fibroids Flashcards
which hormone are fibroids sensitive to?
oestrogen
what is another word for fibroids?
leiomyomas
what are the 4 types of fibroids?
- intramural- grow within the myometrium
- subserosal- just below the outer layer of the uterus-> they can become very large and fill the abdominal cavity
- submucosal-> just below then inner lining of the uterus
- pedunculate-> on a stalk
how can fibroids present?
- heavy menstural bleeding
- menstural bleeding more than 7 days
- urinary and bowl symptoms- feeling full
- deep dyspareunia
- reduced fertility
what age does fibroids present?
late reproductive years
which ethnicity is affected by fibroids more?
black
when do fibroids need to be referred to gynaecology to be managed?
when they are >3cm
what is the management for fibroids <3cm?
the same as menorrhagia;
- Mirena coil - must be <3cm with no distortion of the uterus
- NSAIDS and TXA
- COCP
- cyclelical progestogens
what are surgical options for managing fibroids?
- myomectomy
- uterine artery embolisation
- endometrial ablation
- hysterectomy
what investigations can you do for fibroids?
- hysteroscopy-> for submucosal fibroids
- pelvic USS- choice for larger fibroids
- MRI scanning-> considered before surgery to get a better idea od the size and shape of the fibroid
what are complications of fibroids?
Heavy menstrual bleeding, often with iron deficiency anaemia
Reduced fertility
Pregnancy complications, such as miscarriages, premature labour and obstructive delivery
Constipation
Urinary outflow obstruction and urinary tract infections
Red degeneration of the fibroid
Torsion of the fibroid, usually affecting pedunculated fibroids
Malignant change to a leiomyosarcoma is very rare (<1%)
which fibroids are more likely to undergo red degeneration?
> 5cm
how does red degeneration of fibroids present?
Red degeneration presents with severe abdominal pain, low-grade fever, tachycardia and often vomiting. Management is supportive, with rest, fluids and analgesia.
- more likey in pregnant women
