Fibroids and its types

Types of Fibroids

Uterine Fibroids are classified according to their location within the uterus. There are three primary types of fibroid tumors:

Subserosal fibroids develop in the outer portion of the uterus and continue to grow outward. These fibroids typically do not affect a woman's menstrual flow, or cause excessive menstrual bleeding, but can cause pain due to their size and the added pressure on other organs.

Intramural fibroid tumors are the most common and develop in the uterine wall and expand. These fibroids can cause the uterus to appear larger in size which can be mistaken for weight gain or pregnancy. Associated symptoms include heavy menstrual bleeding, pelvic and back pain, frequent urination and pressure.

The other type of fibroid tumor is submucosal, the least common of the three. These fibroids develop within the uterine cavity and can cause excessive menstrual bleeding along with prolonged menstrual cycles.

A woman may have one or all of these types of fibroids. It is common for a woman to have multiple fibroid tumors and it may be difficult to understand which fibroid is causing your symptoms. Because fibroid tumors are a diffuse disease of the uterus, there are usually more fibroids present than can be detected because of their small size. Even a woman who has only one visible fibroid needs to assume that there are multiple uterine fibroids present when discussing therapy. Uterine fibroids may also be referred to as myoma, leiomyoma, leiomyomata, and fibromyoma.

If you think you may have uterine fibroids, or are experiencing any of the related signs and symptoms of uterine fibroids, please contact your primary care provider or OB/Gyn as soon as possible in order to rule out any other complications that could be causing your symptoms. Knowing the types of fibroids and understanding their symptoms can help you choose the right fibroid treatment. For more information on uterine fibroid treatments and learning more about alternatives to hysterectomy procedures, please continue browsing our site.

Simple yet effective methods to Improve Fertility in Men

VitE & Zinc helps to develop and prevent damage to Sperms

Lot of guidelines and medicines are available to improve fertility. Most of them claim that the ingredient are naturally available without any doctor’s prescription to improve Fertility, but does not necessarily mean that it is safe to take. These ingredients may have unknown side effects with its toxicity which may lead not to improve Fertility.












You should always notify your physician before starting any type of medication, supplement, or over the counter medication in order to improve fertility which you wish to follow like friends recommendation or by word of mouth. Generally Vitamin E is recommended which prevents the damage to sperm cells by acting as an antioxidant. Vitamin E also supports the sperm motility. This is widely used to improve fertility, as there are no reported side effects.


Zinc plays an important role to improve fertility in the formation of new sperm and maintenance of sperm motility. Adequate levels of zinc in the body are essential for men's reproductive health. Even foods high in Zinc like Oysters, beef, pork, turkey, lamb, and nuts can improve fertility. In natural herbal roots like Ginseng can improve fertility by increasing sperm counts, motility, and sexual stamina and reduce fatigue.

Although the results are still uncertain, no side effect or tolerated well when used in limited doses. Homeopathic medications show good records with increased sperm counts and motility. Nutritional foods include fresh fruits and vegetables, grains, nuts like cashew, almonds or walnuts, sweet & juicy fruits such as mangoes, peaches, plums, and pears all can improve fertility of both men and women.

How to deal with different type of cysts

Ovarian Cysts / Chocolate Cysts: Types, Diagnosis and Treatment

Ovarian cysts are usually seen in three forms:

* Follicular or Functional Ovarian Cysts
* Corpus Luteal Ovarian Cysts
* Endometrioma or Chocolate Cysts














What are Follicular Cysts?

These are the most common of the benign functional cysts. Each time an egg is produced by the ovary a small cyst forms. The cyst is usually very small and ruptures when releasing the egg during ovulation. If the cysts don't rupture they may continue to grow; however, as they rarely grow larger than 8 centimeters and normally shrink after ovulation, surgery is usually not required. If rupture occurs, pelvic pain may result and last 24-48 hours. The pain is due to a small amount of bleeding which is irritating to the abdominal cavity. Surgery may be indicated in cases when bleeding continues or is excessive.

Treatment:Follicular cysts usually resolve on their own in 3-6 weeks.


What are Corpus Luteum Cysts?

