Fibroids are non cancerous growth of the womb (uterus). These are known by many names such as uterine fibromyomas myomas or leiomyomas. They vary in sizes being as small as a pea or as big as a melon. The fibroids show a tendency to increase or decrease in size and sometimes even disappear with time. It is not clear to the doctors but has been found that the fibroids are sensitive to oestrogen hormone. The fibroids tend to swell up if the level of oestrogen is high i.e. during pregnancy (Patel, 2013). They are found to shrink when level of oestrogen hormone decreases which is usually after menopause.
It has also been found out by many researchers that women with fibroids can have a normal pregnancy and delivery but some complications can also be seen. For example, the sub mucosal fibroids are found to affect womb making it difficult for women to get pregnant. They can also causes issues such as miscarriage, premature labor and bleeding (Jolley, 2009). However, the problem occurs when the fibroids tend to get cancerous. There can be a sudden growth in its size leading to heavy pain. The concern is especially significant if it happens after the women reaches menopause.Therefore, focus of current research report is to conduct study of patients with fibroids and the options available in front of them for successful treatment, which is Hysterectomy and Myomectomy. Other non invasive and minimally invasive procedures are also available but they have not been included in the present study. Other than this, hospital stay followed by a short recovery has also been discussed. The treatment of fibroid is necessary if they cause underlying problems in form of painful or severe bleeding between menstrual cycle, full sensation of lower abdomen, frequent or painful urination, persistent low back or leg pain (Holloway, 2011). It is also required to be treated if it is causing infertility due to blockage of the tubes thereby preventing the eggs from reaching uterus. Hence, the treatment is essential if it is causing unnecessary suffering.
As per the data revealed from The National Women’s Health Information Center, it has been found that the prevalence of fibroid in UK is in around 10 to 20 percent of women. The prevalence rate is found to be approximately 1 in 20 women. This shows that at least 13.6 million women are suffering from one or the other form of fibroid 36. (Cha and et.al., 2011). Fibroids are also considered to be a number one reason for undergoing hysterectomy. In this regard, around 150,000-175,000 hysterectomies have been preformed till now in the country.
Demographics and epidemiology of fibroids
The uterine fibroids are one of the most common forms of non cancerous tumors that are found to be associated with women who are in their child bearing age. These can be considered as a single most indication towards hysterectomy and are clinically apparent in 25 percent women (Kable, Gibberd and Spigelman, 2008). Fibroids have been found to affect around 20 to 40 percent of women over the age of 35. Among them 50 percent are of African-American origin. The incidences in these women who are in their late 40s are found to be as high as 80 percent. 70 percent of white women in the same age range are also diagnosed with fibroids.
Asian women show a lower incidence of uterine fibroids that are symptomatic in origin. Obese women and the ones who have started menstruating at any early age have a greater risk for development of uterine fibroids. The incidences are also found to increase as the age reaches towards menopause (Lethaby, Ivanova and Johnson, 2006). Along with this, usage of oral contraceptives as well as pregnancy decreases the risk of uterine fibroids. It is also revealed that as per the available surgical options being Myomectomy and hysterectomy; less educated women are found to undergo hysterectomy.
The rationale behind selection of this research topic is due to the fact that 20 to 25 percent of women in their reproductive age have fibroids. It is more common among women who are in the age group of late 40 or early 50s. At least 25 percent of women develop fibroids which has a tendency to cause further problems in their overall physical health (Uba, 2011). Although a lot many treatment options are available for fibroids but the lack of evidence makes it difficult for decision-makers to decide over the relative benefits, harms and costs of treatment options available in front of them. This will aid in the direction of selecting the appropriate treatment as per the requirements.
Aims, objectives and area of inquiry
The main aim of the research study happens to be assessment about the available options for surgical treatment to deal with fibroids. The objectives for research project are as follows;
The current report has thus been prepared to have an understanding about various surgical options available for treatment of fibroids followed by short recovery (Pearce and Easton, 2005). It also provides answers to questions such as
As per the definitions given by Flink, 2004, literature review can be defined as the text written by a researcher for consideration of critical points in terms of current topic. It is also inclusive of the substantive findings and the methodological contributions given by various research works on a given topic (Flink, 2004). These can be considered as secondary sources that do not report any new work but it is a review of abstracts accomplished by different authors. In present scenario, the focus of this section happens to be analyzing surgical treatment and recovery options available for fibroids. It is to center on the basic nature of disease in terms of types and symptoms associated with fibroids.
According to Sears, 2012, fibroids are benign tumors that arise from the smooth muscles that make up the uterus wall. They may grow as single nodules or in clusters and usually range in size from 1 mm to more than 20 cm in overall diameter. They are found to grow within the wall of uterus or also have a tendency to project into the interior cavity. Sometimes it may also be towards outer surface of uterus. However, in a rarest of case, they may grow on stems and project from the surface of uterus. They are basically classified on the basis of the position within uterus (Jolley, 2009).
Subserosal fibroids – They develop in the outer portion of uterus and grow outwards. They do not affect the menstrual flow in any form but can cause pain due to size and the pressure on other organs.
Intramural fibroids – These are very common and expand from the uterine wall. They are usually mistaken for weight gain or pregnancy. The symptoms are in form of menstrual bleeding, pain in back and pelvis, frequent urination (Pron and et.al., 2005).;
Submucosal fibrioids – It is the least common one and develops within uterine cavity. Due to its very location it leads to excessive menstrual flow and longer cycles.
