Fibroids are the commonest benign growths that we see in women of reproductive age. They occur in up to 30% of women of all races but are commonest in West African and Afro-Caribbean women. They grow in response to Oestrogen and shrink after the menopause.
They are poorly named, as they are not made up of fibrous tissue, rather, they are composed of smooth muscle. Their correct name is therefore Leiomyoma or smooth muscle growth.
Normally the smooth muscle fibres of the womb do not divide. In women with fibroids the mechanism that prevents cell division is faulty and muscle cells start dividing and continue to do so until a lump (fibroid) develops. Each individual fibroid can grow to about 12cms and they are often multiple. There is a strong hereditary factor in fibroid formation.
Often fibroids do not cause any symptoms and they do not require treatment. In some women they can lead to a variety of problems.
To some extent symptoms will depend on the location of the fibroids in the womb.
Sub-serosal fibroids do not affect the cavity of the womb so are unlikely to affect periods or fertility. If they are large they may be noticeable externally and may press on the bladder or bowel causing symptoms.
Even small fibroids that encroach on the cavity of the womb may cause heavy menstrual bleeding and fertility problems.
There are a number of possible treatment options for fibroids and the key is to choose the right method for each individual patient.
In many women symptom of heavy menstrual bleeding can be controlled using hormone manipulation or the Progesterone coil (Mirena). In others the fibroids themselves need to be treated in which case there are a number of treatment options
At OBGYN matters we offer a comprehensive patient centred approach to the care of women with fibroids. As in all areas of medicine the key to successful treatment of fibroids is in the careful selection of the right treatment for each individual patient. Patients have different needs and it is important that these are acknowledged and that treatment is centred round them.
Where surgery is required we are able to offer keyhole surgery of the highest possible standard thus maximizing the success of surgery and minimizing possible complications, even in fibroids up to 12cms in diameter.
Christian Barnick is a consultant at OBGYN Matters and is an expert in keyhole surgery. He works privately but is also the lead for Laparoscopic surgery at the Homerton University Hospital NHS trust in East London. He has been managing fibroids for over 20 years. He has three operating lists every week on which he performs keyhole surgery for fibroids, endometriosis and also other benign gynaecological conditions.
If morcellation of the fibroid is required this may be carried out in an intra-corporeal bag to minimise the risk of tissue contamination.
Mr Barnick is well recognized as an expert in the field of laparoscopic surgery and is an accredited surgical trainer at the Royal College of Obstetricians and Gynaecologists.