Are intramural uterine fibroids dangerous?

Intramural fibroids are common types uterine fibroids that are non-cancerous abnormal uterine growths. Intramural uterine fibroids can vary in size, ranging from small, undetectable nodules to large masses affecting the shape and size of the uterus. This can vary in size from 1mm to 20cm or even more, and it is possible to have multiple intramural fibroids located in the same area.

Types of intramural fibroids

Different types of intramural fibroids depend on the area where they grow.

• Anterior intramural fibroids: These are located in the front of the uterus.
• Posterior intramural fibroid: These are in the back of the uterus.
• Fundal intramural fibroid: These are located in the upper part of the uterus.

Intramural Fibroid Symptoms

Common intramural uterine fibroid symptoms are:

• Experiencing heavy, excessive, and irregular blood flow during menstruation.
• Fibroid tumors can cause strain on the bladder and can increase the frequency of urination.
• The lower abdominal can appear large or feel a sensation of fullness, swollen, and bloated.
• Feeling discomfort and mild to severe pain during intercourse.
• The amount of vaginal discharge also increases and becomes persistent.
• Fibroid can cause difficulty in bowel movements and constipation.

Causes of Intramural Fibroid

The exact cause of fibroids is undiscovered, but the following factors contributed to the growth of intramural fibroids.

• Hormonal factors: During female reproductive years, the level of female reproductive hormones estrogen and progesterone is generally high and promotes the growth of fibroids.
• Genetic/hereditary contribution: Certain genetic factors contributed to the development of intramural fibroids. An individual becomes more susceptible to developing intramural uterine fibroids if any female already has fibroids in the family.

• Race and ethnicity: According to research, there are some genetic elements, overall lifetime stress, diet, and deficiency of vitamin D, which result in fibroids being more common in women of African descent compared to white women.
• Other factors: Obesity, environmental influences, and specific dietary factors also contributed to the growth of intramural fibroids.

Detecting intramural fibroid

Exams for detecting intramural fibroids include:

• Physical examination: Fibroids can be detected through the gynecologic exam or felt during the pelvic exam.
• Ultrasonography/ Sonograms:  A painless imaging test in which sound waves can make pictures of organs, tissues, and other structures inside your body.
• Magnetic resonance imaging (MRI): This medical imaging uses magnets and radio waves and creates a cross-sectional detailed picture of the organs inside your body.
• Computer tomography (CT) scan: This scan combines X-ray pictures taken from different angles in the body and creates cross-sectional pictures of your organs from multiple angles.
• Hysteroscopy: in this procedure, a hysteroscope is a thin tube with a light and a camera inserted through your vagina to examine the womb. 

• Hysterisalipingography (HSG): During this x-ray test, a special dye is injected into the uterus. The X-ray records images of your uterine cavity.
•  Sono-hysterography: Saline is injected into the uterus, which creates a clear image during an ultrasound examination and records the structure and shape inside your uterus.
• Laparoscopy: It is a type of diagnostic surgical procedure in which small incisions are made in the abdomen, and a thin tube with an attached camera is passed through this incision to examine internal organs.

Intramural uterine fibroid treatment

There are surgical and non-surgical options available for fibroids treatment. 

Non-surgical options:

Following regular monitoring through pelvic exams and ultrasound, small fibroids can be left untreated if you have no symptoms.

•  The number, size, and location of fibroids, the desire for pregnancy, and the desire to preserve the uterus are considered in the treatment plan. 
• Gonadotropin-releasing hormone (GnRH) can be used to shrink fibroids temporarily or used before surgery, making the fibroids more straightforward to remove.
• Hormonal birth control can help reduce symptoms like menstrual cramps, heavy bleeding, and pain during your period.

Surgical options:

The answer depends on the size, location, and number of fibroids and the desire for future pregnancy can influence the type of fibroid removal surgery. Some surgical options aim to preserve the uterus for future pregnancy, while others involve removing the uterus.

Myomectomy- Myomectomy is a surgical procedure used for fibroid removal.

Different types of myomectomy fibroid removal can include:

1. Hysteroscopy: In this, a hysteroscope is inserted through the vaginal opening and cervix, allowing access to the uterus. 
2. Laparoscopy: In this procedure, a few small incisions are made in the abdomen for the endoscope to enter to remove the fibroids and exit. 
3. Laparotomy: In this procedure, doctors made a large incision in the abdomen to remove fibroids.

Other surgical options include

Hysterectomy:  In this surgical procedure, the uterus is partially or completely removed. It is recommended when fibroids are too many, big in size or life threatening. It is typically a last resort option recommended to women with no future child plans.
 

Uterine fibroid embolization: in this procedure, a specialized radiologist and gynecologist work together to reduce the blood flow to the fibroids, shrink them, and improve symptoms. 

A small tube is inserted into the blood vessels to block it with tiny particles that supply the fibroid. 

Radiofrequency ablation (RFA): RFA can be performed using minimally invasive techniques such as laparoscopy, transvaginal, or transcervical approaches, and it is considered a safe and effective treatment for women experiencing symptoms from uterine fibroids.

Are intramural fibroids dangerous? 

Intramural fibroids are usually not dangerous on their own, but they can sometimes cause symptoms like heavy menstrual bleeding, pain, or fertility issues. The severity of these symptoms can vary, and treatment may be needed in some cases. It’s important to consult a healthcare provider for proper evaluation and guidance if you suspect you have intramural fibroids.

Consult Dr. Mustafa Aldam for intramural fibroids treatment

Dr. Mustafa Aldam is a specialist obstetrician & gynecologist in Dubai with experience of over 20 years. He is skilled in obstetrics, cosmetic, and laparoscopic gynecology surgery. 

For fibroid treatment in Dubai, consult Dr. Mustafa Aldam.

Book your appointment today.