Fibroid Treatment in South Delhi | Advanced 3D Laparoscopic Solutions

About Fibroid

Uterine fibroids are common growths of the uterus. They often appear during the years you're usually able to get pregnant and give birth. Uterine fibroids are not cancer, and they almost never turn into cancer. They aren't linked with a higher risk of other types of cancer in the uterus either. They're also called leiomyomas (lie-o-my-O-muhs) or myomas.

Fibroids vary in number and size. You can have a single fibroid or more than one. Some of these growths are too small to see with the eyes. Others can grow to the size of a grapefruit or larger. A fibroid that gets very big can distort the inside and the outside of the uterus. In extreme cases, some fibroids grow large enough to fill the pelvis or stomach area. They can make a person look pregnant.

Many people have uterine fibroids sometime during their lives. But you might not know you have them, because they often cause no symptoms. Your health care professional may just happen to find fibroids during a pelvic exam or pregnancy ultrasound.

What are Fibroids?

Fibroids are monoclonal neoplasms arising from the uterine myometrium, varying in size (1 mm to >20 cm), number, and location.

Types of uterine fibroids.

There are different types of uterine fibroids depending on where they’re located and how they attach. Specific types of uterine fibroids include:

• Intramural fibroids: These fibroids are embedded into the muscular wall of your uterus. They’re the most common type.
• Submucosal fibroids: These fibroids grow under the inner lining of your uterus.
• Subserosal fibroids: This type of fibroid grows under the lining of the outer surface of your uterus. They can become quite large and grow into your pelvis.
• Pedunculated fibroids: The least common type, these fibroids attach to your uterus with a stalk or stem. They’re often described as mushroom-like because they have a stalk and then a wider top.

Fibroids: Signs and symptoms

Many people who have uterine fibroids don't have any symptoms. In those who do, symptoms can be influenced by the location, size and number of fibroids.

The most common symptoms of uterine fibroids include:

• Heavy menstrual bleeding or painful periods.
• Longer or more frequent periods.
• Pelvic pressure or pain.
• Frequent urination or trouble urinating.
• Growing stomach area.
• Constipation.
• Pain in the stomach area or lower back, or pain during sex.

Rarely, a fibroid can cause sudden, serious pain when it outgrows its blood supply and starts to die.

Often, fibroids are grouped by their location. Intramural fibroids grow within the muscular wall of the uterus. Submucosal fibroids bulge into the uterine cavity. Subserosal fibroids form on the outside of the uterus.

Fibroids Causes

1. Hormonal Influence

• Estrogen and progesterone, the hormones that regulate the menstrual cycle, play a major role in fibroid growth.
• Fibroids contain more estrogen and progesterone receptors than normal uterine muscle cells.
• These hormones stimulate the growth of fibroids during the reproductive years.
• Fibroids often shrink after menopause, when hormone levels decline.

2. Genetic Predisposition

• Many fibroids contain specific genetic mutations, especially in genes related to cell growth.
• The MED12 gene mutation is found in up to 70% of fibroids and is believed to play a key role in their development.
• Alterations in the HMGA2 gene have also been implicated, especially in larger or rapidly growing fibroids.
• A family history of fibroids can increase a woman’s risk, suggesting an inherited component.

3. Extracellular Matrix (ECM) Abnormalities

• ECM is the structural framework that surrounds and supports cells.
• In fibroids, there’s an overproduction and abnormal accumulation of ECM.
• This excess ECM makes fibroids stiffer and denser, and may contribute to their size and resistance to treatment.
• It also affects how cells respond to hormones and growth signals, potentially fueling growth.

4. Growth Factors

• Certain growth factors, like Insulin-like Growth Factor (IGF), are thought to stimulate fibroid cell proliferation.
• These proteins enhance cell division, and in fibroids, the response to IGF may be exaggerated.
• Other signaling molecules, such as transforming growth factor-beta (TGF-β), may also promote fibrosis and ECM production.

Fibroids Risk Factors

• Race: 3x higher risk in Black women.
• Age: Most common between 30–50 years.
• Family history: Increased risk if a first-degree relative has fibroids.
• Obesity and hypertension.
• Early menstruation (before age 10).
• Nulliparity (no pregnancies).