These are much less common than follicular cysts. Corpus luteum cysts develop after the ovary releases its egg and the formed follicular cyst changes into a small hormone producing "yellow body", also known as the corpus luteum. If the yellow body reaches a size of greater than 3 centimeters, it is then referred to as a cyst. Rupture of these ovarian cysts occurs more often on the right side, during intercourse and during the later days of the menstrual cycle when the cysts are at their largest. If they grow too large, they may need to be surgically removed.

Smokers have a two-fold increased risk of developing functional ovarian cysts.

Oral contraceptive therapy has been known to markedly reduce the risk of the formation of the functional ovarian cysts.


What are Endometriomas/Chocolate Cysts?

This disease process is also known as Endometriosis of the ovaries. Tiny implants of cells that line the uterine cavity become transplanted and form small cysts on the outside of the ovary. These cysts enlarge and produce Endometriosis of the ovary. They respond to hormone stimulation during the menstrual cycle and produce many small cysts, which may then occupy and even replace the normal ovarian tissue.

These endometriomas are filled with a thick chocolate-type material, which is the reason they are known as "chocolate cysts". When this type of ovarian cyst ruptures, the material spills over into the pelvis and onto the surface of the uterus, bladder and bowel and the corresponding spaces between. Adhesions can develop because of this rupture and may lead to pelvic pain.


What are the symptoms of Ovarian Cysts?

If these cysts remain small (less than 3 centimeters) no symptoms may result. Cysts larger than 10 centimeters cause the most common symptoms such as pelvic pain, which may present either unilaterally or bilaterally.

As with Endometriosis, pain may be worse at different points throughout the menstrual cycle. If these cysts rupture and peritoneal implants are present, the same type of debilitating pelvic pain may occur.

Do Ovarian Cysts cause infertility?

Endometriomas do not appear to affect egg quality, but they can interfere with follicular development and ovulation. This situation occurs when the endometriomas adhering to the pelvic side wall cause interference with the ovulatory mechanism leading to the ovum (egg) pickup.


How are Ovarian Cysts diagnosed?
As with any disease, a known medical history is very important. If a patient with a known history of Endometriosis presents a pelvic ultrasound with a large ovarian cyst, there is a high probability that this will be an endometrioma.


Ultrasonography Studies:

Transvaginal and abdominal ultrasounds are the most commonly used tests to diagnosis endometriomas. Transvaginal scanning has the advantage of providing additional information about the internal makeup of the ovarian mass.

These ovarian cysts vary in appearance, from purely cystic to complex with septations, debris or even a solid consistency. This is primarily due to the thick "chocolate" material. A CT scan and MRI are seldom indicated as a primary diagnostic procedure, although if cancer is a strong consideration, using one of these may be helpful.


How are Ovarian Cysts treated?

Contrary to Endometriosis, these cysts are primarily an ovarian process. Traditional gynecologists will address ovarian cysts with oophorectomy (removal of ovary), or the radical approach of a hysterectomy.

Fibroids: Types, Diagnosis & Treatment

Types of Fibroids: Fibroids are classified by their location (see figure), which effects the symptoms they may cause and how they can be treated. Fibroids that are inside the cavity of the uterus (intracavitary myomas) will usually cause bleeding between periods (metrorrhagia) and often cause severe cramping. Fortunately, these fibroids can usually be easily removed by a method called "hysteroscopic resection," which can be done through the cervix without the need for an incision. Submucous myomas are partially in the cavity and partially in the wall of the uterus. They too can cause heavy menstrual periods (menorrhagia), well as bleeding between periods. Some of these can also be removed by hysteroscopic resection. Intramural myomas are in the wall of the uterus, and can range in size from microscopic to larger than a grapefruit. Many of these do not cause problems unless they become quite large. There are a number of alternatives for treating these, but often they do not need any treatment at all. Subserous myomas are on the outside wall of the uterus. A fibroid may even be connected to the uterus by a stalk (pedunculated myoma.) These do not need usually treatment unless they grow large, but they can twist and cause pain. This type of fibroid is the easiest to remove by laparoscopy.


