If you have ever experienced symptoms of uterine fibroids, you know that they can dictate your schedule, interfere in your career and your family time, and cause rifts in your most intimate relationships. There are not many treatments available for fibroids, and the two surgical ones that exist either eliminate all the fibroids as well as your uterus or preserve your fertility but leave your uterus compromised, and with a good chance you will have to undergo another surgery in the future when the fibroids come back.
The question “Why do fibroids grow back after surgery? Often comes up during our patient consultations, and today we are going to talk about why having a myomectomy is not a guarantee of total elimination and how fast uterine fibroids grow back after surgery. We will also talk about an alternate treatment for fibroids that preserves your fertility and is between 85% and 90% effective at permanently eliminating all the fibroids that are present.
Why Is Fibroid Surgery Done?
Uterine fibroids are also called leiomyomas or myomas and are benign growths that develop in or around the uterus. These growths are made of muscular and fibrous tissue similar to the uterine wall and can vary in size, ranging from as small as a seed to as large as a melon. Experts tell us that almost 80% of all women will have uterine fibroids during their lifetime but some will never experience symptoms or even know they are present.
Other women with large or numerous fibroids face issues like heavy menstrual bleeding that lasts longer than normal, pelvic pain, pressure on the bladder or bowel, pain during sex, and more symptoms that influence their quality of life. After reaching a point where the symptoms become unbearable, they usually consult their OB/GYN, who often suggests surgery as the best option.
The issue with surgery is that neither option is ideal, with hysterectomy eliminating the entire uterus and taking your fertility options with it, and myomectomy that often is unable to remove all the fibroids and comes with a very likely chance of fibroid recurrence.
What Are The Chances Of Fibroids Growing Back After Myomectomy Surgery?
A myomectomy is a surgical procedure that removes fibroids one by one while preserving the uterus, so women who desire to have children in the future will normally choose this option vs. a hysterectomy, which causes sterilization. One of the primary complications to consider after myomectomy is the potential for fibroids to grow back.
Fibroid recurrence is not uncommon, and studies report that up to 50% of women who undergo myomectomy experience a recurrence of fibroids within five years. How fast fibroids grow back after a myomectomy can vary significantly for different women depending on certain conditions, such as:
- The number of fibroids removed;
- If the doctor was able to remove all the fibroids;
- The patient’s hormone levels (excess estrogen makes fibroids grow fast).
In some cases, new fibroids can begin to grow as soon as a few months after surgery, while in other cases, it might take several years for fibroids to reappear. We have had several patients here at the Atlanta Fibroid Center undergo multiple myomectomies, just to have their fibroids come back repeatedly.
This patient had 5 myomectomies before coming to the Atlanta Fibroid Center and undergoing uterine fibroid embolization (UFE). Her fibroids kept coming back after surgery, but three months after her UFE procedure, she was free from fibroid symptoms!
Patient: "I Had 5 Surgeries Before UFE"
A patient of Dr. John C. Lipman share her fibroid journey. Before undergoing UFE, she had 5 surgeries that did not fully resolve her symptoms.
Why Do Fibroids Develop And Grow Large?
No one knows what causes fibroids to form, but researchers have discovered links between certain circumstances and their development as well as the speed of their growth. Some of the circumstances that make a woman more likely to develop fibroids include:
- Women who started their period at a very young age;
- Women who have a vitamin D deficiency;
- Women who are obese;
- A diet high in red meat;
- Excess estrogen exposure;
- Family history and genetics;
- Ethnicity (African American women have a higher instance of fibroids than Caucasian women).
Fibroids grow larger when exposed to excess estrogen, and this is why fibroids tend to grow during a woman’s reproductive years when hormone levels are at their highest and also tend to grow larger during the first trimester of pregnancy.
Why Do Fibroids Grow Back After Surgery?
During myomectomy surgery, the doctor cuts each fibroid out of the location where it is growing and removes it. There are different types of fibroids that are classified by where they grow:
- Subserosal fibroids develop on the outer wall of the uterus;
- Intramural fibroids grow within the muscular wall of the uterus, and
- Submucosal fibroids grow just beneath the lining of the uterine cavity.
