ends up causing contractions at the end of pregnancy in preparation for labor and delivery. A smaller version of this action is the cramping you may experience during your period when small contractions act to push menstrual (“period”) blood out onto a tampon or napkin. The ingenious thing about this muscle is that those small contractions during your period are designed to cinch down against blood vessels that bleed when the menstrual tissue falls away, and this cinching down make the blood loss minimal.

What kinds of problems do fibroids cause?

Fibroids cause all of their problems by occupying space. And the larger they grow, the more space they occupy, which can distort the normal architecture of your uterus. Also, larger ones weigh more, which can weigh down your uterus.

Pain and Painful Sex: your uterus is supported in its position in your pelvis with ligaments, but when it gets too heavy because of the extra weight the fibroids add, it can flop back and forth within your pelvis, twanging where those ligaments insert: PAIN. This can result in back pain, tailbone pain, and pain in your inguinal and vaginal areas. Worse, the mechanical act of intercourse can cause sudden movement of your heavier uterus, making sex painful.

Heavy Periods, Painful Periods: due to fibroids, smooth muscle cannot squinch down against open blood vessels that are exposed with menstruation. Hence, the muscle’s function to close those blood vessel openings can fail, which translates into heavier bleeding. This also can add to the pain, because larger clots stimulate stronger cramps to help move them out. Worst-case scenario is blood loss that can becoming life-threatening, requiring transfusions.

Infertility: implantation of a fertilized egg depends on a bed of enriched tissue that has a good blood supply. Besides directly being tissue on which a landing fertilized egg cannot implant successfully, nearby tissue where the egg implants may have to compete with the fibroid for blood supply. Both conditions may prevent implantation, which results in a failed pregnancy before you even miss your period! Fibroids can bulge and block the path from your fallopian tubes and your uterine cavity, preventing a fertilized egg from following through normally and possibly even causing an ectopic (tubal) pregnancy.

Pregnancy Complications: fibroids can bulge into the intrauterine cavity where the developing fetus is, affecting his/her movement, position, and growth. They are a common cause of breech position that requires a C-section. They can also cause ineffective labor, all of the vector forces (out!) against the baby becoming disorganized.

Fibroids are also misinterpreted by your uterus as something that needs to be expressed out, which can cause contractions that result in a miscarriage or later, preterm labor.

Mother and Newborn Complications: preterm labor can cause birth before your baby is mature, causing neonatal complications due to immature lungs. Fibroids also can interfere with your baby’s descent down the birth canal and can even increase blood loss after even a vaginal delivery, raising the risk of needing transfusions.

Interference with other organs: fibroids can bulge against your bladder, making it think it’s full before it really is, causing urinary frequency and urgency. It can do the same against your rectum, giving you the urge to have a bowel movement or symptoms that resemble constipation. Rarely they can be big enough to press on your ureters (which drain your kidneys) and this can put your kidneys at risk. The tugging on your uterus can involve tissue that also overlies your bladder, causing an imbalance in the stresses needed to urinate: this can cause incontinence.

What are fibroid symptoms?

As described above:

• Heavy periods
• Painful periods
• Infertility
• Pregnancy loss
• Preterm labor
• Premature birth
• Urgency to have a bowel movement (constipation symptoms)
• Urinary frequency and urgency
• Urinary incontinence

How are fibroids diagnosed?

Since enlargement of your uterus from fibroids is a mechanical enlargement, they can be felt by your doctor with an exam. Also, their size and number can be determined by ultrasound imaging, which is a painless, non-invasive sonogram. These investigations are usually provoked by the above complaints, but small fibroids are often found accidentally with imaging for other reasons. Large fibroids, however, grow from small ones, so even small ones without symptoms bear watching, which a fibroid specialist like Dr. Bozdogan of NJEndometriosis can do.

How big is too big?

As many as 80% of all women may have fibroids. Many without symptoms never require any type of intervention since they are “silent,” causing no problems. The fibroids that usually result in complaints are the size that either singly or collectively make your uterus the same size as that of a pregnancy in its third month. Even so, the symptoms may not be enough for a woman to feel she needs a procedure to remove it (them), but once the uterus is the size of a second trimester pregnancy, it’s usually time to consider surgery due to the risk of either hemorrhage or risk of needing even more extensive surgery—later—if they’re allowed to grow even more.

How are fibroids removed?

• They can be “starved” of their blood supply, by blocking the artery to the fibroid(s).
• They can be “pounded” by guided ultrasound into smaller fragments that the body eliminates.
• They can be allowed to shrink with hormones.
• They can be removed surgically.

Aren’t all of the other methods better than having surgery?

Certainly if you were to refuse surgery—”no matter what”—the other methods can be considered. However, these are not harmless procedures and can have severe complications themselves (sepsis, false menopause) while at the same time offering no guarantee that the fibroids have definitely been eliminated. In fact, they can have risks just as serious as those possible in surgery.

What type of surgery is recommended for fibroids?

• Myomectomy: this is removal of just the fibroid(s), done by entering the abdomen and cutting it away. It can also be done via a vaginal approach if the fibroid is hanging from a stalk within the cavity of your uterus.
• Hysterectomy: your uterus has babies, so if you’ve finished your family, unless a fibroid is solitary, removing your uterus will guarantee that your fibroid problems are over. However, hysterectomy should never be an option for a couple who might want to have children.

Today, with the minimally invasive laparoscopy techniques and the da Vinci robotic surgery Dr. Bozdogan uses, both these approaches have about the same quick recovery and minimum of discomfort.

Conclusion

Uterine fibroids, “leiomyomata,” are benign growths that—literally—get in the way of how your uterus should normally function—having periods and having babies. Pain is part of the picture with the distortion to your anatomy that fibroids cause. Thankfully, remedies for fibroids are not “your mother’s” remedies anymore, and news of their presence offers many options such that a personalized approach can be offered, via the expertise of a skilled and experienced surgeon like Dr. Ulas Bozdogan of NJEndometriosis. Quality of life and fertility depend on the expertise of the doctor you choose!