Uterine fibroids progression and complications

Uterine fibroids are benign tumors of the uterus, common in women of childbearing age. Uterine fibroids are dangerous depending on how advanced the tumor is and the risk of complications to reproductive health.

Uterine fibroids, also known as uterine fibroids, are benign smooth muscle cell tumors of the uterus, common in women of childbearing age between 30 and 50 years old.
Fibroids are formed when a smooth muscle cell abnormally divides into many cells and grows into a firm, elastic mass that separates from the rest of the uterine wall. They can develop into a mass or multiple fibroids with sizes ranging from 1mm to 20mm.
There are the following types of uterine fibroids:
Subserosal fibroids: May or may not be pedunculated, usually growing toward the abdomen, the iliac fossa, or between the leaves of the broad ligament, leading to compression pressure on the ureter, often mistaken for an ovarian tumor; Interstitial fibroids: A tumor that forms from the middle part of the uterine muscle, causing distortion of the uterine cavity; Submucosal fibroids: A fibrous tumor that forms under the mucosal layer. Sometimes these fibroids have stalks that push into the uterine cavity, called fibroids. Uterine fibroids are no longer dangerous depending on the location and size of the tumor, corresponding to different symptoms.

Uterine fibroids usually grow quite slowly. However, if not detected and treated, after a period of progression in the body, the tumor can increase in size, causing many dangerous symptoms and complications.
If the fibroid is small, does not cause menstrual disorders, and does not interfere with conception, the patient only needs to be monitored and does not need to be treated, unless otherwise prescribed by the doctor. In general, small tumors cause no significant symptoms or complications.

On the contrary, if uterine fibroids have grown large, causing menorrhagia, dysmenorrhea, affecting fertility, risk of infertility, miscarriage, the patient needs to be treated. Depending on the type of tumor and the woman's health situation, the doctor will choose an appropriate treatment method, but the treatment decision depends on the patient's choice, after being consulted. carefully discuss the benefits and risks.
Only about 0.05% of benign uterine fibroids become sarcoma (a potentially invasive, connective tissue cancer). During a woman's menopause, fibroids may even stop growing.

The degree of progression and the risk of complications to fertility are factors that determine if fibroids are dangerous.
3.1. Complications for non-pregnant women Abnormal uterine bleeding: Usually due to submucosal fibroids; Delayed pregnancy or infertility; Causing compression to the surrounding organs: Fibroids can put pressure on the ureters, large tumors will press on the bladder and rectum; Degenerative tumor: In some cases when the tumor grows large, there may be complications of aseptic necrosis or glass degeneration; Torsion of a subserosal tumor with a stalk: Causes severe pain in the pelvic fossa, accompanied by signs of peritoneal irritation (patients present with vomiting, constipation, defecation). 3.2. Complications for women in pregnancy Risk of miscarriage, intrauterine growth retardation, premature birth; Placenta striker , placenta comb teeth ; Difficult birth due to contractions or fetal position: When a pregnant woman goes into labor, uterine fibroids often cause contractions, leading to prolonged labor, abnormal fetal position, and poor bowing. Fibroids become tumors of the prostate, obstructing the exit of the fetus, making the delivery time longer, and possibly dangerous to the fetus; The period of placental abruption often causes bleeding, uterine atony; In the postpartum period, uterine fibroids can lead to fluid retention, postpartum infection, aseptic necrosis, and in case of subserosal fibroids, the stalk can be twisted.

In case the fibroids are large or accompanied by many growing tumors, the doctor may recommend surgery to remove the fibroids. Uterine fibroid surgery based on the size, location and condition of the patient to choose the appropriate method. Currently, the common surgical methods include: open surgery and laparoscopic surgery, in which robotic laparoscopic surgery is considered the leading treatment method.

Laparoscopic surgery by robot to remove uterine fibroids is currently being implemented at Vinmec International General Hospital. This method has many outstanding advantages over both classical laparoscopic surgery and open surgery:
No limitation of traditional vision, optimal image quality with higher accuracy; The robot has 4 hands, equivalent to 2 surgeons, which eliminates unnecessary vibrations (hand tremors); Able to operate in difficult positions, can move freely at 6 angles, wriggle into the smallest and deep cavities; Safety, minimizing the risk of complications, surgical infection; Less pain compared to conventional surgery; Less blood loss, quick recovery, reduced hospital stay; Ensure aesthetics due to very small surgical scars; Enhance recovery after surgery. For specific advice on the treatment of uterine fibroids at Vinmec, please come directly to Vinmec medical system or book an online examination HERE.
Reference source: National guideline on reproductive health services - Ministry of Health