Fibroids Complications

• Anemia from heavy bleeding.
• Infertility or recurrent pregnancy loss (submucosal fibroids).
• Preterm labor or cesarean delivery risk during pregnancy.
• Urinary retention or constipation (large fibroids).

Diagnosis of Uterine Fibroids.

1. Pelvic Exam

• A manual examination performed by a healthcare provider.
• May reveal:
  
  • An enlarged uterus.
  • Irregular shape or contour of the uterus.
  • Firm masses felt through the abdominal or vaginal wall.
• While this exam can suggest fibroids, it doesn't confirm them—it usually leads to further imaging.

2. Ultrasound

• First-line imaging tool, often used to confirm the presence of fibroids.
• Can be performed in two ways:
  
  • Transabdominal ultrasound (through the abdomen).
  • Transvaginal ultrasound (provides a clearer, closer view of the uterus).
• Helps assess:
  
  • Size, number, and location of fibroids.
  • Whether the fibroids are intramural, subserosal, or submucosal.
• It’s safe, non-invasive, and widely available.

3. MRI (Magnetic Resonance Imaging)

• Used when ultrasound results are unclear or when fibroids are large, numerous, or complex.
• Offers high-resolution images of soft tissues, helping distinguish fibroids from other conditions (like adenomyosis).
• Helps with pre-surgical planning, especially for minimally invasive procedures.

4. Hysteroscopy

• A minimally invasive procedure where a thin, lighted tube (hysteroscope) is inserted through the vagina and cervix into the uterus.
• Used mainly to evaluate submucosal fibroids that affect the uterine cavity.
• Allows direct visualization of the fibroid and surrounding tissue.
• Can also be used to remove small submucosal fibroids during the same procedure.

Uterine Fibroids Treatment

Medications:

• NSAIDs (e.g., ibuprofen) for pain.
• Hormonal therapy: GnRH agonists shrink fibroids.
• Tranexamic acid to reduce bleeding.

Note: Medication is taken only under the consideration of a physician.

Minimally invasive procedures:

1. 3D Laparoscopic Myomectomy

• Purpose: Surgical removal of fibroids while preserving the uterus.
• Technology: Uses 3D imaging for enhanced depth perception and precision.
• Benefits:
  
  • Minimally invasive (small incisions).
  • Better visualization of fibroids and blood vessels.
  • Shorter recovery time compared to open surgery.
• Ideal for: Women who want to retain fertility or avoid hysterectomy.

2. 3D Laparoscopic Hysterectomy

• Purpose: Complete removal of the uterus using a 3D laparoscopic approach.
• Technology: 3D visualization helps improve surgical accuracy and safety.
• Benefits:
  
  • Minimally invasive with faster recovery.
  • Reduced blood loss and lower risk of infection.
  • No risk of fibroid recurrence.
• Ideal for: Women with multiple or large fibroids not desiring future pregnancy.

3. 3D Laparoscopic Excision / Ablation

• Purpose: Removal or destruction of fibroid tissue using minimally invasive tools.
• Types:
  
  • Excision: Cutting out fibroids.
  • Ablation: Destroying fibroids using energy (e.g., laser, heat).
• Benefits:
  
  • Preserves uterus.
  • Enhanced accuracy with 3D imaging.
  • Less post-op pain, quicker healing.
• Ideal for: Select fibroid types and patients wanting uterine preservation.

4. Hysteroscopic Myomectomy (Diagnostic)

• Purpose: Diagnoses and removes submucosal fibroids via the cervix.
• Procedure:
  
  • A hysteroscope (thin camera) is inserted into the uterus through the vagina.
  • No abdominal incisions.
• Benefits:
  
  • Minimally invasive, often done in a day-care setting.
  • Accurate diagnosis of intrauterine fibroids.
  • Can treat abnormal bleeding and improve fertility.
• Ideal for: Women with fibroids protruding into the uterine cavity.

Surgery:

• Myomectomy: Fibroid removal (preserves fertility).
• Hysterectomy: Uterus removal (definitive cure)