Uterine fibroid

A **uterine fibroid** is a tumor that is not cancer. It is a benign tumor. This kind of tumor grows in the muscle of the uterus, or womb. Fibroids often do not grow very large and do not always need to be treated. This kind of tumor often gets smaller after menopause. But sometimes fibroids cause heavy bleeding or pain. In this case, a physician may treat it.

Fibroids are almost always benign (not cancerous). Rarely (less than one in 1,000) a cancerous fibroid will occur. This is called leiomyosarcoma. Doctors think that these cancers do not arise from an already-existing fibroid. Having fibroids does not increase the risk of developing a cancerous fibroid. Having fibroids also does not increase a woman's chances of getting other forms of cancer in the uterus.

## Treatment 
Treatment may not be necessary if there are no or minor symptoms. Fibroids often shrink after the menopause and symptoms will usually either ease or disappear completely.
For fibroids that need treatment, medicine may help to relieve the symptoms.

### Medicine for symptoms 
Medicines are available that can be used to reduce heavy periods, but they can be less effective the larger the fibroids are.

#### Myomectomy 
A myomectomy is surgery to remove the fibroids from the wall of your womb. It may be considered as an alternative to a hysterectomy if you'd still like to have children.
But a myomectomy is not suitable for all types of fibroid. Your gynaecologist can tell you whether the procedure is suitable for you based on factors such as the size, number and position of your fibroids.
Depending on the size and position of your fibroids, a myomectomy may involve making either a number of small incisions in your tummy (keyhole surgery) or a single larger incision (open surgery).
Myomectomies are carried out under general anaesthetic and you'll usually need to stay in hospital for a few days afterwards. You'll be advised to rest for several weeks while you recover.
Myomectomies are usually an effective treatment for fibroids, although there's a chance the fibroids will grow back and further surgery will be needed.

#### Hysteroscopic resection of fibroids 
A hysteroscopic resection of fibroids is a procedure where a thin telescope (hysteroscope) and small surgical instruments are used to remove fibroids.
The procedure can be used to remove fibroids from inside the womb (submucosal fibroids) and is suitable for women who want to have children in the future.
No incisions are needed because the hysteroscope is inserted through the vagina and into the womb through the entrance to the womb (cervix). 
A number of insertions are needed to ensure as much fibroid tissue as possible is removed.
The procedure is often carried out under general anaesthetic, although local anaesthetic may be used instead. You can usually go home on the same day as the procedure.
After the procedure you may experience stomach cramps. There may also be a small amount of vaginal bleeding, which should stop within a few weeks.

#### Hysteroscopic morcellation of fibroids 
Hysteroscopic morcellation of fibroids is a procedure where a clinician who's received specialist training uses a hysteroscope and small surgical instruments to remove fibroids.
The hysteroscope is inserted into the womb through the cervix and a specially designed instrument called a morcellator is used to cut away and remove the fibroid tissue.
The procedure is carried out under a general or local anaesthetic. You'll usually be able to go home on the same day.
The main benefit of hysteroscopic morcellation compared with hysteroscopic resection is that the hysteroscope is only inserted once, rather than a number of times, reducing the risk of injury to the womb.
The procedure may be an option in cases where there are serious complications.
Read the National Institute for Health and Care Excellence (NICE) guidance about hysteroscopic morcellation for uterine fibroids

Page last reviewed: 09 September 2022
Next review due: 09 September 2025

## References
**Attribution:**

## Other websites 
* Fibroids are serious. Surgery isn’t the only way to stop them. - The Washington Post, 2022