Diagnosis

Fibroids may be felt during a pelvic exam, but many times myomas that are causing symptoms can be missed if the examiner relies just on the examination. Also, other conditions such as adenomyosis or ovarian cysts may be mistaken for fibroids. For this reason, I routinely do an ultrasound examination at the time of the first visit(saline enhanced sonography or sonohysterogram). While this will often provide additional information to the regular ultrasound, I usually learn much more by looking inside the uterus with a little telescope. This exam, called hysteroscopy, is usually done in my office, and allows me to directly look inside the uterus. when a woman has symptoms of abnormal bleeding or cramping, or if I feel an abnormality on examination. Vaginal probe ultrasound only takes a few minutes to do, is not uncomfortable, and rapidly provides invaluable information if the examiner is experienced in looking at uterine abnormalities. It is possible to fill the uterus with a liquid during the ultrasound

Adenomyosis confused with fibroids:

One of the most common conditions confused with fibroids is adenomyosis. This can be a serious error, as the treatment may be quite different. In adenomyosis the lining of the uterus infiltrates the wall of the uterus, causing the wall to thicken and the uterus to enlarge. This can cause severe pain, and heavy bleeding.

On ultrasound examination adenomyosis will often appear as diffuse thickening of the wall, while fibroids are seen as round areas with a discrete border. Adenomyosis is usually a diffuse process, and rarely can be removed without taking out the uterus. Since fibroids can be removed by myomectomy, it is essential to differentiate between the two conditions before planning treatment. It is also common to have adenomyosis and fibroids in the same uterus.

Which fibroids can be removed laparoscopically?

Fibroids that are attached to the outside of the uterus by a stalk (pedunculated myomas) are the easiest to remove laparoscopically. Many subserous myomas (close to the outer surface) can also be removed through the laparoscope.

Fibroids that are deep in the wall of the uterus, or submucous are most difficult to remove laparoscopically. Although there have been successful pregnancies after laparoscopic removal of deep or multiple myomas, the real question is whether or not the uterus can be repaired as well through the laparoscope as can be done through an abdominal myomectomy.

What are the advantages and disadvantages of laparoscopic myomectomy?

The advantage of a laparoscopic myomectomy over an abdominal myomectomy is that several small incisions are used rather than one larger incision. It is important to understand that even a laparoscopic myomectomy is real surgery, and often requires several weeks of recovery. Another major factor in recovery time is motivation; I have found motivation can be just as important in recovery as the type of surgery.

One concern when there are multiple fibroids is of leaving smaller myomas behind. Often it is necessary to feel the uterus to find the smaller myomas; these likely would be left behind during a laparoscopic myomectomy. To summarize, I think laparoscopic myomectomy is best for pedunculated and superficial myomas. When there are deep myomas and a large number of myomas, I think that it is possible to repair the uterus better by doing an abdominal myomectomy.

Reproductive Surgery: To restore normal anatomy & function to the reproductive organs.

The principle goal of reproductive surgery is to restore normal anatomy and function to the reproductive organs. Damage caused by inflammation, infection, or endometriosis leaves these structures more vulnerable to postoperative adhesion formation.

Therefore, standard surgical techniques are not appropriate for reproductive surgery, and these delicate procedures are best performed by a Specialist trained in Microsurgery and infertility. It is best advised to perform reproductive surgeries adapting microsurgical methods.

Laparoscopic surgery is usually preferable to a standard open surgical approach, because this reduces handling of tissues, prevents drying of surfaces, and allows better access to and visualization of the deep pelvic structures. It also provides magnification and the ability to achieve more complete hemostasis. The net result is a better restoration of anatomy, decreased adhesion formation, lower risk of recurrence of endometriosis or pain, and higher pregnancy rates.

The Reproductive Surgery Unit of ObGyn Department specializes in all aspects of gynecologic surgery related to fertility and infertility.

Reproductive surgery is an art, and the most technically demanding of all gynecologic surgery. The Srushti Reproductive Surgery is proud of its reputation as India’s premier center for reproductive surgery. Our experience and expertise allow us to perform approximately 80% of our operations laparoscopically on an outpatient basis.

The following is a list of some important points to discuss with your specialist prior to surgery:

Surgery for Endometriosis

• Endometriotic implants may have varied appearances. All lesions should be treated.
• Deep lesions should be completely excised or vaporized.
• Endometriotic cysts in the ovary should be completely excised, never drained, ablated, or cauterized.
• Adhesion barriers are sometimes used.
• Post-op medical therapy may also be indicated.

