One out of every three women in the age group of 20 to 45 years in Mumbai suffers from uterine fibroids, say city gynecologists. “In fact, post 30, every second woman in the city has fibroid growth,” says Dr Nikhil Datar, a gynaecologist at Malad’s Cloudnine Hospital. The percentage has grown by 15 in the last decade.
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Uterine fibroids are benign (non-cancerous) tumors that grow within the muscle tissue of the uterus. These growths are often small, and could increase or decrease with time.
Dr Rakesh Sinha at his Khar clinic. Pic/Shadab Khan
“While the exact cause of fibroids is not known,” says Dr Rakesh Sinha, a Mumbai-based laparoscopic and robotic surgeon who runs a women’s hospital in Khar, “It has been observed that fibroids in women is associated with delayed childbirth. Which explains the high incidence in an urban pocket like Mumbai where most women are working professionals.”
Fibroids often don’t cause symptoms, which is why most patients do not know they have them. “While not all fibroids are troublesome, the problem begins when their increased size protrudes into the cavity of the uterus,” says Kiran Coelho, consultant gynaecologist, Hinduja Healthcare Surgical, Khar, who says she performs at least four fibroid surgeries a day, adds that fibroids are often accompanied by heavy menstrual bleeding, pain during intercourse, discomfort in the lower abdomen (especially if the growth is large), infertility, backache and frequent urination. “That's when you need to take notice,” she adds, “Although fibroids are common, chances of a malignant tumour are 1 in 100.”
Laparoscopy is the way
A 32-year-old Bandra resident, who was diagnosed with fibroids last year when she felt pain in her abdomen while working in the kitchen, was initially advised open surgery but later opted for laparoscopy. During a laparascopic surgery for fibroids, four one-centimeter incisions are made in the lower abdomen.
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The abdominal cavity is filled with carbon dioxide gas and a thin, lighted telescope is placed through an incision so the doctors can see the uterus, ovaries, and the fallopian tubes. Then, instruments, inserted through the other incisions, are used to remove the fibroids. The uterine muscle is then sewn back, the gas is released, and incisions are closed.
Dr Sinha says, “3-D laparoscopy is a far safer and more accurate technique. It provides more depth while conducting surgery. There is no pain, very little bleeding, no restriction movement, diet and the convalescence period is remarkably short.”