By Job Osazuwa
THERE is hardly a woman who doesn’t feel a wave of terror when she is told there is fibroid in her womb. Indeed, the world, tumour, of any type, sends a strange sensation to the patient’s spine, even if there is little to really worry about.
An Obstetrician and Gynaecologist at Lagos University Teaching Hospital (LUTH), Kehinde Okunada, told Daily Sun that one out of every two black women is living with fibroid in her uterus. According to him, although all uterine fibroids are the same, they are
categorised based on their location in the body.
He explained that fibroids most commonly occur among women between the ages of 30 and 40, and above, with black women at greatest risk.
A professor of obstetrics and gynaecology at NYU Medical Center, United States of America, Steve Goldstein, describes fibroid tumours to be composed of renegade muscle cells that come together to form a fibrous mass within the uterus.
He corroborates Okunade’s view that there is virtually no immediate threat of fibroid, and revealed that there were a number of excellent treatment options, ranging from drugs to surgery. He recommended
early diagnosis and doctor’s advice on the type of treatment to take as key to overcoming the tumour.
Sadly enough, in this part of the world, women usually embark on marathon spiritual exercise to overcome the medical challenge rather than depending on medication. Investigation reveals that many women who are down with the health challenge have subjected themselves to psychological torturing, in a bid to avoid what the doctors describe as simple operation – if necessary.
An obstetrician and gynaecologist at a private hospital in Lagos, Ekene Jude, said women, usually out of ignorance, have been struggling emotionally and physically with these tumours simply to avoid the knife.
However, the good news is that, according to him, patients, after most surgeries, generally recover in 10 days to two weeks. For effective treatment, he said it is a combination of patients’ symptoms, the location of the fibroid, and the numbers and size, as well as age and childbearing potential, that help determine the course of treatment.
Risk factors
Okunada said most fat or obese women are predisposed to developing fibroids. He clarifies that not all fat people have fibroids and not all slim women are free from the condition. Other experts have said that, at least one genetic link has been identified, indicating that fibroids may also run in families.
Symptoms and diagnosis
Okunada said for some women, fibroids cause none or major symptoms, but when they do, problems often involve heavy menstrual periods and prolonged bleeding, as well as pelvic or abdominal pain or swelling and increased urination.
“A menstrual period could increase from five to 10 or more days. There is also what we call pressure symptom,which has to do with frequent urination because other parts of the system have been affected by the growth of the tumour. And when the fibroids get bigger, it could lead to vomiting and other reactions,” he said.
On diagnosis, he said physical examination is the first approach, saying that a grown fibroid is easily noticed as the woman’s stomach protrudes.
However, he warned that not all swollen stomachs are symptom of fibroids, while explaining that after physical examination, cervical ultra-sound scan is done to reveal the presence or otherwise of fibroids in the uterus.
The doctor recommended surgeries as the best remedy to tackling fibroid tumours. He, however, said there were drugs used in fighting the disease, which have been helpful, but quickly warned that the drugs would only suppress the symptoms while fibroids keep resurfacing.
Alternative to surgery Managing Director of Cedarcrest Hospital, Ikeja, Lagos State, Dr. Felix Ogedegbe, has said women may no longer necessarily have to undergo fibroid removal surgery following new method of treatment
Ogedegbe, while speaking about uterine fibroid embolisation (UFE), said women who have fibroid could have a catheter passed through their blood vessel to get to the fibroid, adding: “Certain things are put on the fibroid to make it burn away in few weeks. Women do not need to have open operation to have fibroid removed anymore.”
“Blood transfusion is often not needed, risk of infection, long stay in the hospital and all things that traditional fibroid operation comes with. It is proved to be beneficial to a lot of women because it is common among black women.’
Treatment options: What you should know
Not too long ago, doctors routinely performed a hysterectomy for fibroid tumours. And while newer, less-invasive treatments are available, studies show this dramatic operation is still being performed today – far more frequently than necessary.
A panel recently convened by the governing body of the American College of Obstetricians and Gynaecologists found that 76 per cent of all hysterectomies performed today do not meet the criteria for this surgery.
“They are being done unnecessarily,” says Ernst Bartsich, associate professor of obstetrics and gynaecology at Cornell Medical Center in New York. He said many women were conceding to a hysterectomy for fibroid tumours because they are led to believe it’s the only solution, which he said was wrong.
At the same time, Goldstein said it was also important to recognise that not all hysterectomies are alike. In particular, he said the newest form of this operation, called a supra cervical hysterectomy, could still hold the answer for some women.