Fibroids: Avoiding the big cut

By Dr Ryan Halsall

Monday, July 10, 2017

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UTERINE fibroids are probably one of the most talked about women's health topics. Most of us know someone who has or has had fibroids at some point. It's even said that about three-quarters of women in Jamaica will have fibroids at some point in their lives.

Fibroids vary greatly in size ranging from pea-sized to the big breadfruit-sized ones. They can exist as a single fibroid, or as a multitude of tumours. The most I've recorded removing from a single operation is a whopping 62!

Even though fibroids are not cancerous, they can cause terrible symptoms including heavy periods, painful periods, difficulty passing stool, frequent or difficult urination, difficulty getting pregnant, and even damage kidneys. Some can grow so large that women may appear to be nine months pregnant.

Luckily, fewer than half of the women who have fibroids experience any complications from them. Treatment is therefore usually given only to those who have problems with fibroids.

The best way to rid yourself of fibroid-related issues is surgery; usually removing the womb entirely or removing the fibroids and leaving the womb intact. But what of women who aren't ready for surgery? What options do they have?

The answer depends on where the fibroids are, how many, and how big. So have a discussion with your gynaecologist to determine what's best for you.

Symptom treatment

This involves giving painkillers to reduce cramps, and hormone tablets or injections to reduce heavy bleeding. This works as long as you are on the medication. Once you stop, the pain and bleeding will resume

Shrinking them

There are medications available here in Jamaica that we can use to reduce the fibroid size. This in turn results in less pain and bleeding. What's the catch? The medications are expensive and tend to have more side effects than regular hormone pills and painkillers. Also, the shrinkage isn't permanent. Usually within a year of stopping the medication the fibroids will start to grow back. It's a good option for women who are near menopause or as a temporary measure while you wait to get surgery done.

Minimally invasive surgery

Yes, this is surgery, but not the traditional surgery involving a big cut and four to six weeks' sick leave. If the fibroid is small and located on the inside of the womb, then hysteroscopy can be used to remove it. Here the operation is done through the vagina and cervix using cameras and tiny instruments, thus avoiding all cuts, and you can usually go home the same or the next day.

Some of these include vaginal hysterectomy, which involves removing the womb through the vagina. Again this leaves no scars on the belly and you can usually go home the following day; and laparoscopy, another viable option. It can aid vaginal hysterectomy in women with previous surgery, or it can be used to remove fibroids alone. With this method you are left with only barely visible tiny scars the size of a fingernail, and you can go home the following day.

If you are having symptoms that could be related to fibroids, get them checked out as soon as possible. Don't wait until it's severe before seeking help.

Dr Ryan Halsall is a gynaecologist at Island Laparoscopy. To schedule a consultation send e-mail to or call 876-455-4527. Facebook Page —




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