What is a benign tumor?

A benign tumor can be described as a non-cancerous, collection of abnormal cells. Uterine fibroids are an example of a benign tumor that develops in the uterus. It affects a significant percentage of women, with estimates suggesting that up to 40-50% of women have them by the age of 35. Some women may have a single fibroid, while others may have multiple. Many women may have uterine fibroids without experiencing any noticeable symptoms. Benign tumor treatment for uterine fibroids is readily available in Singapore.

These fibroids come in four different types, categorized by their location within the uterus and can vary greatly in size, from tiny seedlings to large masses that can alter the shape and size of the uterus:

1. Subserosal Fibroids form on the outer layer of the uterus and extend outward as they continue to grow.
2. Intramural Fibroids are the most common type of fibroids. These form within the uterine wall and expand inward.
3. Submucosal fibroids are one of the less common types of fibroids. These emerge within the uterine cavity, often leading to heavy and prolonged menstrual bleeding.
4. Pedunculated fibroids grow on stalks or stems, with these stalks attaching to the uterine wall. They can either protrude outside the uterus or grow within the uterine cavity.

(https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/multimedia/fibroid-locations/img-20006761)

What are the symptoms of uterine fibroids?

Uterine fibroids can lead to various symptoms, but it’s important to remember that people experience them differently. Common symptoms include:

1. An abnormal menstrual cycle with heavy or frequent periods.
2. Painful periods and severe menstrual cramps.
3. Discomfort during sexual intercourse
4. Frequent urination or difficulties emptying the bladder completely.
5. Sharp, acute, or severe pelvic pain.
6. A swollen or bloated abdomen.

.

The severity and combination of these symptoms can vary greatly among women. If you suspect uterine fibroids, consult a vascular surgeon for proper evaluation and management.

What are the causes and risk factors associated with uterine fibroids?

1. Age – Uterine fibroids are more likely to develop during a woman’s reproductive years.
2. Heredity – A family history of fibroids, especially among close female relatives, increases the risk of developing this condition.
3. Early onset of menstruation – Women who start menstruating at a young age could be at a higher risk of developing fibroids.
4. Obesity – Being overweight has been associated with an increased risk of uterine fibroids.
5. Conditions: Women with a vitamin D deficiency have an increased risk of developing uterine fibroids in their lifetime.
6. Lifestyle – Heavy alcohol consumption and smoking may contribute to fibroid growth.
7. No Pregnancy History – Women who have never been pregnant may have a slightly higher risk of developing fibroids.

Do uterine fibroid symptoms go away after menopause?

Menopause is associated with a decrease in symptoms for uterine fibroids primarily due to hormonal changes. As women approach menopause, the decline in estrogen and progesterone levels causes existing fibroids to shrink and new ones to stop forming. Even so, not all symptoms may disappear entirely, and individual experiences can vary. Consulting a vascular surgeon for appropriate management is advisable for those with uterine fibroids.

How are uterine fibroids diagnosed?

The primary diagnostic methods for uterine fibroids are ultrasound scans of the uterus, with CT scans used when multiple fibroids are suspected. These imaging techniques help identify fibroid presence, size, and location, guiding treatment decisions effectively.

1.Ultrasound, also known as sonography, uses a transducer to send and receive sound waves as they bounce off tissue boundaries within the body. The resulting information, based on the speed and direction of these waves, is processed by a computer to create two-dimensional images on a screen, enabling non-invasive visualization of internal structures.

(https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.scielo.br%2Fj%2Frb%2Fa%2FGNm7PJByn3ZK5km4GXmfwCK%2F%3Fformat%3Dpdf%26lang%3Den&psig=AOvVaw0G8IrZm5FEp4Y5PE2ty3YB&ust=1694750225524000&source=images&cd=vfe&opi=89978449&ved=0CBMQ3YkBahcKEwi4iafbmqmBAxUAAAAAHQAAAAAQEQ)

2.Computed tomography, or CT, involves rotating a narrow x-ray beam around a patient to generate cross-sectional images called tomographic slices. These slices are then digitally stacked by a computer to create detailed three-dimensional images, aiding vascular surgeons in identifying structures and potential abnormalities with precision.

(https://www.ogmagazine.org.au/19/1-19/fibroid-uterus-unusual-cause-intraperitoneal-haemorrhage/)

What are the treatment options for uterine fibroids?

