Uterine fibroids are tissue and muscle growths that develop inside or on the uterine wall. These growths are typically benign (non-cancerous) and are the most common type of benign tumor found in women.
Fibroids can cause a wide range of symptoms, including pain and heavy or irregular vaginal bleeding. However, some women experience no symptoms at all, making them unaware of the presence of fibroids. Treatment options are usually tailored to each patient’s symptoms and condition.
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Types of Uterine Fibroids
Fibroids may grow as a single mass or appear in clusters. Clustered fibroids can vary widely in size, ranging from as small as 1 millimeter to more than 20 centimeters (8 inches) or even larger. For comparison, fibroids can be as small as a seed or as large as a watermelon. They may grow within the uterine wall, inside the main uterine cavity, or on the outer surface of the uterus.
There are several types of uterine fibroids categorized based on their location and how they attach to the uterus:
- Intramural fibroids: These grow within the muscular wall of the uterus and are the most common type.
- Submucosal fibroids: These develop beneath the inner lining of the uterus.
- Subserosal fibroids: These form beneath the outer surface of the uterus. They can grow very large and may extend into the pelvic area.
- Pedunculated fibroids: The rarest type, these fibroids attach to the uterus by a stalk. They are often described as mushroom-like due to their stem and wider top.
What Causes Uterine Fibroids?
The exact cause of fibroids is still unknown, but experts believe that estrogen and progesterone play a significant role in their growth. Fibroids most commonly appear during a woman’s reproductive years. Studies show that fibroids tend to grow when hormone levels are high (such as during pregnancy) and shrink when hormone levels decrease (such as during menopause).
Several factors can increase a woman’s risk of developing fibroids, including:
- Obesity and high body mass index (BMI)
- Family history of fibroids
- Never having been pregnant
- Early onset of menstruation
- Late onset of menopause
What Are the Symptoms of Uterine Fibroids?
Most small fibroids do not cause symptoms and require no treatment other than regular monitoring. However, larger fibroids may cause symptoms such as:
- Heavy or painful menstrual bleeding
- Bleeding between menstrual cycles
- Feeling of fullness or bloating in the lower abdomen
- Frequent urination (due to pressure on the bladder)
- Pain during intercourse
- Lower back pain
- Constipation or pressure on the rectum
- Long-term (chronic) vaginal discharge
- Difficulty urinating or inability to empty the bladder completely
- Abdominal enlargement that may resemble pregnancy
Fibroid symptoms often stabilize or even disappear after menopause as hormone levels decrease.
What Are the Risks of Untreated Fibroids?
Most uterine fibroids do not cause serious complications. However, some common complications may include:
- Increasingly severe pain
- Swelling in the abdomen or pelvic area
- Excessive bleeding
- Anemia
- Infertility (rare)
How Do Doctors Diagnose Uterine Fibroids?
Several tests may be performed to diagnose uterine fibroids, such as:
- Ultrasound: A noninvasive imaging test that uses sound waves to produce internal organ images.
- MRI: Produces detailed images of internal organs using magnets and radio waves.
- CT Scan: Uses X-rays to create detailed cross-sectional images of internal organs.
- Hysteroscopy: A thin tube with a camera (scope) is inserted through the vagina and cervix to view fibroids inside the uterus.
- Hysterosalpingography (HSG): A detailed X-ray test where contrast dye is injected before imaging the uterus.
- Sonohysterography: A catheter is inserted through the vagina to inject saline into the uterus, producing clearer images than a standard ultrasound.
- Laparoscopy: A small incision is made in the lower abdomen, and a thin camera tube is inserted to examine internal organs more closely.
Fibroid Treatment at Mandaya Royal Puri Hospital
Mandaya Royal Puri Hospital offers various treatment options for uterine fibroids, including:
1. HIFU (High Intensity Focused Ultrasound)
HIFU is a non-invasive technology that uses high-intensity ultrasound waves to destroy fibroid tissue without incisions or surgery. The procedure works by precisely focusing thermal energy on the fibroid, causing the fibroid cells to coagulate and gradually shrink—without damaging surrounding healthy tissue.
The entire process is guided by imaging to accurately locate and target the fibroid.
