Intramural Fibroids
Tuesday, March 31st, 2009
An intramural fibroid develops in the middle of the uterine wall. Intramural fibroids make the uterus apparently bigger in size and the woman may look pregnant or have a rounded stomach that she cannot get rid of by going on a diet or exercising.
The characteristic symptoms of intramural fibroid are heavy periods, menstrual clots of blood, pain during periods, feeling of heaviness, continuous pain or pressure around the pelvic region, bladder and colon disorders such as continual urination at short intervals, difficulty in urinating or constipation due to the pressure of the fibroid on organs which are close to it.
When the size of intramural fibroids are very large, there is a chance to block the supply of blood, oxygen and nutrients to the organs like kidneys. Sometimes permanent injury to the kidney may occur, when the fibroids are large in size.
Fertility of women may be affected by Intramural fibroids. As the report of Mount Sinai School of Medicine in New York stated that these variety of fibroids reduces the pregnancy rate to 11% than those having submucosal fibroids, and 58% chance for miscarriages. The report also stated that there is more possibility for caesarean and premature delivery.
According to a study carried out at the University of Valencia in Spain, intramural fibroids had no effect on the pregnancy rates of women undergoing IVF. But Baskent University in Turkey discovered that if IVF drugs were taken to further activate the ovulation process, the intramural fibroids got enlarged.
Abdominal myomectomy is the general treatment for intramural fibroids. When the fibroids grows more than 5 or 7 centimeters in size, or more fibroids are to be removed, then the above treatment is suggested.
In the procedure of abdominal myomectomy, the fibroids are removed surgically by making a cut through the abdomen. The uterus is pulled out through the cut and the fibroid is removed. The uterus is then stitched up and reinstated. As is the case with all other surgeries, there are chances of bleeding and infection in this procedure but it is important to have knowledge about adhesions and scar tissue. Some women have complained of the scar tissue sticking to the organs which can aggravate problems, for example, the fallopian tubes may get blocked.
Another surgical method is Uterine Artery Embolization. In the above method, the blood vessels which supply blood, oxygen and nutrients to the fibroids are blocked. The fibroids starving for the above things causes the tissue to die.
A study was carried out by Leeds Teaching Hospital on 10 women suffering from 11 centimetres or even larger intramural fibroids. Uterine Artery Embolization had been carried out on each woman and the doctors pursued their progress after 12 and 36 months. The symptoms of most of the women had decreased but two of them were still experiencing heaviness and an extra surgery was needed on two women because their kidneys had been damaged. After a period of 7 months, hysterectomy was required to be performed on one woman. According to the doctors, Uterine Artery Embolization was a safe treatment but statistics show that an extra surgery was necessary for 20% of the women who had undergone surgery. It was discovered by me also that within a period of five years, these symptoms came back in 30% of the women who had undergone surgery.
Another secondary condition experienced with Uterine Artery Embolization is excessive bleeding from the vagina. Two women were studied by the McGill University in Canada who were having excessive bleeding after undergoing this procedure. An endometrial biopsy was performed by the surgeons and both the women were found to have necrotic fibroids (a condition when the tissue becomes dead in the absence of blood supply).
Soon after the biopsy was performed, both women developed infection in the uterus and it became necessary to perform hysterectomy on them. The doctors reported that when Uterine Artery Embolization was performed in the situation of the intramural fibroids being close to the uterine lining, the chances of infection were greater. This seems sensible because bacteria get attracted to a dead tissue.