Dr. Biswa Bhusan Dash is a Gyne Laparoscopic Surgeon and has done several laparoscopic hysterectomies in India. He is known for his expertise particularly in cases with big uterus, previous caesarean scars and with severe endometriosis. He has been associated with various hospitals of Delhi NCR, including Max Hospital Saket, Fortis La Femme, Adiva Multispeciality Hospital, Sukhmani Hospital and The Cradle & Artemis Hospital, Gurgaon. After completing his masters degree from the prestigious All India Institute of Medical Sciences (AIIMS), he got professional exposure in Canada, USA and UK. Here, he tells us about fibroids.
Fibroids are the most common tumour in female reproductive organ
How do we define fibroids?
Fibroids are the most common tumour in female pelvis / uterus. They are mostly non cancerous.
Uterine fibroid sizes vary from the size of a coin to the size of a melon
How do we identify fibroids?
Fibroids are hormone dependent tumours and are commonly seen in reproductive age group. The incidence (chances of developing fibroids) increase with age. After menopause they stop growing and usually new fibroids don’t develop. Most of the fibroids (up to half) are asymptomatic (without any symptoms or problems) and are detected in ultrasonography. They may be present with increased bleeding during menses, irregular bleeding, pain in the lower abdomen and as a tumour or lump in the lower abdomen that the patients can feel.
Patients with previous caesarean scar and severe endometriosis are particularly challenging and should be operated by expert gyne laparoscopic surgeons in order to avoid complications
What are the complications if one develops fibroids?
Fibroids can cause infertility (difficulty in getting pregnancy), repeated abortion and premature labour. Very big fibroids can compress the ureters and cause hydronephrosis or swelling of the kidneys.
Most of the fibroids are without symptoms and do not need any treatment
When do we require medication or surgery if detected with fibroids?
Asymptomatic fibroids in general do not need any treatment. Menstrual (bleeding) problems can be treated with medicines unless until the fibroids are too big and projecting into the cavity of the uterus (womb). Big fibroids, fibroids projecting or lying inside the uterine cavity, fibroids pressing on the urinary tract need surgical removal (removal by operation). In rare situations when other causes of infertility are excluded Myomectomy is a good option in infertile females.
In a woman who has a normal body mass index or BMI or is slightly overweight, fibroid tumours can also be mistaken for weight gain or pregnancy
Tell us about the surgery wherein you removed the gigantic 9.4 kg fibroid tumour.
This remains the world’s largest fibroid of the uterus removed laproscopically. Because the patient was on the heavier side, she could not feel the tumour for a long time which must have grown for about six years. Only a few weeks ago, she noticed a protrusion of a growth from her abdomen. On examination, the doctors diagnosed the growth as a gigantic fibroid. We removed the fibroid laparoscopically and this is the largest fibroid in the world removed laparoscopically. The operation was successfully done without any complications and the patient recovered quickly. The patient had a huge fibroid filling the entire abdomen and bigger than a triplet pregnancy size uterus. The patient had no menstrual or bleeding complaints and only she could feel the fibroid as a hard tumour. This is an unusual situation where the fibroid grown to such big size without symptoms. Since the patient was morbidly obese (117) kg she could not feel the tumour initially. The patient was unmarried and we could avoid a big scar and removed the fibroid through key holes. The patient is doing good now after surgery.
How can a patient get in touch with you?
I am available on firstname.lastname@example.org and 09212397781. My official address is at Rejoice, Infertility and Gyne endoscopy clinic, D-41, South Extension Part II. For non affording patients we offer surgeries in a very nominal price also.