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How fast do fibroids grow back after myomectomy?

Updated: May 21


How fast do fibroids grow back after myomectomy?

Some women may start to see signs of fibroid recurrence from two years post-surgery. The speed of regrowth depends on individual factors like hormonal balance, the completeness of the initial fibroid removal, and genetic predispositions. It's important to have regular follow-ups with a healthcare provider to monitor for any signs of recurrence and manage them promptly.


The rate at which fibroids can grow back after a myomectomy varies widely among individuals due to factors like how thoroughly the fibroids were removed, hormonal influences, and genetic predispositions. While the short-term risk of recurrence is relatively low, studies indicate that up to 50-60% of women may experience fibroid recurrence within 5 to 10 years after the surgery.


To manage the risk of recurrence, regular follow-up exams, lifestyle adjustments, and considering hormonal treatments are important. For women looking to conceive post-myomectomy, planning for pregnancy sooner rather than later is advisable to minimise the risk of significant recurrence.


Introduction to fibroid recurrence


Uterine fibroids affect countless women, manifesting through symptoms that can disrupt daily life and well-being. The Rylon Clinic, with its prestigious locations including Harley Street and The Shard in London, specialises in advanced gynaecological treatments like myomectomy- a surgical option for removing fibroids that offers hope for symptom relief and fertility preservation.


Myomectomy is favoured for its potential to improve quality of life while keeping the uterus intact, a significant consideration for women aiming to maintain fertility. At The Rylon Clinic, Mr. Naji leverages his expertise and advanced scanning technologies to ensure optimal outcomes for a diverse patient base, including English and Arabic-speaking women from various backgrounds.


A primary concern post-myomectomy is the recurrence of fibroids. It's crucial for patients to understand the risk factors for regrowth and the strategies to minimise recurrence. The Rylon Clinic is committed to not just successful surgical outcomes but also to the long-term health and education of their patients, guiding them through their journey to recovery and beyond.


In this blog, we will discuss fibroid regrowth after myomectomy, preventative measures, and alternatives to surgery, underscoring the clinic's dedication to informed patient care and comprehensive support.


The regrowth of fibroids post-myomectomy


The likelihood of fibroid regrowth after a myomectomy varies but is a recognized risk. Studies suggest that fibroid recurrence can occur in approximately 10% to 60% of patients within 5-10 years following surgery. This wide range reflects differences in individual factors such as the initial number and size of fibroids, surgical technique, and genetic and hormonal influences on each patient. The risk of recurrence necessitates regular follow-up care to monitor for new fibroid growth and manage symptoms effectively. Despite the removal of fibroids during surgery, these underlying causes can lead to the growth of new fibroids over time.


The rate of fibroid regrowth varies significantly among individuals. Some women may not experience recurrence, while others might see new fibroids emerging within a few years after surgery. This variability underscores the importance of understanding and managing the factors that contribute to fibroid development.


Hormones, particularly oestrogen and progesterone, play a critical role in fibroid growth. Managing hormonal levels through medical or lifestyle interventions can be key to reducing the risk of new fibroid formation. Additionally, lifestyle choices such as diet, physical activity, and stress management have been linked to uterine health and fibroid risk. Adopting a healthy lifestyle may not only aid in recovery post-myomectomy but also help in minimising the chances of fibroid regrowth.


Regular follow-up care is crucial for monitoring uterine health after myomectomy. Early detection of new fibroids can lead to more effective management and treatment options, potentially preventing the need for further surgical intervention.


While myomectomy is an effective treatment for fibroid removal, attention to post-surgical care and lifestyle adjustments is essential for reducing the likelihood of fibroid recurrence. Understanding the factors that influence fibroid growth and taking proactive steps to address them can significantly impact long-term health and well-being.


How do you stop fibroids growing back?


After undergoing a myomectomy, the possibility of fibroids making a comeback is a valid concern for many women. While it's true that surgery addresses the fibroids present at the time of treatment, it doesn't negate the risk of new ones forming. However, there are strategies that can help mitigate this risk, focusing on addressing the root causes and contributing factors to fibroid development


Hormonal Management: Since the growth of fibroids is often fueled by hormones, particularly oestrogen, managing hormonal levels is a critical strategy. Medical interventions may include the use of hormone-modulating therapies aimed at maintaining a balance that discourages fibroid growth. It's important to discuss these options with a healthcare provider, as they can offer personalised advice based on individual health profiles and needs.


Lifestyle Adjustments: Diet and exercise play pivotal roles in overall health and can influence the risk of fibroid recurrence. A diet rich in fruits, vegetables, whole grains, and lean proteins can support hormonal balance and reduce inflammation, potentially decreasing the likelihood of fibroid growth. Regular physical activity also contributes to hormonal balance and may help maintain a healthy weight, which is another factor in reducing fibroid risk.


