Isha Gupta, SA Inamdar, Neema Acharya
Uterine fibroids, known otherwise as leiomyomas or simply myomas are benign smooth muscle tumours. They are one of the most common benign tumours in females presenting usually in the age group of 30 – 40 years. Although usually asymptomatic and seen as an incidental finding on USG, they may present with a variety of symptoms like menorrhagia and dysmenorrhea. Large sized fibroid may cause pressure symptoms like urinary frequency, urgency, low back pain, etc. They may also be associated with infertility, complications in pregnancy and adverse obstetric outcomes. Most fibroids decrease in size with menopause but symptomatic fibroids may require early intervention. In early days, the only management available for uterine fibroids was surgical hysterectomy, but with advancements in medical pharmacotherapy and surgery, various treatment options have become available like selective progesterone receptor modulators, GnRH antagonists, invasive and minimally invasive surgeries like uterine artery embolization and magnetic resonance guided focused ultrasound surgery, etc. However, there is no universal management which could be applied to each case but management differs with every single patient. Various factors have to be taken into consideration for management of uterine fibroid such as size of the fibroid, its site, the patient’s age, symptoms, desire to conceive, etc. Therefore, it is important for the clinician to offer the patient treatment options which best suit her needs and inform her about the pros and cons of every method so that she can make an informed decision. This not only improves patient satisfaction, but also decreases concern about future regret. As the number of treatment options increase, it becomes difficult for the patient as well as the clinician to decide the modality which would best suit the patient's needs. Hence in this article, we have tried to summarize the various treatment options available to a woman with uterine fibroid with their advantages and disadvantages.