Intramural Fibroid
Medically Reviewed by Dr Sravya, MBBS, MS
Introduction
When it comes to women’s health, certain conditions can cause considerable discomfort and concern. One such condition is intramural fibroid. In this article, we will dive into the details of intramural fibroids, shedding light on what they are, the different types, their impact on fertility, potential causes and risks, common symptoms, methods of diagnosis, and available treatment options.
By the end, you will have a comprehensive understanding of this condition, which will help you make informed decisions about your health. They are the most common type of fibroid and can cause a range of symptoms, including heavy menstrual bleeding, pelvic pain, and pressure.
While intramural fibroids are generally benign, they can sometimes grow large enough to cause complications and may require treatment.
Meaning of fibroids?
Fibroids are non-cancerous growths that form in the uterus’s muscular wall. It’s critical to understand what a fibroid is before introducing the concept of intramural fibroids. Fibroids, sometimes called uterine leiomyomas, are benign growths that form inside or on the surface of the uterus. These growths, which are made of muscle tissues, can range in size from tiny and asymptomatic to massive and significant.
Types of Fibroids
Fibroids can occur in different parts of the uterus, leading to specific classifications based on their locations. The three main types are:
1. Anterior intramural fibroid:
An intramural fibroid that develops especially in the front (anterior) area of the uterine wall is known as an anterior intramural fibroid. The uterus can develop benign (non-cancerous) growths called uterine fibroids.
The most typical type of fibroids, known as intramural fibroids, form inside the uterus’s muscular wall. The word “anterior” denotes that the fibroid is situated on the uterus’s front side.
Anterior intramural fibroid symptoms, location, and size can differ from person to person. Others may have symptoms, including heavy or protracted menstrual flow, pelvic pain or pressure, frequent urination, or trouble getting pregnant. Some people may have no symptoms at all.
You should speak with a healthcare provider for an accurate assessment and recommendations if symptoms exist or if the fibroid is causing a lot of discomfort.
A myomectomy (removal of the fibroid) or a hysterectomy (removal of the uterus) are two surgical operations that are alternatives to therapies. Therapy with hormones is another possibility. The precise course of treatment will depend on the size and location of the fibroid, the severity of the symptoms, and the unique circumstances of each patient.
2. Submucosal Fibroids:
These fibroids develop underneath the inner lining of the uterus, known as the endometrium. They can protrude into the uterine cavity and potentially cause heavy menstrual bleeding and fertility issues.
3. Intramural Fibroids:
Intramural fibroids strategically position themselves within the muscular wall of the uterus. This type of fibroid can lead to various symptoms, including heavy menstrual bleeding, pelvic pain, and fertility concerns.
4. Fundal intramural fibroid:
A fundal intramural fibroid is a specific type of uterine tumor that develops inside the uterus’ muscular wall and is found at its top (fundus). The uterus can develop benign (non-cancerous) growths called uterine fibroids. The most prevalent type of fibroids, known as intramural fibroids, are located inside the uterus’s muscle layer. The word “fundal” designates a fibroid’s location as being in the upper part of the uterus.
5. Multiple intramural fibroids
Several intramural fibroids develop within the uterine muscle wall. These fibroids can vary in size and location and are benign (non-cancerous) growths. Women with multiple intramural fibroids experience symptoms differently.
While some show no symptoms at all, others may experience signs, including heavy menstrual bleeding, pelvic pressure or pain, frequent urination, or problems getting pregnant. The method of treatment for multiple intramural fibroids depends on the size, position, and number of the fibroids, the severity of the symptoms, and the patient’s unique situation.
6. A large intramural fibroid:
An intramural fibroid that is huge and located inside the uterus’ muscular wall is a large intramural fibroid. Depending on a person’s unique situation and a doctor’s discretion, what is called “large” may have different physical characteristics.
Large intramural fibroid symptoms and effects can differ from individual to individual. Like multiple intramural fibroid conditions, Large intramural fibroid treatment choices also depend on size, location, specific symptoms, and personal preferences.
7. Subserosal fibroid:
A subserosal fibroid is a benign (not malignant) uterine growth that develops on the exterior of the uterus. Pedunculated subserosal fibroids are those that are joined by a short stalk. Although rarely harmful, these growths can produce unpleasant symptoms and impair the operation of surrounding organs.
