Fibroids are benign muscle tumours that form on or in the muscle wall of the uterus. They may be located on the outer wall of the uterus (subserosal), within the muscle layer (intramural) or even under the inner lining (submucosal). Only the latter is strongly associated with increasing bleeding volume per cycle, though any fibroid that distorts the inner lining may contribute to relative infertility. The subserosal fibroids generally contribute only to pressure symptoms on the bowel or bladder.
Fibroids are generally very slow growing tumours. It is reasonable to assess the interval change every one to two years by ultrasound scan. Rapidly growing fibroids, especially those with an irregular margin are of clinical concern and may in fact represent the relatively rare ‘leiomyosarcoma’ (cancer within a fibroid).
Fibroids are hormone dependent and so can be ‘shrunk’ with medications. Surgery to remove fibroids by laparoscopic means is both common and feasible. The location of fibroids and the desire to retain fertility will dictate the most suitable type of surgery; this can be readily discussed with Dr Gordon.