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<p><span style="color: #00826a;"><strong>Uterine Fibroids</strong></span> are caused by abnormal division of uterine muscle cells for unknown reasons. It is assumed that it may be due to genetics or female hormones stimulating the fibroids to grow, as fibroids are mostly found to shrink after menopause.</p>
<h4></h4>
<h4><span style="color: #00826a;">Am I at risk of having uterine fibroids?</span><strong><span style="color: #00826a;"><br />
</span></strong></h4>
<p>About 40 percent of women of reproductive age, between 30-50 years old, have uterine fibroids and often do not realize it because there are no abnormal symptoms. Uterine fibroids are not serious and are not cancerous, and the rate of malignant transformation is very low.</p>
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<h4><span style="color: #00826a;">How to know if you have uterine fibroids?</span><strong><span style="color: #00826a;"><br />
</span></strong></h4>
<p>Those who have uterine fibroids but show no abnormal symptoms can find out early by getting a medical examination through a pelvic exam or ultrasound.</p>
<h4></h4>
<h4><span style="color: #00826a;">Where in the uterus can fibroids be found?</span><strong><span style="color: #00826a;"><br />
</span></strong></h4>
<p><span style="color: #00826a;"><strong>Fibroids can be found in all positions of the uterus, including:</strong></span></p>
<ol>
<li>The outer wall of the uterus</li>
<li>Within the uterine muscle</li>
<li>Fibroids pressing into the uterine cavity</li>
</ol>
<h4><span style="color: #00826a;">What are the symptoms of uterine fibroids?</span><strong><span style="color: #00826a;"><br />
</span></strong></h4>
<p>Fifty percent of people with uterine fibroids are unaware because there are no visible abnormal symptoms. However, it can be detected during annual health check-ups by pelvic exam or ultrasound. The abnormal symptoms found include:</p>
<ul>
<li>Increased menstrual bleeding, prolonged bleeding, or painful periods</li>
<li>Bloating, indigestion, abdominal fullness, lower abdominal swelling due to large fibroids, and sometimes palpable lumps</li>
<li>Frequent urination due to fibroids pressing on the bladder</li>
<li>Chronic constipation due to fibroids pressing on the intestines and rectum</li>
<li>Pain during sexual intercourse because fibroids grow into the vaginal canal or are located at the cervix</li>
<li>Infertility or frequent miscarriage because fibroids obstruct fetal growth or embryo implantation</li>
</ul>
<h4><span style="color: #00826a;">How do doctors diagnose uterine fibroids?</span><strong><span style="color: #00826a;"><br />
</span></strong></h4>
<p>Besides taking medical history and physical examination, new medical technologies help improve diagnostic accuracy, such as ultrasound through the abdomen or vagina to plan further treatment. Some cases may require endoscopic examination of the abdomen or uterine cavity depending on the doctor&#8217;s discretion.</p>
<h4></h4>
<h4><span style="color: #00826a;">How are uterine fibroids treated?</span><strong><span style="color: #00826a;"><br />
</span></strong></h4>
<p>Treatment approaches depend on various factors, which the doctor will consider on a case-by-case basis. Factors include fibroid size, age, and whether the patient has children.</p>
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<h4><span style="color: #00826a;">Treatment options include:</span><strong><span style="color: #00826a;"><br />
</span></strong></h4>
<p><span style="color: #00826a;"><strong>Medication to relieve symptoms</strong></span> includes drugs to reduce menstrual bleeding and pain relievers. This method is suitable for small fibroids, about the size of a lime or orange. If the patient is older, no additional treatment may be necessary.</p>
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<h4><span style="color: #00826a;">Surgical treatments include the following methods:</span></h4>
<ul>
<li>Abdominal surgery is the most common method, involving a 6-8 inch incision on the abdomen. The fibroid may be removed alone (Myomectomy) for those who wish to have children in the future, or the uterus may be removed depending on the severity of the condition, such as severe pain or if the patient already has enough children.</li>
<li>Vaginal surgery involves no abdominal incision, less pain, and faster recovery but has limitations such as large fibroids, pelvic adhesions, and narrow vaginal canal making this method difficult.</li>
<li>Laparoscopic surgery involves making 3-4 small incisions of 0.5 – 1 cm in the abdomen to insert surgical instruments and a laparoscope connected to a monitor, allowing the doctor to see inside the abdomen and pelvis and control the surgery externally. (Additional information on laparoscopic surgery)</li>
</ul>
<p><span style="color: #00826a;"><strong>Incision sites for laparoscopic surgery</strong></span> include the navel area for inserting the small camera, and the lower abdomen above the pubic bone and sides of the lower abdomen for inserting surgical instruments.</p>
<h4></h4>
<h4><span style="color: #00826a;">Advantages of laparoscopic surgery</span></h4>
<ol>
<li>Small surgical incisions</li>
<li>Less pain and blood loss</li>
<li>Shorter hospital stay</li>
<li>Faster recovery and return to daily activities</li>
</ol>
<h4><span style="color: #00826a;">Preoperative preparation</span></h4>
<ul>
<li>The doctor will take medical history and perform a physical exam</li>
<li>If you have any chronic diseases or drug allergies, inform the doctor</li>
<li>If you are taking regular medication, inform the doctor</li>
<li>The medical team will perform physical and blood tests before surgery</li>
<li>You must fast from food and water before surgery as instructed by the doctor</li>
</ul>
<h4><span style="color: #00826a;">Postoperative care while in the hospital</span></h4>
<ul>
<li>While in the hospital, the doctor may provide IV fluids until the patient can eat and may insert a urinary catheter until the doctor orders otherwise. Patients must not remove the catheter themselves.</li>
<li>If there is pain or any abnormal symptoms, inform the nurse</li>
<li>Moving, sitting up in bed, or walking helps bowel function and reduces bloating, but the extent of allowed movement depends on the doctor&#8217;s discretion</li>
</ul>
<h4><span style="color: #00826a;">Self-care after uterine fibroid surgery at home</span></h4>
<ol>
<li>Keep the surgical wound dry and avoid soaking in pools or bathtubs</li>
<li>Clean the external genital area after bowel movements and urination; do not douche the vagina</li>
<li>Eat nutritious food, drink at least 8 glasses of water daily, and eat fruits and vegetables to prevent constipation and avoid straining</li>
<li>Do light exercise without overexertion, such as walking around the house</li>
<li>Sleep 8-10 hours per day</li>
<li>Two weeks after surgery, do light work such as sweeping or cooking; six weeks after surgery, resume normal work; avoid heavy lifting such as carrying children for 4-6 months after surgery</li>
<li>Abstain from sexual intercourse for 6 weeks after surgery or as advised by the doctor</li>
<li>Take medication on time and complete the prescribed course</li>
<li>Attend follow-up appointments</li>
</ol>
<p><span style="color: #00826a;"><strong>Note</strong></span> The timing for each activity depends primarily on the doctor&#8217;s discretion.<br />
Complications that require urgent medical attention include:</p>
<ul>
<li>High fever</li>
<li>Pain that does not subside</li>
<li>Surgical wound swelling, redness, or oozing blood</li>
<li>Vaginal bleeding with fresh blood and clots requiring frequent sanitary pad changes</li>
<li>Abnormal vaginal discharge with odor</li>
<li>Painful or burning urination</li>
</ul>
<p align="right">
<p align="right"><span style="color: #00826a;"><strong>Dr. Net Boonkum</strong></span><br />
Obstetrician and Gynecologist</p>
<p align="right">Women&#8217;s Health Center</p>
<p align="right">Phyathai 3 Hospital</p>


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Uterine Fibroids: The Silent Threat Women Should Know About!

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