Stress Reduction: Chronic stress can disrupt hormonal balance and contribute to the conditions that favour fibroid growth. Implementing stress-reduction techniques such as yoga, meditation, or deep-breathing exercises can have a positive impact on overall hormonal health and, by extension, fibroid risk.


Regular Monitoring: Keeping up with regular gynaecological check-ups post-myomectomy is crucial. These appointments allow for early detection of new fibroids, which can be smaller and more manageable, making them easier to treat. Ultrasound and other imaging techniques can be used to monitor the uterus and ovaries for signs of new fibroid formation.


Supplements and Vitamins: Certain supplements and vitamins may also play a role in preventing fibroid regrowth, although it's essential to approach this area with caution and seek professional guidance. For instance, vitamin D has been linked to a lower risk of fibroid development, and its supplementation might be beneficial for some individuals.


Implementing these strategies requires a holistic approach to health and well-being. By focusing on hormonal balance, lifestyle choices, stress management, and regular medical follow-ups, women can actively participate in reducing the likelihood of fibroid recurrence. While there's no guaranteed way to prevent fibroids from returning, these measures can significantly lower the risk and contribute to overall health improvement.


Moving on to the next section, we'll explore "Alternative Treatments to Consider" for managing uterine fibroids, providing a broader perspective on the options available beyond surgical intervention.


How many times can you have a myomectomy?


Undergoing a repeat myomectomy, which is a surgical procedure aimed at removing uterine fibroids while preserving the uterus, is generally considered safe for many women, particularly for those who wish to retain their fertility. The decision to proceed with multiple myomectomies, however, hinges on a comprehensive evaluation of several critical factors. These include individual health considerations, the specific attributes of the fibroids in question, and the outcomes of any previous surgical interventions.


One of the primary concerns with repeat myomectomy is the potential for scarring and the formation of adhesions resulting from surgical procedures. Each surgery carries the risk of creating scar tissue that might complicate future surgeries by affecting access to the uterus and potentially complicating the removal of new fibroids without damaging surrounding tissues. Moreover, the structural integrity of the uterus itself might be compromised by multiple surgeries, a factor that is particularly concerning for women who intend to conceive. The risk of complications such as uterine rupture during labour may see a marked increase after undergoing several myomectomies. Additionally, risk of needing to perform emergency hysterectomy increases after multiple myomectomies.


The recovery process and the potential for complications are also pivotal considerations. Many women recover from a myomectomy with minimal issues, but every surgical procedure inherently carries risks, including those related to bleeding, infection, and reactions to anaesthesia. These risks necessitate a thorough discussion between the patient and healthcare provider to weigh the benefits of the surgery against its potential drawbacks.


The necessity for a repeat myomectomy often arises from the severity of symptoms caused by the recurrence of fibroids, such as significant menstrual bleeding, discomfort in the pelvic region, or issues related to fertility. The decision to undertake another surgical procedure also depends on the size, location, and number of the fibroids. Before opting for another myomectomy, it is crucial to explore less invasive alternatives that may effectively manage fibroid symptoms. These alternatives can range from pharmacological treatments to procedural options like uterine artery embolization or MRI-guided focused ultrasound surgery, offering potentially effective solutions without the need for additional surgeries.


In essence, while repeat myomectomy can offer a viable path for managing recurrent fibroids, particularly for women focused on fertility preservation, it requires careful deliberation of the associated risks and benefits. A personalised approach, considering the patient’s specific health circumstances, the characteristics of the fibroids, and the overall goals for treatment, is indispensable in navigating the decision to undergo further surgical intervention.


Alternative treatments to Myomectomy


While myomectomy is a common and effective treatment for uterine fibroids, it's not the only option available. Understanding alternative treatments can empower women to make informed decisions that best suit their health needs and lifestyle preferences. These alternatives not only offer different approaches to managing fibroids but also vary in invasiveness, recovery times, and impact on fertility.


Uterine Fibroid Embolization (UFE)


UFE is a minimally invasive procedure that serves as a significant alternative to traditional surgery. It involves the embolization of the arteries supplying blood to the fibroids, leading to potential shrinkage and symptom relief. UFE is particularly appealing for its shorter recovery time compared to surgical options and its effectiveness in reducing fibroid-related symptoms without the need for incisions.


Medication


There are several medications available that can help manage fibroid symptoms, though they do not remove fibroids. These include gonadotropin-releasing hormone (GnRH) agonists, which can shrink fibroids and reduce bleeding but are typically used only short-term due to potential side effects. Other medications, such as tranexamic acid, can help manage heavy menstrual bleeding associated with fibroids.


