Not all fibroid cases need surgery —Experts

EXPERTS say that uterine fibroids are still a major problem for many women and its treatment through surgery is determined by its size, location and severity of symptoms. 

Professor Chris Aimakhu, a consultant obstetrician and gynaecologist, at a conference with the theme “Latest Advancement in management of uterine fibroids” said that between 20 and 80 per cent of females would have developed fibroids by the age of 50 although it is unclear exactly why they form. However, according to him, it seems to develop when the oestrogen levels are higher. 

The hybrid fibroids conference was organised by the Society of Gynecologists and Obstetrics of Nigeria (SOGON) in collaboration with The Fibroid Care Centre at Nordica, and the Association of Nigerian Private Medical Practitioners (ANPMP) Prof Aimakhu said many women may have one or multiple fibroids, with no symptoms whereas others end up experiencing pain, bleeding or both gradually over time. 

According to him, “treatment for fibroids is related to the womb while wanting to preserve fertility. Surgery is used when there are heavy vaginal bleeding, urinary or bowel problems, pelvic pain or infertility all related to fibroids.” 

He added: “The most suitable treatment options will depend on the number, location and size of the fibroids. The surgeon’s goal during myomectomy is to take out symptom-causing fibroids and reconstruct the womb. Unlike a hysterectomy which removed your entire womb, a myomectomy removes only the fibroids and leaves the womb intact. 

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“Women who undergo myomectomy report improvement in fibroids symptoms, including heavy menstrual bleeding and pelvic pressure. It restores fertility in some women who fibroids may be the cause of infertility.” 

Dr Victor Ajayi, also an obstetrician and gynaecologist at the Nordica Fertility Centre, Lagos, stated that in Nigeria, the incidence of fibroids varies from different reports varies from 30 to 70 per cent and black women are three times more likely to have fibroids and advanced age is its risk factor. 

According to Dr Ajayi, “not all fibroids need treatment. If treatment is not needed then don’t do it. Sometimes treatment especially open myomectomy and traditional treatment can make matters worse, causing tubal damage, scarred womb and vagina, affect implantation thus leading to IVF failure, miscarriage, bleeding in pregnancy and infertility.” 

Dr Abayomi Ajayi, MD Fibroid Care Centre at Nordica, Lagos, however, said some women with fibroid can also benefit from a nonsurgical method called High Intensity Focused Ultrasound (HIFU), a relatively new technology that uses high energy-focused sound waves to destroy the fibroids. 

According to him, “with time as the fibroid mass attempts to heal, it will start shrinking in size. As the fibroids shrink in size, this has been shown to reduce symptoms in women. With HIFU, many complications from surgery such as bleeding, anaesthetic complications and uterine adhesion can be avoided.