Uterine Fibroid Embolization (UFE) involves accessing the arteries through either a groin or radial artery puncture. A catheter is then directed using fluoroscopy, a form of x-ray technology, to target the arteries supplying blood to the uterus and fibroids. Subsequently, tiny particles or microspheres are injected into these arteries, effectively interrupting the blood supply to the fibroids. As a result, the fibroids typically begin to shrink and decrease in size following the procedure.

(https://modernvascular.com/ufe/)

Uterine Fibroid Embolization (UFE) is a suitable treatment for women who meet the following criteria:

1. You are a woman aged 35 years or older.
2. You are not currently pregnant.
3. You have been previously diagnosed with uterine fibroids.
4. You are currently experiencing symptoms such as heavy and excessive bleeding, pelvic pain, cramping, bloating, or frequent urination.
5. You are seeking a non-surgical treatment for uterine fibroids that allows you to retain your uterus.

Uterine Fibroid Embolization (UFE) is an alternative choice to open surgery for uterine fibroids. It’s minimally invasive with faster recovery, fewer complications, and preserves the uterus. Consulting a healthcare provider is crucial to determine the best treatment based on individual needs and fibroid characteristics.

What are the benefits of Uterine Fibroid Embolization?

Uterine Fibroid Embolization (UFE) is a minimally invasive procedure that effectively reduces uterine fibroids. It only requires local anesthesia, numbing a specific area rather than inducing full sedation with paralysis, and leaves no scarring, unlike traditional surgical techniques. Post-procedure discomfort is typically less than that experienced after surgery. It is an excellent choice for those seeking to preserve their uterus instead of opting for a hysterectomy, with approximately 85-90% of women experiencing significant symptom relief. Recovery is quicker compared to traditional surgery, often completed as a same-day procedure without the need for an overnight stay, and it carries a reduced risk of infection in comparison to conventional open surgery.

What should I do after undergoing Uterine Fibroid Embolization?

Regular check-ups with your vascular surgeon are crucial. You should notify your doctor if you experience any unusual symptoms after the procedure. Fortunately, women who undergo Uterine Fibroid Embolization typically resume normal activities shortly after the procedure, with post-operative recovery recommendations to avoid strenuous activities and follow medical guidance. This treatment often provides long-term benefits such as reduced menstrual bleeding and alleviating fibroid-related symptoms that disrupt daily life.

What questions should I ask my vascular surgeon?

When consulting with a vascular surgeon, you should ask questions to help you understand your condition, treatment options, and the recommended course of action.

1. What are the treatment options available for this condition?
2. Is Uterine Fibroid Embolization suitable for me and my condition?
3. What should I do to prepare for the procedure?
4. Do I need to stop taking any medications in order to prepare for the procedure?
5. What can I expect during the procedure?
6. How long does the procedure last?
7. What is the recovery period for the procedure?
8. Will Uterine Fibroid Embolization affect my fertility and menstrual cycle?
9. How much does this procedure cost?
10. Does my insurance cover this procedure?

FAQs:

References:

1. https://my.clevelandclinic.org/health/diseases/22121-benign-tumor
2. https://www.radiology.ca/article/how-does-ultrasound-work/
3. https://health.clevelandclinic.org/uterine-fibroids-after-menopause/
4. https://www.sgvascularctr.com/a-comprehensive-guide-to-uterine-fibroids-in-singapore/

Dr Chen Min Qi profile

Dr. Chen Min Qi is a fellowship-trained Vascular and Endovascular Surgeon who graduated from the National University of Singapore in 2005. He subsequently completed his basic and advanced training in General and Vascular Surgery while obtaining the Member of Royal College of Surgeons of Edinburgh (MRCSed) qualification in 2010, and the Master of Medicine (General Surgery) qualification in 2015. Dr Chen was subsequently successful at the fellowship exams obtaining the Fellow of Royal College of Surgeons of Edinburgh (FRCSed) qualification in 2016.

Upon completion of his advanced surgical training, Dr Chen Min Qi joined the newly opened Ng Teng Fong General Hospital (NTFGH) as a specialist in the Vascular Surgery division. In 2018, Dr Chen was awarded the Health Manpower Development Plan (HMDP) grant from MOH to undergo further subspeciality Vascular training at the internationally renowned St Mary’s Hospital in London, United Kingdom. There Dr Chen gained further experience in surgeries on complex abdominal and thoracoabdominal aortic aneurysms, redo open repair of abdominal aortic aneurysms following failed EVAR surgeries as well as carotid endarterectomy surgery and lower limb revascularization surgeries.

Upon his return in 2020, Dr Chen Min Qi joined the newly formed Woodlands Health as head of their Vascular service, before joining his current practice at the Vascular and Interventional Centre in January 2023.