22) Uterine Fibroids

Question 1

What is the Definition of Uterine Fibroids?

Answer 1

• Also known as Leiomyomas
• Which are localised BENIGN SMOOTH MUSCLE Tumors of UTERUS
• They’re Hormone-Sensitive as it’s stimulated by OESTROGEN
• Affect women aged 25 - 40

Question 2

What are the Causes for UF?

Answer 2

• Nullparity (NEW)
• Early Menarche
• Obesity
• Family History

Contribute to HIGH OESTROGEN Levels

Question 3

How are Uterine Fibroids CLASSIFIED?

Answer 3

1) Submucosal - under endometrium

2) Intramural (MOST COMMON) - within myometrium / uterine wall

3) Subserosal - below serosa and grows OUTWARDS

Question 4

What are the Clinical Features of UF?

Answer 4

• MeTRorrhagia - (Bleeding AT IRREGULAR Intervals)
• MeNorrhagia - (HEAVY MENSTRUAL Bleeding)
• Bimanual Pelvic Exam = Shows Enlarged, Firm Uterus
• Infertility
• UTI Symptoms - Frequency, Retention, Incontinence
• Abdominal / Pelvic Pain
• Foul-Smelling Discharge

Question 5

What is the Diagnosis for UF?

Answer 5

• Abdominal Exam = Shows irregular nodular tumors against abdo-wall
• Pelvic Exam = Shows Uterine Enlargement

IF SYMMETRIC = SUBMUCOSAL
IF MOVES FREELY = SUBSEROSAL

• Pelvic US / CT / MRI
• Endometrial Biopsy = TO RULE OUT MALIGNANCY

Question 6

What is the Treatment for UF?

Answer 6

FOR HEAVY MENSTRUAL BLEEDING

• Gonadotropin-RH Agonists
• IUD
• Combined Oral Contraception

SURGICAL - Myomectomy or Hysterectomy

UTERINE ARTERY EMBOLISATION