Fibroid uterus

Fibroid Uterus

Define fibroid Uterus  : It is a benign tumor of myometrium composed of non – striated (smooth) muscle with supported fibrous tissue enclosed in a pseudo capsule.

We have described :

what are the types of fibroid?

Risk factors of fibroid

Clinical features of fibroid uterus.

Investigations of fibroid uterus

Management of fibroid uterus

Complication of Fibroid Uterus


what are the types of fibroid?


Types of fibroids:

A. Body (corporeal) :

  1. Interstitial (intramural) : Those embedded within the myometrium.
  2. Subserous ( sub peritoneal) :  Those occur beneath the covering serosa.
  3. Submucous : Those occur beneath the endometrium.
  •    Sessile
  •    Pedunculated

B. Cervical : It is usually confined to the supra vaginal part of cervix.

  1. Anterior
  2. Posterior
  3. Central
  4. Lateral


Risk  factors of fibroid : 

  • Increased risk : 
  1. Nulliparity.
  2. Obesity.
  3. Hyperoestrogenic state.
  4. Black women.
  5. High fat diet.
  6. Family history.


How will you manage a case of fibroid uterus?


Management of fibroid uterus : 


Clinical features:


  1. Asymptomatic-majority cases.
  2. Menstrual disturbance: Menorrhagia, Metrorrhagia, dysmenorrhoea
  3. Dyspareunia
  4. Infertility
  5. Pressure symptoms : Constipation, dysuria, retention of urine.
  6. Recurrent pregnancy loss : Miscarriage, preterm labour.
  7. Lower abdomen or pelvic pain
  8. Abdominal enlargement.

Sign : 

A. General examination :

  1. Anaemia
  2. Rapid pulse.
  3. Decreased blood pressure.
  4. Varicosit

B. Abdominal examination : 

  1. Inspection : Lower abdomen is swelling
  2. Palpation : A lump in the lower abdomen which is 
  •     Rounded, smooth or lobulated
  •     Firm in consistency.
  •     Non tender
  •     Mobile from side to side but not from above downwards as fixed with ligaments.

3. Percussion : Dull on percussion.

C. per vaginal examination:

  1. A mass is felt which is smooth , hard or firm and non tender.
  2. The mass moves with the movement of the cervix.
  3. The mass cannot be separated from the uterus.

Investigations of Fibroid uterus:

  1. USG of the lower abdomen and pelvis.
  2. Colour Doppler (TVS)
  3. MRI
  4. Laparoscopy.
  5. Hysteroscopy
  6. Uterine curettage

Treatment of fibroid uterus:

 Symptomatic treatment : 

A. Medical treatment: 

  1. Anti Progesterones : Mifepristone (25-30 mg) for 3 months.
  2. Danazol : Used only for a period of 3-6months.
  3. GnRH agonists : Gosereline, Luporeline, buserelin, naferelin.
  4. GnRH antagonists : Cetrorelix, ganireflix.
  5. Anti – fibrinolytics : Tranexamic acid.
  6. Prostaglandin synthetase inhibitors.
  7. Levonorgestrel – releasing intrauterine system.

B.Surgical treatment :

  1. Myomectomy : May be done by laparotomy, laparoscopy or hysteroscopy
  2. Embolotherapy.
  3. Myolysis.
  4. Hysterectomy : Best treatment for uterine fibroids in women age > 40 years and the family is complete.


Asymptomatic treatment

  1. Observation: The judicious observation may be instituted in cases: 
  •     Size <12 weeks.
  •     Diagnosis certain
  •     Follow up possible

2. Surgery: If the symptoms of fibroid appear and it grows and increases in size surgery is indicated.

Complication of Fibroid Uterus.

  1. Haemorrhage.
  2. Intracapsular.
  3. Intraperitoneal.
  4. Necrosis
  5. Infection
  6. Sarcomatous Changes

5 Responses

  1. I found your weblog website on google and test a couple of of your early posts. Continue to maintain up the superb operate. I just additional up your RSS feed to my MSN Information Reader. Searching for ahead to reading extra from you later on!…

  2. Terrific work! This is the type of info that should be shared around the web. Shame on the search engines for not positioning this post higher! Come on over and visit my web site . Thanks =)

  3. tlovertonet says:

    Good day! I know this is somewhat off topic but I was wondering if you knew where I could locate a captcha plugin for my comment form? I’m using the same blog platform as yours and I’m having trouble finding one? Thanks a lot!

  4. kkslot777 says:

    Heya i am for the first time here. I came across this board and I in finding It truly helpful & it helped me out much. I hope to give one thing again and aid others such as you aided me.

  5. Bom88 says:

    As soon as I detected this web site I went on reddit to share some of the love with them.

Leave a Reply

Your email address will not be published. Required fields are marked *