Okoawo: Only reliable treatment for fibroid is surgery

Fibroids, also known as uterine myomas, leiomyomas, or fibromas, are firm, compact tumours, made of smooth muscle cells and fibrous connective tissue that develop in the uterus. Fibroids can bulge from the inside or outside of the uterus. Experts say that uterine fibroids, also called uterine leiomyomas are the most common benign tumours in women of reproductive age and can have a major impact on women’s health.

Reports say that the rate at which women grow fibroid is bothersome. It is estimated that 80 per cent of women will have fibroids in their lifetime, although not all of these women have disturbing fibroid symptoms. Some women will develop fibroids sometime during their childbearing years, although only about one-third of these fibroids are large enough to be detected by a health care provider during a physical examination.

Experts say that in more than 99 per cent of fibroid cases, the tumours are benign (non-cancerous). These tumours are not associated with cancer and do not increase a woman’s risk for uterine cancer. Black women are more likely to have fibroids than women of other racial groups.

Medical Director of Safehands Medical Centre, Old Ojo Road, Lagos, Dr. Innocent Okoawo, a family physician and a laparoscopic surgeon said that fibroid is an abnormal growth in the womb or uterus. The uterus is made up of muscles, fibrous tissue and endometrial tissue (the lining of the inside of the uterus).

On what causes fibroid, the expert said the cause is unknown. “I can categorically say that it grows in a woman in or from the womb. Any woman of reproductive age can have fibroid. I have operated on young women of 22 years old, up to 60 years for fibroids. Even after menopause, a woman’s fibroid can be so big that it gives her problems. I have handled such cases in my hospital.

“Intramural fibroids grow within the wall of the uterus, submucosal fibroids grow in the inner part of the womb, while subserosal fibroids grow on the outside of the uterus. They may range in size. They can be as small as a grain of rice and as big as a watermelon. To detect fibroid, a woman can go for an ultrasound scan,” says Okoawo.

The doctor, with special interest in women’s health, said at the early stage, there are usually no symptoms. “Fibroids are more likely to cause symptoms, if they are large, there are many fibroids, or if the fibroid is located in certain places in the uterus. Fibroids can increase the amount or the number of days of menstrual bleeding and cause painful periods. Women who have excessive menstrual bleeding are at risk of having a low blood count (anaemia). Family history could be a factor. If your mother or sister has fibroids, you are at risk of developing them.

“Larger fibroids can cause pelvic pressure or fullness in the abdomen, similar to the feeling of being pregnant. Sometimes, women have protruded tummy and people will think that they are pregnant, when they are not. This is as a result of fibroids, which can also cause other symptoms, depending on the location in the uterus.”

The specialist explained that most women with fibroids are able to become pregnant without a problem. “Fibroid is not a reason for infertility, though it can cause infertility. That a woman can’t get pregnant does not necessarily mean she has fibroid. If the location of the fibroid stops implantation to take place, it can obstruct pregnancy. Sometimes, fibroid can distort the shape of the womb, so much that it does not allow fertility. Most women with fibroids have a completely normal pregnancy without complications.

“The only reliable treatment for fibroid is surgery. People have tried other things and when they fail, they come to the hospital. In some cases, they allow it to degenerate, take concoctions that damage their reproductive organs and whatever happens to them, they say it is the surgery they went for. Women with no symptoms do not need to have treatment. The size, number and locations of fibroids and desire for a woman to get pregnant are also considered in most treatment decisions. Myomectomy is the standard surgical option for women with fibroid who want to bear children. Most women who do myomectomy are able to have children afterwards.

“There are also other surgical options, depending on the patient’s agreement with the doctor. My advice to women who are having fibroid problems is to stop seeing surgery as a death sentence and go for it before it becomes fatal. They should seek the services of a professional and avoid quacks.”