Intramural Fibroids Treatment in Singapore
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What are Intramural Fibroids?
Intramural fibroids are benign growths of smooth muscle and connective tissue that develop within the muscular wall (myometrium) of the uterus. They are a common type of uterine fibroid and may occur as a single growth or as multiple fibroids. Some intramural fibroids do not cause symptoms, while larger or multiple fibroids may contribute to heavy or prolonged menstrual bleeding, pelvic pressure, abdominal or back pain, urinary symptoms and reproductive difficulties. Symptoms depend on the size, number, and location of the fibroids and whether they distort the uterine cavity.
What is the Importance of Timely Treatment?
Timely evaluation can help determine the size, number and location of intramural fibroids and whether they are contributing to symptoms such as heavy menstrual bleeding, anemia, pelvic pressure or fertility problems. Asymptomatic fibroids may only require observation, whereas symptomatic or enlarging fibroids may require medication, minimally invasive procedures or surgery. Early assessment also helps identify other causes of abnormal uterine bleeding or pelvic symptoms and allows treatment to be selected according to reproductive plans and individual preferences.
What are the Common Symptoms of Intramural Fibroids?
- Heavy or prolonged menstrual bleeding
- Menstrual bleeding between periods
- Painful menstrual periods
- Pelvic pressure or a feeling of fullness
- Lower abdominal or pelvic pain
- Lower back pain
- Abdominal enlargement or fullness
- Frequent urination or difficulty emptying the bladder when a fibroid presses on the urinary tract
- Constipation or rectal pressure in larger fibroids
- Pain during sexual intercourse
- Fatigue or weakness related to iron-deficiency anemia from heavy bleeding
- Difficulty conceiving in some patients
- Pregnancy-related complications in selected cases
Causes and Risk Factors of Intramural Fibroids
Causes
- The exact cause of intramural fibroids is not completely understood. They develop from abnormal growth of smooth muscle cells within the uterine wall and are influenced by genetic and hormonal factors.
- Oestrogen and progesterone contribute to fibroid growth, which is why fibroids commonly develop during the reproductive years and often shrink after menopause.
- Genetic changes within uterine cells may also contribute to their development.
Risk Factors
- Increasing reproductive age, particularly during the years when fibroids are most likely to develop
- Family history of uterine fibroids
- Genetic or cellular factors associated with fibroid development
- Overweight or obesity
- Hormonal exposure during the reproductive years
- Early onset of menstruation
- Certain population and genetic factors
- Increasing age before menopause
- Factors associated with metabolic and hormonal health
Latest Research and Technologies in the Treatment of Intramural Fibroids in Singapore
Recent advances in intramural fibroid treatment in Singapore include ultrasound-guided high-intensity focused ultrasound (USgHIFU), a non-invasive technique that uses focused ultrasound energy to destroy fibroid tissue while preserving the uterus. MRI-guided focused ultrasound and uterine artery embolisation are other uterus-preserving options for selected patients, with suitability depending on fibroid characteristics, symptoms, and future pregnancy plans.
Treatment options for Intramural Fibroids
Myomectomy : Myomectomy removes fibroids while preserving the uterus and may be considered for patients with significant symptoms or selected fertility-related concerns. Depending on fibroid size and location, it may be performed through laparoscopic, robotic or open surgery.
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Uterine Artery Embolisation: UAE is a minimally invasive procedure in which small particles are introduced through the uterine arteries to reduce blood flow to the fibroid, causing it to shrink over time. It can provide a uterus-preserving treatment option for appropriately selected patients, although its suitability should be discussed carefully in patients who wish to become pregnant.
Hysterectomy : Hysterectomy removes the uterus and provides definitive treatment for uterine fibroids. It may be considered when symptoms are severe, other treatments are unsuitable or unsuccessful, or the patient does not wish to preserve fertility. The decision depends on individual circumstances and preferences
- Clinical assessment:
- Gynecological Evaluation: A detailed medical and menstrual history assesses bleeding pattern, pelvic pain, pressure symptoms, urinary or bowel symptoms, reproductive history, fertility concerns and previous treatment. Pelvic examination may help identify an enlarged or irregular uterus.
- Assessment of Menstrual Blood Loss and Anemia: Complete blood count and iron studies may be performed when clinically indicated to assess the effects of chronic blood loss.
- Reproductive and Fertility Assessment: For patients who are planning pregnancy or experiencing difficulty conceiving, evaluation may include reproductive history and assessment of the uterine cavity and other potential causes of infertility.
- Assessment for Other Causes of Abnormal Bleeding: Depending on age, symptoms, and clinical findings, doctors may evaluate other causes of abnormal uterine bleeding, including endometrial pathology, adenomyosis, endometriosis, pregnancy-related conditions, or hormonal disorders.
- Imaging Tests:
- Transvaginal Ultrasound: Commonly used to identify fibroids and assess their size, number and location within the uterus.
- Transabdominal Ultrasound: May be useful for evaluating larger fibroids or when a broader view of the pelvis is required.
