Uterine fibroids
are a common clinical condition that affects millions of women across
the globe. There are a number of different risk factors that can lead
to the development of fibroids such as alteration in hormone levels and
genetic aetiologies.
The treatment
of uterine fibroids varies from patient to patient and can include both
medical and surgical treatments. However, not all patients who have received
a diagnosis of uterine fibroids necessarily require surgical treatment.
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In this article, we shall briefly review the treatment of uterine fibroids
without the need for surgery.
Medical Therapy
Firstly, it must be borne in mind that uterine fibroids are a form of
tumour of the uterus. As one may know, most tumours require surgical removal.
For example, patients who have prostate cancer require removal of the
prostate gland. In patients who have uterine fibroids, a hysterectomy
may be the surgical option offered. However, patients are now looking
at obtaining nonsurgical treatment options to see if they can be of any
benefit.
The primary indication for medical therapy in managing uterine fibroids
is the relief of pain. Drugs such as calcium channel blockers have been
widely used in the management of uterine fibroids induced pain. They work
by blocking calcium channels that are present within the muscle cells
and therefore stop the abnormal contraction of the uterine fibroids muscles,
thus relieving pain. Whether or not it is completely ineffective is doubtful
but it has been used with some success in some patients.
Other treatments that are used in managing pain include gabapentin and
phenoxybenzamine. Recent evidence has emerged that women who have normal
levels of vitamin D have a low risk of developing uterine fibroids. In
other words, in women in whom vitamin D levels are low, supplementation
may be an option to prevent uterine fibroids from forming.
Another nonsurgical option that is available in the treatment of uterine
fibroids is called uterine embolisation. This involves blocking of the
blood supply to the uterine fibroids completely which results in its shrinking
in a matter of weeks. This can help avoid the need for surgery in the
form of a hysterectomy.
Clinical studies assessing embolisation versus surgery have demonstrated
that while the fibroids did become a lot smaller and almost disappeared
in most patients, the associated symptoms such as pain took a lot longer.
In a sense, this could mean that despite adequate medical therapy, patients
may require surgery at some point that will help remove the uterine fibroids
completely and get rid of the patient's symptoms.
In addition, it must be borne in mind that fibroids can recur, and further
additional treatments may be warranted in the event of new symptoms arising.
Conclusion
Uterine fibroids
can be a distressing condition the patient and warrants urgent treatment.
While surgery may be one of the options, it must be remembered that medical
therapy itself can have excellent results. Treatment of pain is the primary
objective followed by the removal of the fibroids completely through specialised
in nonsurgical procedures such as embolisation. But, based on the severity
of the condition, uterine fibroids can also be removed successfully through
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