Uterine Fibroid: Causes & Symptoms
What are uterine fibroids?
Uterine fibroid is a leiomyoma(benign tumor from smooth muscle tissue) that originates from the smooth muscle layer (myometrium) of the uterus.
Causes of fibroids in women
- Unknown.
- Family history
- Genetic alterations.
- Hormones.
- Other chemicals.
What are the risk factors for these tumors?
- Heredity.
- Race.
- Pregnancy
- childbirth.
- Nulliparity
- Obesity
- Oral contraceptives.
How do we classify uterine fibroids?
Body or corporeal fibroids
• Intramural or interstitial fibroids
• Sub serosal fibroids
• Submucosal fibroids
Cervical fibroids
Secondary changes in uterine fibroids
Degenerative changes
• Hyaline degeneration
• Cystic degeneration
• Calcification
• Fatty degeneration
• Red degeneration
• Septic degeneration
Infection
Atrophy
Necrosis
Vascular changes
Sarcomatous changes
What problems are caused by uterine fibroid?
• 75 % remains asymptomatic
• Menustrual abnormalities – Menorrhagia (30%) – Metrorrhagia or irregular bleeding
• Dysmenorrhea
• Infertility(30%)
• Pain lower abdomen
• Abdominal swelling (lump)
• Pressure symptomsWhat are the diagnostic methods ?
• An abdominal, transvaginal or pelvic ultrasound
• An endometrial biopsy
• A hysteroscopy
• Hysterosalpingography
• Laparoscopy
What your doctor finds on examination?
Abdominal examination
• Feel is firm more towards hard may be cystic in cystic degeneration.
• Margins are well defined except the lower pole.
• nodular may be uniformly enlarged
• Mobility is restricted from above downwards but can be moved from side to side.
• Percussion : swelling is dull
Pelvic examination
• Bimanual examination
reveals uterus irregularly
enlarged
• Uterus is not felt
separated from the
swelling and as such
a groove is not felt
between the uterus
and the mass.
• The cervix moves
with the movement
of the tumour felt per
abdomen.
How do we treat uterine fibroid?
For symptomatic fibroids
• Medication to control symptoms
• Medication aimed at shrinking tumours
• Ultrasound fibroid destruction
• surgically aided methods to reduce blood supply of fibroids
• Myomectomy or radio frequency ablation
• Hysterectomy
• Treatment for infection and anemia
• Embolization
Medications
• Oral contraceptive pills
• GnRH agonists
• The antihormonal drug RU-486 (mifepristone)
• Danazol (Danocrine)
• Antifibrinolytics (tranexamic acid)
• Nonsteroidal anti-inflammatory agents
• Progesterone receptor modulator named EllaoneSurgery
• Myomectomy
• Hysterectomy
• Uterine artery embolization
• Uterine artery ligation
• Radio frequency ablation
• Endometrial ablationComplications of Uterine fibroid
• Menorrhagia.
• Abdominal pains
• Premature birth, labor problems, miscarriages
• Infertility
• Leiomyosarcoma
• Twisting of the fibroid
• Anemia
• Urinary tract infections
• A C-section may be needed
• Some pregnant women with fibroids have heavy bleeding immediately after giving birth.
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