Uterine fibroids, often known as just fibroids or leiomyomas, are fairly typical, affecting 50% to 80% of persons with uteruses at some point in their life. It is possible to have them without being aware of them because they do not necessarily result in symptoms.
What is myomectomy?
The term myomectomy refers to a surgical procedure aimed at removing fibroids from the uterus while preserving the organ itself. This procedure is often recommended for those experiencing severe fibroid symptoms or fertility issues caused by intramural fibroids. By removing the fibroids, myomectomy can relieve symptoms and improve the chances of conception.
What Is a Hysterectomy?
In some cases, when less invasive treatment options have been exhausted or other complications arise, a hysterectomy may be considered. A hysterectomy is a surgical procedure involving the complete removal of the uterus. Although effective in alleviating fibroid symptoms, it is a significant decision for women as it permanently eliminates the possibility of future pregnancies.
Uterine Fibroid Embolization
An alternative to surgical interventions like myomectomy and hysterectomy is uterine fibroid embolization (UFE). UFE involves blocking the arteries that supply blood to the fibroids, causing them to shrink and eventually die off. This minimally invasive procedure can be an effective option for those who want to avoid surgery and preserve their fertility.
Intramural Fibroid Impact on Fertility
One of the primary concerns for women with intramural fibroids is their potential impact on fertility. These fibroids can disturb the structure of the uterus, making it more challenging for fertilized eggs to implant and grow. Additionally, their presence within the uterine wall can interfere with the blood supply to the endometrium, further hindering the chances of successful conception.
Causes and Risk Factors
The exact cause of intramural fibroids is still unknown, but research suggests a combination of genetic factors and hormone imbalances may contribute to their development. Several risk factors have been identified, including age, family history, obesity, and certain hormonal imbalances. However, the presence of risk factors doesn’t necessarily mean one will develop intramural fibroids.
Symptoms
The symptoms experienced by individuals with intramural fibroids can vary significantly. Some women may have no symptoms at all, while others may have a combination of the following:
- Heavy menstrual bleeding
- Prolonged menstrual periods
- Pelvic pain or pressure
- Back pain
- Frequent urination
- Constipation
- Difficulty conceiving or recurrent miscarriages
- Diagnosis
To accurately diagnose intramural fibroids, a healthcare professional may take the following steps:
- Medical History: The doctor will discuss any symptoms experienced, family history of fibroids, and previous pregnancies.
- Pelvic Exam: During a pelvic exam, the doctor can feel the presence of fibroids and evaluate their size and position.
- Imaging Tests: Ultrasound, MRI, or other imaging tests may be conducted to visualize the uterus and detect the size, number, and location of fibroids accurately.
- Hysteroscopy: This procedure involves inserting a hysteroscope, a thin tube with a camera, into the uterus to examine the uterine cavity and the fibroids more closely.
- Biopsy: In rare cases, a tissue sample may be taken for biopsy to rule out any cancerous growths.
Treatment
The appropriate treatment for intramural fibroids depends on various factors, including the severity of symptoms, desire for future fertility, and personal preferences. Some common treatment options include:
- Medications: Certain medications, such as hormonal contraceptives or GnRH agonists, may help regulate menstrual bleeding and reduce the size of fibroids temporarily.
- Myomectomy: As mentioned earlier, myomectomy involves surgically removing the fibroids while preserving the uterus, making it a popular choice for those wanting to conceive in the future.
- Hysterectomy: If the fibroids are severely impacting the quality of life or future fertility is not a concern, a hysterectomy may be recommended.
- Uterine Fibroid Embolization (UFE): This minimally invasive procedure blocks the blood flow to the fibroids, causing them to shrink and alleviating symptoms.
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MRI-guided High-Intensity Focused Ultrasound (MRgFUS):
(i) MRgFUS is a non-invasive treatment option that uses focused ultrasound waves to destroy fibroids.
(ii) It is crucial to consult with a healthcare professional to determine the most suitable treatment plan based on individual circumstances.
Conclusion
Intramural fibroids can bring about various challenges for women, impacting their quality of life and fertility. Understanding the nature of these fibroids, recognizing their symptoms, and exploring the available treatment options can empower individuals to make informed decisions about their health. If you suspect you may have intramural fibroids, seek medical guidance to receive an accurate diagnosis and tailored advice regarding the most suitable treatment options for your well-being. Remember, you don’t have to face these challenges alone, and there are medical interventions available to help you manage and overcome intramural fibroids.
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