Surgery for Adhesions

• When possible, adhesions should be fully excised, not simply cut.
• Complete hemostasis (stopping all bleeding and oozing) is crucial.
• Adhesion barriers are often used.

Surgery for Tubal Damage or Occlusion

• Magnification is usually needed to adequately repair the tube.
• Sutures, if used, should be fine and placed sparingly.
• Hemostasis is crucial

Surgery for Tubal Reversal

• Operative magnification is critical.
• Adhesions should be removed and cautery applied with micro forceps.
• As much tubal length as possible should be salvaged.

Postponing motherhood: the risk of unforeseen waiting

Increasing numbers of women in India and abroad are choosing to have families later in life. Many are focused on finishing college, pursuing careers and establishing solid relationships before beginning their families, but a new study indicates women over age 35 face more pregnancy-related risks than their younger counterparts. The study, conducted by researchers at the in Copenhagen, found the risk of unsuccessful pregnancy rises dramatically to 20 percent and higher after a woman reaches age 35.

"We found the risk of miscarriage increases with maternal age–irrespective of a woman’s reproductive history," said lead author Dr. Anne-Marie Nybo Anderson, professor of epidemiology. The report, published in the British Medical Journal, provides some sobering statistics:

• by age 35, one in five of all pregnancies ends in miscarriage, stillbirth or ectopic pregnancy (a dangerous condition in which the fertilized egg implants outside the uterus);
• by age 42, the failure rate rises to more than half; and
• after age 45, nearly three out of four pregnancy results are not successful.

By contrast, women in their early to mid-20s experience only a 9 percent failure rate.

Although previous studies have suggested older women have higher-risk pregnancies, this study analyzed a very large population over more than a decade.

Also, for the first time, researchers were able to separate the degree of risk according to each woman’s reproductive history; for example, if she had previous children, fertility problems or a history of abortions, researchers were able to track these differences with pregnancy success rates. The rise in miscarriage, stillbirths and ectopic pregnancies increased with age independently of these other factors.

Researchers conclude the study underscores the importance of counseling women about the risks of postponing pregnancy if they are interested in having babies.

Fertility Diet: Avoid these foods

Foods that Harm Your Chances of Getting Pregnant

The following foods can negatively affect fertility:

• Alcohol. An occasional glass of alcohol is generally considered to be safe for women trying to conceive, however, if you irregular menstrual cycles or if you have experienced problems getting pregnant, it is best to avoid alcohol consumption altogether. While some studies have found the link between alcohol and fertility to be inconclusive, others have found a slight relationship between the two. For example, a Danish study that included 430 couples trying to conceive their first child found that woman’s chances of getting pregnant diminished as her consumption of alcohol increased. In fact, women who consumed less than 5 drinks a week were twice as likely to get pregnant compared with those who consumed 10 alcoholic beverages weekly. Studies have also found that men who consume beer, wine or hard liquor on a daily basis had lower levels of testosterone and lower sperm count levels, as well as a higher number of abnormal sperm in their ejaculate.
  

• Caffeine. While most experts agree that a low to moderate daily caffeine intake (2 8-ounce cups of coffee a day or a daily intake of less than 300 mgs of) will not impact fertility, it is best to avoid caffeine altogether if you have fertility problems. This is because caffeine constricts blood vessels, which reduces blood flow to the uterus, making it difficult for a fertilized egg to implant in the uterine wall. A recent study has also found that caffeine affects male fertility, as it causes damage to sperm DNA.

• Refined carbohydrates. White pasta, rice and bread are harmful to your reproductive health and to fertility, particularly if you have Polycystic Ovary Syndrome (PCOS), as increases in insulin levels caused by a high consumption of refined carbohydrates results in irregular ovulation. This is because during the refining process, 17 key nutrients are removed from grain, many of which help to boost fertility, such as iron, B vitamins and antioxidants. You should aim for 6 ounces of whole grains a day, including whole wheat pasta, cereal and bread.

For more information about Infertility and solutions, please visit motherababy.com