Q. I just had several fibroids removed. Three of them are large in size, about 8.8cm each.
I had an open myomectomy (fibroid removal) and the cut on my abdomen is about 10cm long.
Is there anything I can do in order to heal the wound and uterus faster?
How can I prevent fibroids from recurring in the uterus? What are the health risks if fibroids come back again? Are there any foods I should avoid?
A. Fibroids are tumours that develop in the wall of the uterus (womb). These growths consist of muscle and fibrous tissue.
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Fibroids are common and occur in 30 per cent of women.
No one knows exactly what causes fibroids. There may be a genetic predisposition and the presence of female hormones like oestrogen and progesterone seems to be important in some way. This is the reason why they usually shrink after menopause.
They occur most often in women aged 30 to 50.
Recovery from an open myomectomy ranges from four to six weeks after surgery.
Avoid carrying heavy loads or doing strenuous exercise in these weeks following surgery.
Keeping the wound clean and dry and increasing your vitamin C intake encourage healing of the skin. If you are anaemic before surgery, make sure you increase your iron intake as severe anaemia can delay wound healing.
No one knows exactly what causes fibroids. There may be a genetic predisposition and the presence of female hormones like oestrogen and progesterone seems to be important in some way.
This is the reason why they usually shrink after menopause.
Hormones play a part as the female hormones oestrogen and progesterone appear to promote the growth of fibroids. Because of this association, fibroids tend to grow in pregnancy as the levels of these hormones increase, and tend to shrink after menopause, when the hormone levels fall.
Obesity increases the incidence of fibroids as being overweight increases the level of oestrogen in the body.
Other factors such as early onset of menstruation, having a diet higher in red meat and lower in green vegetables and fruit, and drinking alcohol appear to increase the risk.
There has been no evidence to directly link nutrition and diet to fibroids, although eating plenty of green vegetables has been associated with a lower incidence of fibroids.
Fibroids may grow again after surgery and there has been no scientific evidence that avoiding certain foods will prevent its recurrence.
After a myomectomy, there is a 15 per cent to 30 per cent chance fibroids may grow again in the next 10 years.
It may not be a recurrence of the same fibroid, but a new one.
Women can develop several fibroids and the sizes of the fibroids can vary. Fibroids of less than 2cm to 3cm are considered small, 4cm to 6cm moderate in size and at more than 8cm, they are considered large.
Large fibroids can cause heavy menses, leading to anaemia.
They can also cause compressive symptoms by pressing against the bowel or bladder, causing constipation or frequent urination.
Fibroids are also occasionally associated with infertility, miscarriage, and premature labour.
Very rarely, extremely large fibroids may be associated with uterine cancer. Less than 0.1 per cent of fibroids are cancerous.
Fibroids may cause pain if they undergo degeneration (where the muscles of the fibroid undergo lysis or breakdown and causes inflammatory pain).
This can be managed with painkillers and usually the pain will resolve.
Dr Goh Shen Li
Senior consultant and obstetrician & gynaecologist at S L Goh Women's Clinic at Mount Alvernia Hospital