Canada
Health Corner Dr Florence Akindele
Uterine Fibroids When I was told to write an article about women’s health, my first thought was to write about the current trends, so I set out to do just that. I found out that the new trend is the focus on technological advancements like different apps to monitor ovulation or calculate expected dates of delivery. What I have found though, in my over two decades of practicing obstetrics and gynaecology in four different countries is that women often want to be listened to and talked to rather than have machines answer their questions. They want their obstetrics and gynaecologist to explain things in detail which is what I will attempt to do with this article, talking about fibroids. What are they? They are benign tumours of the smooth muscles of the uterus that very rarely turn into cancer and are more common in African women than
among the Caucasians. It is interesting how different connective tissue disorders occur amongst the two groups. Africans tend to have hypertrophied scars, keloids and large uterine fibroids. I am amazed at how different the feel of performing repeat ceaseran sections is between the two groups, much more difficult because of dense scar formation among the Africans. The Caucasian women commonly tend to have a higher incidence of prolapse from sagging of the pelvic muscles. Fibroids come in various sizes and can be found in different locations in the uterus. These factors determine what kind of problem a woman with fibroids could present with. The most common presentation in my experience, are heavy menstrual bleeding, a pelvic or abdominal mass which may be quite big or a combination of both. Sometimes a big fibroid will rest on the bladder and increase the frequency of passing urine and I have seen a case of LadiesCorner.ca – Summer 2021
total blockage of the urethra by a fibroid uterus. Until the time of surgery, the woman had to have a catheter to drain her urine. I remember another woman whom I had to deal with in my first year of residency. She had presented like she was nine months pregnant and bleeding heavily with clots. It was difficult for me then to figure out what it could be because the abdomen was so big. When I presented her case to my senior registrar and he had suggested it could be a fibroid, I could not believe it until the time of surgery (those were days when ultrasound was not readily available, and we relied heavily on clinical judgement). It was a huge fibroid uterus, the biggest I have ever seen untill now. The availability of ultrasound has afforded the opportunity to detect uterine fibroids even in women who have no symptoms and often this has caused needless anxiety for a lot of
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