Uterine fibroids are non-cancerous mass of muscle and connective tissue in the uterus (womb). It is one of the most common non-cancerous gynecological conditions occurring in reproductive-age women, are estimated to affect more than 1 out of 5 women under the age of 50.
The surgical removal of uterus is called hysterectomy as a treatment for fibroids. Every year, about 175,000 American women-most of them 35 to 55-undergo hysterectomy.
It has been found that rate of hysterectomy performed in the United States is very high. By age 60, more than a third of American women have had a hysterectomy, a rate higher than in any other Western country. Most of these are done unnecessarily as if patients don’t feel any problem they may be left untreated.
New medications and less-invasive surgeries have made more treatment options available to women whose fibroids cause them problems. The physician should look objectively at the patient's symptoms, inform her of the treatment choices, and give her the autonomy to decide what she wants to do. Studies of hysterectomies done because of fibroids have not shown that removing a larger uterus poses a greater risk of surgical complications.
There are probably hundreds of thousands of women who have fibroids on their uteruses that don't need to have anything done to them. At the other end of the spectrum, if a woman who has completed her family has a large fibroid that is causing distressing symptoms-like painful cramps, heavy menstrual bleeding, and anemia-she would be a candidate for hysterectomy.
Ovarian cancer might go undetected because the presence of a fibroid makes it difficult for the doctor to feel the ovaries during a pelvic examination. A rapidly growing fibroid may signal uterine cancer. A growing fibroid may produce more debilitating symptoms and add to the risks of surgery later on. The development of ultrasound (the use of high-frequency sound waves to produce an image of a part of the body) makes it possible to look at a woman's ovaries even when a fibroid prevents a manual examination. In any case, ovarian cancer is rare before age 50, and most hysterectomies for fibroids are done on women ages 35 to 44.
Ultrasound and magnetic resonance imaging can be used to screen for uterine cancer, also rare in women under 50.
The development of endoscopes, lasers, and electrosurgical devices has led to new, less-invasive surgical techniques to remove fibroids. An endoscope is a thin fiber optic tube that surgeons insert into the body. It can transmit an image to a television-like screen. A laser is a device that uses a thin, intense light beam to “cut” or vaporize tissue, while electrosurgery or electorcautery devices use electricity to destroy tissue by applying heat.