- Pelvic MRI: Provides detailed mapping of fibroid size, number and location and may be useful when ultrasound findings are inconclusive or when planning complex surgery or other interventions.
- Hysteroscopy: May be considered when an intracavitary abnormality is suspected, although intramural fibroids themselves are located within the uterine wall and are primarily assessed through imaging such as ultrasound or MRI.
- Additional Imaging: Selected patients may require further pelvic imaging depending on symptoms, treatment planning or concern about another pelvic condition.
MediRehab (a chain of Rehab centres, part of MediGence) provides comprehensive tele- rehabilitation services designed to support Intramural Fibroid patients in Singapore. These Services include:
- Physical Activity and Mobility: Appropriate physical activity can help maintain strength and general well-being. Activity may be temporarily modified after myomectomy or other procedures, based on the surgeon's advice.
- Pain Management: Patients may receive guidance on safe movement, prescribed pain medicines, and a gradual return to normal activities after treatment.
- Postoperative Recovery Support: After surgery, rehabilitation focuses on a gradual return to walking, daily activities, work, and exercise while following wound-care and activity restrictions.
- Medicines for intramural fibroids primarily control symptoms rather than permanently removing the fibroid. Non-steroidal anti-inflammatory drugs (NSAIDs) can help relieve menstrual pain and may reduce bleeding in some patients. Hormonal treatments, including combined hormonal contraceptives, progestogen-based treatments or a levonorgestrel-releasing intrauterine system in appropriate patients, may help manage heavy menstrual bleeding. Other fibroid-directed hormonal medicines may temporarily reduce bleeding and fibroid-related symptoms.
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Hospitals for Intramural Fibroids in Singapore
Mount Elizabeth Novena Hospital
Novena, Singapore
Mount Elizabeth Novena Hospital located in Novena, Singapore is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- Capacity of 333 beds
- Intensive Care Unit beds
- Endoscopy beds
- Day ward with 20 beds
- 13 Operating Theatres, which includes 1 Neurological operating room, 2 Cardiac operating rooms, 4 Orthopaedic operating rooms, etc.
- High Dependency Unit (HDU)
- Neonatal Intensive Care Unit (NICU)
- 24/7 Accident & Emergency Department
- Maternity ward
- 1 major operating unit with 13 operating rooms inclusive of 1 hybrid theatre
- In-house Pharmacy
- Rooms are categorized as Single Signature Rooms, Junior Suite and Regal Suite
- All patient rooms are equipped with electric safe, LCD, sofa cum bed, wardrobe, radio channels, and much more
Gleneagles Hospital
Singapore, Singapore
Gleneagles Hospital, located on Napier Road in Singapore, is a leading private healthcare institution offering comprehensive medical services and advanced clinical care. With 221 beds and a strong team of medical specialists, the hospital holds the Singapore Quality Class certification for excellence in healthcare. Its state-of-the-art facilities include ICU, HDU, NICU, Urgent Care Centre, operating theatres, radiology, endoscopy, laboratories, and rehabilitation units. Gleneagles specializes in orthopaedics, oncology, women’s health, and gastroenterology, offering tailored programs for cancer, bone, and gut health. With modern maternity packages and patient-friendly rooms, the hospital ensures compassionate, high-quality care focused on safety, comfort, and recovery.
Parkway East Hospital
Singapore, Singapore
Parkway East Hospital located in Joo Chiat Pl, Singapore is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- Total capacity for 143 beds
- Hospital rooms are available- Single room, 2-bedded room (8), 4-bedded room (2), Deluxe room, and Orchid/Hibiscus Suite
- All rooms are equipped with all ensuite facilities like Free wifi, mini fridge, sofa couch, telephone, in-room safe, TV, etc.
- Maternity wards- Accredited as a baby-friendly hospital under the World Health Organisations Baby-Friendly Hospital Initiative (BFHI)
- 1 Neonatal Intensive Care Unit (NICU) with 14 cots
- Intensive Care Unit
- 1 Operation Theatre with 5 Operating rooms
- 1 Nursery with 30 cots
- 1 Parentcraft room
- 24-hour walk-in-clinic (for emergency)
- 24-hour Pharmacy
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Why Choose Singapore for Intramural Fibroids Treatment?
- Multidisciplinary Gynecological Care: Patients can access gynecologists, minimally invasive surgeons, reproductive specialists, radiologists and other specialists according to their individual needs.
- Advanced Diagnostic Facilities: Major centres may provide transvaginal ultrasound, pelvic MRI, laboratory testing and detailed fibroid mapping for treatment planning.
- Uterus-Preserving Treatment Options: Depending on individual suitability, treatment may include myomectomy, uterine artery embolisation and other minimally invasive approaches.
- Advanced Diagnostic Imaging: Ultrasound and MRI can help assess fibroid number, size, and location to guide treatment selection.
- Multidisciplinary Support: Depending on the treatment required, care may involve gynaecologists, interventional radiologists, imaging specialists, and fertility professionals.