Benefits of HIFU for fibroid treatment include:
- No incisions, no surgical wounds, and no stitches
- Extremely fast recovery—patients can typically return to activities within 1–2 days
- Minimal discomfort due to light anesthesia
- High accuracy thanks to focused ultrasound energy
- Very low risk of complications such as infection, bleeding, or adhesions
- Ideal for women who wish to preserve their uterus and maintain fertility options
2. Laparoscopic Surgery
Laparoscopic surgery is a minimally invasive procedure used to remove fibroids through small incisions in the abdomen. A laparoscope—a thin tube equipped with a camera and light—is inserted into the abdominal cavity to provide a clear view of internal organs on a monitor. This allows surgeons to remove fibroids with precision without making large incisions, as in open surgery (laparotomy).
Typically, 2–4 small incisions measuring 0.5–1 cm are made to insert surgical instruments. Once the fibroid is removed, the area is closed with minimal trauma to surrounding tissues.
Benefits of laparoscopic fibroid surgery include:
- Smaller incisions and less postoperative pain
- Lower risk of bleeding and infection
- Faster recovery compared to open surgery
- Better cosmetic results due to minimal scarring
- Clear visualization of internal organs for safer and more accurate surgery
Expert Fibroid Treatment Doctors at Mandaya Royal Puri Hospital
In addition to advanced technology, Mandaya Royal Puri Hospital is supported by a team of experienced specialists in uterine fibroid management, including:
1. dr. Gracia Merryane R.G Rauw, Sp.OG
dr. Gracia Merryane R.G Rauw, Sp.OG is an obstetrician-gynecologist specializing in women’s reproductive health, pregnancy, and gynecological conditions. She completed her general medical and specialist training at Sam Ratulangi University.
She provides comprehensive women’s health services, including routine check-ups, pregnancy planning, lactation consultation, family planning, ovulation induction, normal delivery, C-section delivery, and gynecological procedures such as hysterectomy, sterilization, laparoscopy, Pap smear, SIS, and LEEP.
Practice schedule at Mandaya Royal Puri Hospital:
- Monday: 08.00–11.00 & 13.00–18.00
- Tuesday: 08.00–11.00 & 13.00–18.00
- Wednesday: 08.00–11.00 & 13.00–18.00
- Thursday: 08.00–11.00 & 13.00–18.00
- Friday: 08.00–11.00 & 13.00–18.00
- Saturday: 08.00–11.00 & 13.00–18.00
2. dr. Doddy F.P. Gultom, Sp.OG (K), M.Kes
dr. Doddy F.P. Gultom, Sp.OG (K), M.Kes is a consultant obstetrician-gynecologist with extensive experience in reproductive health, pregnancy care, and gynecological disorders. He is a graduate of Trisakti University, completed his specialist training at Hasanuddin University, and earned his consultant degree at Universitas Indonesia.
He provides services such as pre-pregnancy counseling, prenatal diagnosis, fetal imaging, contraceptive planning, pregnancy complication management, benign gynecological disorders, and minimally invasive procedures.
Practice schedule:
- Tuesday: 17.00–20.00
- Thursday: 13.00–16.00
- Saturday: 08.00–12.00
3. dr. Ong Tjandra, M.Kes, Sp.OG, Subsp. Onk
dr. Ong Tjandra is a gynecologic oncology subspecialist experienced in managing cervical cancer, ovarian cancer, vaginal cancer, and various other gynecologic conditions. He is also skilled in performing fibroid and cyst removal using laparoscopic techniques, including high-precision hysterectomy procedures.
Known for his comprehensive approach, Dr. Ong is highly trusted in handling complex cancer or gynecological cases.
Practice schedule:
- Monday: 10.00–17.00
- Thursday: 16.00–20.00
4. dr. Unedo Hence Markus Sihombing, Sp.OG, Subsp. Onk
dr. Unedo is an obstetrician-gynecologist with a subspecialty in gynecologic oncology. He completed his medical education at Sriwijaya University, continued his training at Sebelas Maret University, and earned his Consultant and Doctorate degrees from Universitas Indonesia.
He has extensive experience managing cervical cancer, uterine cancer, ovarian cancer, vulvar cancer, vaginal cancer, and various benign gynecological conditions such as polyps and uterine tumors. His careful, empathetic, and thorough approach helps patients feel safe and comfortable throughout treatment.
Practice schedule:
- Tuesday: 16.00–20.00
- Thursday: 16.00–20.00
- Saturday: 13.00–16.00
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