Fibroids can present different clinical symptoms in patients depending on their size and location in the uterus. The complaints and potential risks associated with fibroids can be managed in women who attend regular gynecological check-ups.
In this article, we will address questions such as "Is a 5 cm fibroid dangerous?", "At what size does a fibroid become risky?", "What are the possible complaints and risks based on fibroid size?", and "Can fibroids prevent pregnancy?"
Fibroids are benign tumor formations originating from the smooth muscle cells of the uterus. The likelihood of encountering malignant cells within these benign masses is extremely rare.
Fibroids occur in approximately 20% of women. The majority persist in the uterus without causing any symptoms.
Fibroid symptoms can be categorized into three main groups:
Beyond these primary symptoms, fibroids can cause pregnancy complications in pregnant patients, potentially leading to miscarriage, or unsuccessful outcomes in those trying to conceive.
In patients who attend regular gynecological check-ups, fibroids are often detected when they are much smaller. They are commonly monitored in patients, with any increase in size being noted. The location of a fibroid can be as significant as its size in terms of the problems it may cause.
A 5 cm fibroid may not cause any symptoms if it grows outside the uterus (subserosal); however, it may also lead to intense pressure on the bladder and bowels.
If the fibroid is embedded in the uterine wall and presses against the uterine lining, this can result in heavy vaginal bleeding. If a fibroid in the uterine wall undergoes degeneration or necrosis due to rapid growth, fibroid-related pain is commonly observed.
A 5 cm fibroid, if pressing on the uterine lining, may be linked to negative pregnancy outcomes as it grows during the continuation of the pregnancy.
The reason for addressing the question "Are fibroids dangerous?" is to emphasize the importance of early detection and follow-up rather than the inherent danger of fibroids.
In reality, fibroids are not dangerous. What can be dangerous is allowing a fibroid to grow to a size that threatens the integrity of the uterus due to a lack of monitoring. Ignoring a fibroid increases the risk of possible treatment complications.
There is no exact answer to the question "At what size does a fibroid become dangerous?". A very small fibroid can cause significant complaints due to its location, while a larger fibroid may persist without causing any issues.
There is no inherently dangerous fibroid; rather, there are neglected fibroids. For women who attend regular gynecological check-ups and have fibroids detected, intervention should be considered when there is a growth trend or increased symptoms.
Apart from fibroid size, its location in the uterus determines the potential risks. There is no set size at which a fibroid becomes risky.
As a fibroid grows, it may become more challenging to remove it from the uterus and could require surgery with more bleeding. A fibroid that could previously be removed by minimally invasive surgery may necessitate open surgery if it grows larger.
The critical factor with a 9 cm fibroid is that its size approaches the limits of minimally invasive surgery. If the fibroid is located close to the endometrial lining of the uterus, laparoscopic surgery may not be a safe option.
The size of a fibroid often necessitates imaging procedures like pelvic MRI or pelvic ultrasound. Pelvic MRI, in particular, can help us assess risks related to separating the fibroid from the endometrium. Preserving the endometrium (uterine lining) is crucial for favorable pregnancy outcomes.
Studies have shown that fibroids extending into the uterine cavity or embedded in the uterine wall may negatively affect conception. Subserosal fibroids, located on the outer wall of the uterus, are not associated with adverse effects on pregnancy.
Fibroids in the uterine wall or extending into the uterine cavity can impair the implantation of an embryo. Additionally, as pregnancy progresses and the fetus grows, pressure from fibroids in the uterine wall can lead to negative outcomes, including preterm birth and miscarriage.
In fibroid treatment, medications may temporarily alleviate symptoms before surgery, but they do not provide a definitive cure.
Minimally invasive treatments, such as embolization, HIFU (high-intensity focused ultrasound),and myolysis (fibroid ablation),may reduce the size of fibroids to some extent but do not offer a complete solution.
The definitive treatment for fibroids is the surgical removal of the fibroid or fibroids. If the size and number of fibroids meet the criteria for minimally invasive surgery, laparoscopic fibroid removal can be offered as an option. If the number and size of the fibroids exceed the limits of minimally invasive surgery, an open surgery with uterus-conserving options may be recommended.
