Studies reveal why fibroids regrow after surgery

Ini Dima-Okojie on Thursday revealed her fibroids returned three years after she underwent surgery to remove them. The Nollywood actress was first diagnosed with the tumors in 2017 and underwent surgery in November 2020.

Uterine fibroids, also known as leiomyomas, are the most frequently seen noncancerous tumors of the female reproductive system.

They are more common from age 30. According to the Office on Women’s Health (OWH), between 20% and 80% of females develop fibroids by 50.

What is uterine fibroids?

Uterine fibroids are tumors or growths made of smooth muscle cells, fibroblasts, and other materials that grow in or on the wall of the uterus. They are almost always noncancerous.

Fibroids can grow as a single tumor, or there can be many of them in the uterus — growing in clusters. They can be as small as an apple seed or as big as a grapefruit. In unusual cases, they can become even larger.

However, there are different types of uterine fibroids which are determined by where they’re located and how they attach in the uterus.

The types of uterine fibroids include:

• Intramural fibroids: These fibroids grow inside the muscular wall of the uterus.
• Submucosal fibroids: These fibroids grow under the inner lining of your uterus.
• Subserosal fibroids: These fibroids grow under the lining of the outer surface of your uterus. They can become quite large and grow into your pelvis. They also have more significant symptoms.
• Pedunculated fibroids: These fibroids are not considered different from the types above, but are a variation of subseroral or submucosal fibroids. They grow on a stalk out of the uterine walls, outside(subserosal) or inside(submucosal) the uterus.

What are the symptoms of fibroids?

Sometimes, fibroids don’t cause noticeable symptoms, particularly when they are small.

However, fibroids can cause a variety of symptoms including:

• Heavy and painful periods
• Frequent urination (this can happen when a fibroid puts pressure on your bladder)
• Lower backache or leg pain
• Constipation
• Discomfort or a feeling of fullness in the lower abdomen, especially in the case of large fibroids
• Frequent urination
• Pain during sexual activity

What causes fibroids?

The exact cause of uterine fibroids is unknown. However, studies suggest more than one factor could play a role. These factors could be:

• Genetics: It runs in the family
• Nutrient deficiency: A study found that a deficiency of vitamin D may be associated with uterine fibroids.
• Hormones: Fibroids are majorly controlled by estrogen and progesterone. Fibroids grow when hormone levels are higher (like during pregnancy) and shrink when hormone levels are low (like during the transition to menopause).

Can uterine fibroids be treated?

Yes, it can be treated. However, the treatment depends on the size, number, and location of fibroids, as well as what symptoms they’re causing.

The two major treatments for fibroids are medications and surgery.

MEDICATIONS: If the fibroids have mild symptoms, taking medication might be the first option.

Over-the-counter drugs such as ibuprofen or acetaminophen can be used for mild pain or iron supplements when having heavy bleeding.

Drugs commonly used for birth control help control symptoms of fibroids. Low-dose birth control pills do not make fibroids grow and can help control heavy bleeding.

SURGERY: Surgery becomes an option when the symptoms become moderate or severe. The surgery options include:

• Myomectomy: Surgery to remove fibroids from the muscular wall of the uterus without taking out its healthy tissue. It is best for women who wish to have children after treatment for their fibroids or who wish to keep their uterus for other reasons.
• Hysterectomy: This surgery is the only sure way to cure uterine fibroids. This surgery is used when a woman’s fibroids are large, if she has heavy bleeding, is either near or past menopause, or does not want children.
• Endometrial ablation: It involves removing the uterine lining which may help if fibroids are near the inner surface of the uterus.

Risk of surgery

• Bleeding
• Infection
• The need for a repeat procedure
• Damage to organs in your abdomen, such as your bladder or bowel
• Scar tissue in your abdomen, which can form bands that bind organs and tissue together
• Bowel or urinary problems
• Fertility issues
• Pregnancy complications
• Rare chance that you’ll need a hysterectomy

Can fibroids regrow after surgery?

Yes, it can grow back or new ones can develop according to studies. The reason fibroids may include:

• The type of treatment used: It has been proven that fibroids regrow majorly after myomectomy. A study found that fibroids regrew within the first few years after the procedure in up to 20 out of 100 women. Another research stated that up to 33 percent of women who have this surgery will need a repeat procedure within 5 years because they grow new fibroids.
• Age: This is another factor that contributes to the regrowth of fibroids. A study states that the younger the lady is and the more fibroids at the time of the myomectomy procedure, the more likely to develop fibroids again in the future.
• Incomplete removal of fibroids: During surgery, especially in cases of myomectomy, not all fibroid tissue may be completely removed. Smaller fibroids or fibroid remnants that are not detected can continue to grow after the surgery. This can happen because fibroids often vary in size and number, and some may be too small to detect during surgery. Myomectomy also majorly focuses on removing the existing fibroids while leaving the uterus intact which can lead to new ones forming.