Cervicalfibroids It happens on account of the growth in the cervix. It is most difficult to remove and there are chances that damage may be caused to the surrounding areas as well.
Symptoms of fibroids-Various symptoms are observed in fibroids whose severity is required to be understood so as to access the best available treatment option. Some symptoms of fibroid may take a toll on everyday activities while others may not produce any symptoms at all. Most of the women have a tendency to ignore the symptoms as they get accustomed to pain and pressure (Desai and Patel, 2011). The symptoms are often cyclical in nature on account of the fact that fibroids are hormonally sensitive. However, the list of commonly associated symptoms with fibroids is mentioned below.
Heavy menstrual bleeding – This is the most common symptom associated with fibroid which may further lead to anemia. Clotting formation may also occur if blood stays in uterus for long. This further leads to severe cramping during menstrual cycles. All this happens due to alteration in muscle contractions of the uterus (Kable, Gibberd and Spigelman, 2008). This leads to pressure in the veins thereby causing severe bleeding and associated symptoms. In this regard the treatment options are required if intense bleeding starts to interfere with everyday life.
Urinary Symptoms – As per the views given by Burbank, 2009, fibroids are also found to increase pressure on the urinary tract. This further result in an increased frequency of urination, incontinence, partial blockage of bladder. The symptoms may get worse during menstrual flow and may occur in normal days if the fibroid increases in size (Jahan and et.al., 2011).
Abdominal pain – The large sized fibroids may led to heavy discomfort and blotting of stomach. This is sometimes caused to be on account of increase weight or pregnancy but happens on account of large sized fibroids. In several cases, women may also experience pain in lower back and legs (Ezeama and et.al., 2012). The pain in some situations is in form of a vague discomfort. There are situations when an enlarged uterus may make it difficult to lie face down, bend or causes difficulties during exercises.
In present scenario, there has been a selection of exploratory study as it is essential to carry out an in depth research so as to establish evidences for surgical treatment, hospital stay and short recovery in patients suffering from fibroid. Hence, the exploratory research will involve for gathering the existing research for gaining a better understanding about prevasil8ng subject under investigation (Lethaby, Ivanova and Johnson, 2006). As fibroid cases, its occurrence and the associated complexity vary from patient to patient. Therefore undertaking an exploratory research study will aid in establishment of clinical based evidence to improve the overall outcomes.
It is a well known fact that the effectiveness of any dissertation writing can be improved by seeking adequate support for the mentioned research approaches. Hence, in any report there is a usage of either quantitative or qualitative approach (Crowther and Lancaster, 2012). Here, as per the requirements of research aims and objectives, qualitative approach has been utilized. This will help to gain a brief understanding about the varied types of surgical treatment options that are available for fibroid patient. It will also support in the direction of understanding the very nature of fibroids in terms of types and symptoms.
There will be a critical appraisal of the available evidence so as to enable the researcher for asserting how effective the intervention is. The aim of critical appraisal happens to be identifying the quality of research and focusing on the major areas in form of the results, validity as well as relevancy of results (Campo and et.al., 2005). This encompasses for a thoughtful and balanced argument so as to make the study valid and significant. Hence in present scenario, the outcomes will be gathered by evaluation of the varied surgical options that are available for the treatment of fibroid followed by recovery time and hospital stay. This will further help in identification of themes.
The purpose of any research ethics community is to carry out a thorough review of the proposed study. This aids in the direction of protecting the dignity, safety and rights of the potential participants. There is also a requirement for adherence to ethical advice in terms of principles pertaining to confidentiality of information, justice, beneficence and fidelity. The research has been performed in an ethical manner so as to maintain the overall effectiveness and reliability. No information has been generated that can affect the reputation of surgical procedures that is carried out to remove fibroid. The research findings have not been manipulated to suit the needs of research study.
Fibroids are a form of benign tumors that occur in the womb (uterus). On a general basis they are harmless in nature but at least 25 percent of women have shown the presence of further problems on account of fibroids that affect their overall physical health. These are in form of severe pain, heavy menstrual bleeding, urinary problems and inability to conceive. Therefore focus of current research learning was conducting a study on patients with fibroids and the surgical options that are available for successful treatment. This is also followed by a short hospital stay and recovery period (Evans and Brunsell, 2007).
In the present study, the researcher has tried to find an answer to the questions as to which surgical treatment options are available to deal with fibroids. On the basis of literature review it can be concluded that the surgical options for treatment of fibroids are Hysterectomy and Myomectomy. They are divided into varied types based on the kind of study being performed by doctors. The usage of the surgical option depends on the general health condition of patient as well the requirement. For example, Hysterectomy leads to removal of fibroids with 100 percent success however, there is also a removal of uterus their by adding to the inability of conceiving. On the other hand, Myomectomy may lead to appearance of fibroid even after surgery but there is a restoration of uterus. Other non invasive and minimally invasive procedures are also available but they have not been included in the present study.
The surgeries are followed by a short hospital stay which does not last for more than one to two nights. A complete recovery period takes a time span of three to four weeks (Viswanathan and et al., 2007). However, the hospital stay as well as recovery depends on the overall health and success of surgery. For a sound recovery there is a need to follow several precautions in terms of exercise regime, medications, full rest and avoidance of driving, hot water bath intake of food among others. This is also essential to get over the side effects which are associated with the surgery (Lethaby, Ivanova and Johnson, 2006).