Since intramural fibroids grow within the muscular wall of the uterus, they are often deeply embedded, which makes removing them very tricky. Often the doctor can only remove a portion of the fibroid, leaving part of it still embedded. Sometimes, the fibroids are completely inaccessible, and the doctor cannot remove them at all. There are also cases where a fibroid is there, but it is so small that the doctor is unaware of its presence. These fibroids will be left behind after the surgery and will continue to respond to their environmental surroundings, which may cause them to continue to grow or to grow larger. According to the Mayo Clinic, the younger you are when you have a myomectomy, the more likely you are to experience a recurrence of fibroids.
How Fast Can Fibroids Grow?
Even though fibroids are the most common type of uterine tumor, we still do not fully understand their growth patterns. Historically, it was believed that fibroids grew steadily from puberty until menopause, and then they were expected to shrink due to the reduction in estrogen levels. Recent studies suggest that fibroid growth is unpredictable, with rates varying between 18% and 120% per year, and they can also shrink or grow outside of menopause, even when hormone levels remain stable.
Research on what influences fibroid growth has shown mixed results, with some studies looking at whether the size of the fibroid at diagnosis affects growth, but there is no consensus on whether smaller or larger fibroids grow faster. The study did go on to note that submucosal fibroids (those just beneath the uterine lining) are the least likely to increase in size. Some studies suggest that fibroid growth slows with age, especially in white women, but the evidence is not strong enough yet to confirm this.
So the bottom line is that there is no way to predict which women will experience slow vs. rapid fibroid growth or how fast their fibroids will grow back after a myomectomy, possibly requiring another surgery.
Why Are Most Women Only Offered Surgical Options For Fibroid Treatment?
Uterine fibroids are a common issue that many women face, and when the symptoms get out of control, women often seek help just to be told they have two treatment options, both involving surgery. A hysterectomy will put an end to fibroid formation and symptoms; however, it also eliminates all possibilities of conceiving a child in the future as it eliminates the entire uterus.
A myomectomy is a more fertility-friendly solution; it is not always permanent, and many women experience the regrowth of fibroids and additional surgery. Each surgery brings higher levels of risk and complications and can compromise the uterus creating potential fertility, pregnancy, or childbirth complications.
Women are typically given these two surgical options because they learn about their fibroids from their OB/GYN, who is trained to treat fibroids via surgery. We speak with many women who tell us they were never offered any less invasive treatment options other than hysterectomy or myomectomy.
This patient was told by three different OB/GYNs that her only treatment option for her numerous fibroids and serious anemia was a hysterectomy. Fortunately, she heard about Dr. Lipman, an expert interventional radiologist and pioneer in the field of uterine fibroid embolization, so she contacted the Atlanta Fibroid Center for a consultation. Today she is fibroid-free and she still has her uterus!
Michelle Describes Her UFE Experience with Dr. Lipman
http://ATLii.com - Michelle Cox, a patient of John C. Lipman, MD, FSIR, visited three OB/GYN doctors to treat her severe symptoms from uterine fibroids. She visited Dr. Lipman because she wanted to avoid the hysterectomy surgery recommended by the other doctors. Using the Uterine Fibroid Embolization (UFE) procedure, Dr. Lipman successfully treated Michelle, avoiding both surgery and a hospital stay. She was so pleased with her experience, she recorded this testimonial video for Dr. Lipman. The UFE procedure is also known as Uterine Artery Embolization (UAE). Dr. Lipman was the first physician in Georgia to perform the procedure. He has performed more UFEs than any other physician, and is recognized as a global leader for the treatment of fibroids. To make an appointment with Dr. Lipman, please call his office at (770) 953-2600, or leave a message at his website: http://ATLii.com.
If you have been diagnosed with uterine fibroids or have had a myomectomy and are experiencing fibroid recurrence, contact the Atlanta Fibroid Center for help. Dr. Lipman is an expert in performing the UFE procedure, backed by decades of experience. UFE is an in-office procedure that takes about 45 minutes, and when performed by a highly skilled expert, can eliminate all the fibroids present regardless of their location or how numerous they are. Fibroids that are successfully treated with UFE are gone forever and do not ever come back.
Set up a consultation today and find out more about UFE, how it works, and how it can help you live your life fibroid-free!
