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"This patient had a massive tumour in her uterus. It was more complex and larger than we anticipated from her pre-surgical scans. Meticulous planning was needed pre-operatively for the surgery. Cases like this highlight the importance of strong teamwork, as such cases often demand real-time decision-making and on-the-spot planning that cannot always be anticipated beforehand," said Dr Dinesh Kansal, Senior Director and Head - Obstetrics and Gynaecology and Laparoscopic Surgery, BLK Max Super Speciality Hospital, who led a multidisciplinary team from urology, anaesthesia, and critical care. "The benign fibroid had grown so large that the mammoth uterus was pressing against nearby organs, including the intestine, bladder, and ureter. Her internal anatomy was severely distorted, and key organs were closely adherent to the fibroid. The patient also had internal scarring from previous surgeries, which made the procedure more complex," she added. Dr Kansal said the surgery lasted several hours, and the patient's condition was closely monitored throughout. She was discharged on the fourth day and has now recovered while resuming a comfortable and active lifestyle. What are uterine fibroids? Uterine fibroids, also known as leiomyomas or myomas, are noncancerous or benign growths that develop in the uterus. Experts say they are very common, especially during the childbearing years, and can vary in size and number. While many women with fibroids experience no symptoms, others may have heavy or prolonged menstrual bleeding, pelvic pain or pressure, and other issues. Fibroids can grow as a single nodule or in a cluster, ranging in size from 1 millimetre to more than 20 centimetres in diameter or even larger. For comparison, fibroids can be as small as a seed or as large as a watermelon. These growths can develop within the wall of your uterus, inside the main cavity of your uterus, or on the outer surface of your uterus. According to experts, fibroids are a very common type of growth. Approximately 40 to 80 per cent of women with a uterus have fibroids. They occur most often in people between 30 and 50 years old. Those who have not had their first period yet typically do not have fibroids. They are also less common in people who have entered menopause. Signs and symptoms of uterine fibroids Most of the small fibroids do not cause any symptoms and do not require treatment except regular observation by the doctor. However, larger ones can cause you to experience a variety of symptoms, including:

• Pain and excessive bleeding
• Bleeding between your periods
• A feeling of fullness in your lower belly
• Frequent urination
• Pain during sex
• Lower back pain
• Constipation
• Long-term vaginal discharge
• Inability to pee or completely empty your bladder
• Increased abdominal enlargement

The symptoms of uterine fibroids usually stabilise or go away after you have gone through menopause, since hormone levels decline within your body. Why do fibroids happen? Even though the exact cause of fibroids is unknown, doctors believe the hormones estrogen and progesterone play an important role. Studies say fibroids tend to grow when hormone levels are higher (like during pregnancy) and shrink when hormone levels are low (like during the transition to menopause). There are several risk factors that can play a role in your chances of developing fibroids, which include:

• Obesity and being overweight
• Family history of fibroids
• Not having children
• Early onset of menstruation
• Late age for menopause