In Nigeria, a lot of people are afraid of having surgical operations, even when it is absolutely indicated. For fear of surgery, many Nigerian women have chosen to live with and ‘manage’ their symptoms and problems, take oral medications and injections (for example to shrink fibroids or stop heavy bleeding), or resort to herbal medications for treatment. In the case of fibroids, drug treatment alone is insufficient as they grow back once the drug is stopped; also these drugs have other side effects which make them unsuitable to be used for prolonged periods of time. Others choose to have the procedure done outside the country and so bear the burden of the cost and time that comes with it.

Common fears expressed by patients concerning fibroid surgeries include things like the need for blood transfusion, complications (or even death) from anaesthesia, damage to the womb and possibly causing infertility, damage to other organs during the surgery, the risk of removing the womb completely, having an ugly scar on the abdomen, a long recovery period, or the fact that unfortunately they can grow back and thus require another surgery.

The safety of any surgery starts from the right procedure being chosen for the right patient and done by the right person in the right place. There are minimally invasive methods available for fibroid removal (hysteroscopy, laparoscopy) which are associated with reduced risks in surgery, but these are not appropriate for every patient and many still require the traditional open surgery. Fibroids have a lot of blood vessels and removing them can be associated with bleeding, so it might not be possible to absolutely guarantee that one will not require transfusion. However, there are methods of reducing this risk to the barest minimum, such that transfusion will only occur if it is very necessary. The procedure should be done by a gynaecologist with the required qualifications and experience with managing fibroids, and an experienced anaesthetist.

A fibroid surgery must be done in a centre with standard equipment, well trained and knowledgeable staff, and a positive safety culture. This holds true whether it is done within Nigeria or outside the country.

Anyone who has been diagnosed with uterine fibroids and has problems like bleeding or infertility, should not allow the fear of surgery prevent her from dealing with the problem and taking a decision on treatment, or resort to alternative choices of treatment that will only offer, at best, a temporary relief.

If you’ve been diagnosed with fibroids, here are a few tips on what to do:

• Get information – Read about fibroids and the different types, symptoms, complications, options of treatment, prognosis and available centres for treatment. Most of this information is easily available online; remember that these sources are more accurate than friends or family members, even if they have also been diagnosed with or treated for fibroids.
• Have a clear and definite diagnosis – If you need to seek for a second or a third opinion, don’t hesitate to do so. You must understand what exactly it is that you have and its implication on your quality of life. It is easier to be afraid of something if you do not understand it.
• Find a good hospital for management – Make enquiries and do some research on the centre, its track record, the doctor(s) handling your case; ask for referrals from your doctor or people who have been managed for the same problem. Go to a place where you are comfortable and you can get answers to your questions.
• Ask questions about anything you don’t understand before the surgery or any intervention. Read up on treatments that you are offered which you do not know about.
• Make an informed decision; and go ahead with it! Don’t let fibroids hold you back and prevent you from living fully.

I have learned over the years that when one’s mind is made up, this diminishes fear; knowing what must be done does away with fear. – Rosa Parks (African American Civil Rights Activist, 1913 – 2005)