Uterine fibroids are benign tumors arising from the muscular wall of the uterus and are among the most common gynecological conditions. Many fibroids cause no symptoms and do not require treatment. Depending on their size, number, and location, however, they may cause abnormal bleeding, pain, or other symptoms and may also affect fertility.

The important question is not simply whether a fibroid is present, but where it is located, how large it is, and whether it is causing symptoms.

Possible Symptoms

Fibroids may cause:

• heavy or prolonged menstrual bleeding
• bleeding between periods
• menstrual pain and lower abdominal discomfort
• pelvic pressure or a feeling of fullness
• frequent urination or pressure on the bladder
• pain during sexual intercourse
• difficulty becoming pregnant
• in certain cases, problems during pregnancy
• Heavy or prolonged bleeding can also lead to iron deficiency or anemia.

Diagnosis

Fibroids can usually be identified accurately with a gynecological ultrasound examination. This allows their size, number, and exact location to be assessed.

The location of a fibroid is particularly important when planning treatment. Some fibroids grow toward the uterine cavity, while others are located within the muscular wall of the uterus or grow toward its outer surface.

In certain situations, hysteroscopy or additional imaging such as MRI may also be useful.

When Do Fibroids Require Treatment?

Not every fibroid needs to be treated. Fibroids that do not cause symptoms can often be monitored with regular follow-up examinations.

When symptoms are present, different treatment options are available depending on the findings, age, and future fertility plans. These may include:

• medical or hormonal treatment
• hysteroscopic removal of fibroids within the uterine cavity
• laparoscopic or robot-assisted myomectomy
• other uterus-preserving approaches in appropriate cases
• hysterectomy when medically indicated

Uterus-Preserving Surgery

Particularly for patients who wish to become pregnant in the future or prefer to preserve their uterus, a myomectomy—the targeted removal of fibroids while preserving the uterus – may be an appropriate option.

Depending on the size, number, and location of the fibroids, surgery may be performed hysteroscopically, laparoscopically, or with robot-assisted surgery.

As an experienced surgeon in minimally invasive and robotic gynecological surgery, Dr. Arsenakis can use different surgical approaches and tailor the procedure to the individual findings.

Fibroids do not automatically require surgery – and surgery does not automatically mean removal of the uterus. The key is choosing the treatment that best matches the individual findings and circumstances.