When a uterine fibroid is expelled out of a woman’s body it is called fibroid expulsion. Even though it sounds a bit daunting, it only happens rarely, and it is not normally a cause for concern nor does it usually cause any clinical issue for the woman who experiences this. Fibroids pass from the uterus, through the vagina, and out of the body. The expulsion can be categorized as “complete” or “partial”.
- Complete fibroid expulsion – the entire fibroid is expelled;
- Partial fibroid expulsion – the fibroid breaks up and only pieces are expelled.
What Would Cause Fibroid Expulsion?
The most common reason that can prompt fibroid expulsion is after undergoing uterine fibroid embolization. (UFE)
Uterine Fibroid Embolization is a non-surgical procedure that only takes about 30 minutes and patients return home the same day with only a bandaid. Fibroids require a blood supply to survive and grow and during the UFE procedure, the blood flow to the fibroids is cut off. The fibroids begin to shrink and then gradually die which alleviates the associated symptoms.
Sometimes there are rare cases of spontaneous fibroid expulsion reported that are not related to any type of procedure such as uterine fibroid embolization (UFE)
Do All Women Experience Expelled Fibroids After UFE?
If you are contemplating undergoing UFE, you may be nervous about experiencing fibroid expulsion. It is rare to experience fibroid expulsion after UFE and less than 5% of women encounter this issue, and if it does occur it is almost always partial with pieces of fibroid material expelled. This may last for one or two cycles and then stop altogether.
Normally, after the UFE procedure, the targeted fibroids begin to shrink and die, and, over time, they are gradually reabsorbed by the body. This is a similar process to what happens to fibroids when a woman enters menopause.
How Would You Know If You Were Passing a Fibroid?
Women who experience expulsion feel like they are suddenly in labor. Waves of contracting-like pain as the uterus is trying to propel the fibroid through the cervix in to the vagina (like a baby).
If you think you may be experiencing fibroid expulsion, you should seek treatment from your fibroid specialist right away. While the vast majority of these will expel on their own, there are times when they will not pass without delivery by a gynecologist through a vaginal approach.
What Might Happen If A Fibroid Fell Out?
If a woman thinks a fibroid fell out (experiences fibroid expulsion) she may notice a vaginal discharge that also could contain some fibroid tissue and she may feel cramping that occurs on and off and rarely goes beyond a matter of days. Very rarely, a chronic discharge could develop and may require a hysteroscopy to evaluate. This rare occurrence is due to a communication between the residual fibroid and the uterine cavity which can be alleviated by removing the residual fibroid tissue hysteroscopically.
What Does Expelled Fibroid Tissue Look Like?
If a fibroid fell out, it is fleshly like tissue. It is often pale yellow or tan and can be mixed with blood. It can be a single “blob” with a smooth, glistening exterior or be in strands of tissue. The vast majority of fibroid expulsions are completely of no consequence to the patient other than there is one less fibroid to worry about.
Is It Normal To Experience The Expulsion Of Fibroids In The Toilet?
You may wonder if fibroids can just fall out in the toilet, and the answer is yes, but it does not happen often. Sometimes women pass pieces of fibroid tissue during their menstrual cycle or after they have undergone certain treatments like uterine fibroid embolization.
When no longer attached to the uterus, fibroids can pass in the toilet by making their way down the vaginal canal. A passed fibroid can look like dark, clotted discharge similar to heavy menstrual bleeding, can contain fragments of tissue mixed in, or the fibroids can come out mixed with clots.
Passing fibroid tissue can cause discomfort and be accompanied by cramping or pelvic pressure but over-the-counter pain medication can often alleviate these temporary symptoms. Passing fibroids in the toilet is not common, but it is usually nothing to worry about. Expelling fibroid material after a UFE procedure can have an odor to it. This is very rarely due to an infection, but should be discussed with your doctor. Much more commonly the foul odor is due to the fact that the fibroid material is dead (the desired result from the embolization). Dead material will often have a smell. Wearing a deodorized pad can help. It is very important not to flush out or douche this material. Having significant pain is also possible whenever anything passes through the cervix into the vagina. This can include blood clots or partial or certainly complete fibroid expulsion.
How Frequently Does Fibroid Expulsion Occur?
The Journal Of Vascular and Interventional Radiology published a study that reviewed the medical history of 759 patients who had the uterine fibroid embolization procedure over a ten-year span. Approximately 4.9% of them experienced fibroid expulsion about 3 ½ months post-procedure and of those women, only 5 percent showed any symptoms which consisted of cramping and vaginal discharge.
Of the women who experienced symptoms during fibroid expulsion, 90% of them had partial expulsion with pieces of a fibroid fall out. Submucosal fibroids; particularly pedunculated submucosal fibroids are more likely to be expelled than other types of fibroids.
Some Rare Cases Of Unexplained Fibroid Expulsion
In one very rare case from 2013, a 35-year-old woman suffered a miscarriage due to several fibroids growing inside her uterus. One was a submucosal uterine fibroid that was spontaneously expelled after induced labor. The expelled fibroid was approximately 5 ½” x 4” and weighed over half of a pound.
Does Fibroid Expulsion Require Medical Attention?
It is unusual for a woman who undergoes fibroid expulsion to need any type of medical assistance. Most expelled fibroids safely leave the body unassisted, but women who have had children seem to have a lower incidence of fibroid expulsion. As mentioned previously, there are rare instances when medical help may be required such as if a fibroid is only partially expelled or becomes lodged it may require a gynecological procedure to remove it. This is again a very unlikely scenario.
What Is the Treatment for a Partially Expelled Fibroid?
These are almost always handled with an outpatient vaginal approach procedure called hysteroscopic myomectomy. in severe cases, a hysterectomy may be necessary.
To learn more about fibroid expulsion or uterine fibroid embolization, contact The Atlanta Fibroid Center today and set up a consultation. A quick UFE procedure can free you from fibroids and their painful, life-hindering symptoms.
Dr. John Lipman, an interventional radiologist at the Atlanta Fibroid Center, has over 25 years of experience helping women eliminate their fibroid symptoms through UFE. With over 10,000 procedures to his credit, Dr. Lipman is one of the leading experts in UFE in the nation. Do not suffer for one more minute, call The Atlanta Fibroid Center today!