MRI-guided Focused Ultrasound Surgery (MRgFUS)


This non-invasive treatment uses high-frequency ultrasound waves to heat and destroy fibroid tissue, guided by magnetic resonance imaging (MRI). MRgFUS is noted for its precision and the ability to treat fibroids without surgery, offering an option for women seeking a non-invasive approach.


Endometrial ablation


This procedure is suitable for women with fibroids that are primarily causing heavy menstrual bleeding and who do not wish to conceive in the future. Endometrial ablation destroys the lining of the uterus to reduce or stop bleeding but is not suitable for treating large fibroids.


Lifestyle and diet changes


While not a direct treatment for fibroids, making specific lifestyle and diet changes can help manage symptoms and potentially slow fibroid growth. A diet low in red meat and high in green vegetables, fruits, and whole grains, along with regular exercise, may help maintain a healthy hormone balance and reduce the risk of fibroid growth.

When considering alternative treatments, it's crucial to discuss all options with a healthcare provider to understand the benefits, risks, and how each treatment aligns with individual health goals, particularly regarding fertility and symptom management. Each woman's situation is unique, and a personalised approach to treatment planning is essential for achieving the best outcomes.


Making an informed decision about fibroids and myomectomy


The journey to selecting the most appropriate treatment option for uterine fibroids is intricate, requiring a balance between medical advice, personal health goals, and the practicalities of daily life. The cornerstone of this process is a comprehensive consultation with healthcare professionals, where a detailed exploration of one’s medical history, the severity of fibroid symptoms, and any prior treatments takes place. This dialogue should extend to cover the full spectrum of treatment possibilities, from surgical interventions like myomectomy and hysterectomy to non-invasive approaches such as Uterine Fibroid Embolization (UFE) and MRI-guided Focused Ultrasound Surgery (MRgFUS). It’s vital for patients to inquire about the implications of each option, including the likelihood of achieving symptom relief, potential side effects, recovery duration, and how each choice aligns with their fertility aspirations and overall health objectives.


Personal health goals significantly influence the decision-making process, especially in contexts where fertility preservation is a priority. Treatments that offer a non-permanent solution and maintain uterine integrity, such as myomectomy or UFE, might be preferred by those considering pregnancy in the future. Conversely, options like hysterectomy, which provides a definitive resolution to fibroid problems but eliminates fertility, may be more suitable for individuals not planning to conceive. The impact of each treatment on one’s lifestyle cannot be understated; factors such as recovery time, the need for ongoing medication, or the possibility of recurrence play into the calculus of decision-making. Some may prioritise a quick return to daily activities, leaning towards less invasive procedures, while others might consider the long-term effectiveness of a treatment option to be paramount, even if it entails a more extended recovery period.


Education plays a pivotal role in navigating fibroid treatment options. Arming oneself with information from credible medical sources, participating in forums, or engaging with support groups for those with fibroids can illuminate the path forward. This self-education process not only demystifies the complexities of each treatment but also empowers individuals to engage in more meaningful discussions with their healthcare providers.


Finally, the decision-making process should encompass a holistic review of all available treatments, including emerging therapies and those in clinical trials. The landscape of fibroid treatment is continually evolving, with advances in medical technology frequently introducing new and potentially more effective options. Keeping abreast of these developments ensures that individuals are making the most informed choice possible, taking into consideration not just the current state of medical knowledge but also future innovations.


Conclusion


The management of uterine fibroids, particularly with a focus on minimising recurrence, demands a comprehensive and multidimensional approach, as exemplified by the practices at The Rylon Clinic. From the initial consultations that set the stage for a personalised treatment plan, to the detailed follow-up care designed to monitor and address any signs of recurrence, each step is crafted with the patient's long-term health and quality of life in mind.


The Rylon Clinic's commitment to incorporating advanced technologies and innovative treatments offers patients the most cutting-edge options available for fibroid management. This, combined with a focus on precision medicine, ensures that each patient's treatment is as individual as their health needs and goals.


As we look to the future of fibroid management, The Rylon Clinic’s model of care provides a promising blueprint for integrating medical excellence with compassionate, personalised patient care, setting a new standard in the treatment and management of uterine fibroids.


Author: Mr Osama Naji


Mr Naji offers a “one-stop” gynaecology clinic for instant detection of various gynaecological cancers as well as providing all the diagnostic and treatment services needed under one roof.



Mr Naji provides advanced gynaecology scanning which is essential when conducting any gynaecology consultation, he is bilingual in English and Arabic and has an NHS base at the highly reputable Guy's and St Thomas' Hospital in London.

He is passionate about raising awareness of various subtle signs and symptoms of gynaecological conditions that are often overlooked by patients.

You can read more about Mr Naji on his about page here.


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