Fibroids Flashcards
What is a fibroid?
Benign tumour of the smooth muscle of the uterus
What are fibroids associated with?
Afro-Caribbean ethnicity
Post pubertal-thought to grow in response to oestrogen
What are symptoms of fibroids?
Asymptomatic Menorrhagia- leading to iron deficient anaemia Dysmenorrhoea Urinary symptoms- frequency esp if large Bloating Subfertility
How are fibroids diagnosed?
Transvaginal USS
What is the management of fibroids?
Asymptomatic- no treatment required
Menorrhagia
- IUS unless uterine distortion
- NSAIDs- mefenamic acid
- Tranexamic acid
- COCP
- POP
- Depot
Treatment to shrink or remove fibroids
What are treatment options to shrink or remove fibroids?
Medical
- GNRH antagonists
- reduce size of fibroids- short term management and often regrow after stopping treatment
- good to have pre-operatively
- does not aid in subfertility management
Surgical
- Myomectomy= 1st line to aid fertility return
- hysteroscopy with endometrial ablation
- hysterectomy
Uterine artery embolisation
What are some of the complications of fibroids?
Subfertility
Iron deficient anaemia
Red degeneration
-occurs especially during pregnancy
-rely on oestrogen to grow
-during pregnancy there is increased oestrogen so they grow and can out-grow their blood supply and degenerate
-patients present with abdo pain, mild fever and vomiting
-conservative management with analgesia and rest
-resolve sin 4-7 days