Fibroids

Question 1

What is a fibroid and what one causes the most problems?

Answer 1

This is a benign tumour of the myometrium

Submucosal

Question 2

In what demographic are fibroids more common?

Answer 2

Afro-Carribean

Question 3

What are the risk factors for fibroid?

Answer 3

• Early menarche
• 0 parity
• Obesity

Question 4

What is the typical presentation of fibroids?

Answer 4

1. Menorrhagia
2. Longer period
3. Dysmenorrhea
4. No intermenstrual or post coital bleeding

Also

1. Anaemia
2. Pressure urinary symptoms

If they ar near vagina you may get dyspeuronia

Question 5

What would you find on examination?

Answer 5

• Firm mass in the pelvis
• Blood on cusco speculum
• adnexal tenderness

Question 6

What investigations would you do?

Answer 6

• Pregnancy test
• US
• Bloods - FBC, CA125, BHCG
• Outpatient endometrial biopsy if >40

Question 7

What are the complications of fibroids?

Answer 7

• Torsion
• Infection
• Cancer

Question 8

What are the three treatment pathways for fibroids?

Answer 8

1. conservative
2. medical
3. surgical

Question 9

What is the conservative option?

Answer 9

Explain what it is and do nothing. This is a good option if there is no pain

Question 10

What are the medical options? (Four)

Answer 10

1. Transexmic Acid
2. GNRH analogues
3. COCP
4. Esyma (lowers FSH/LH and reduces susceptibility to progesterone

Question 11

What are the surgical options for fibroids? (3)

Answer 11

1. Myomectomy - Surgical removal
2. Hysterectomy
3. Uterine artery embolization

Question 12

What is a myomectomy?

Answer 12

Surgical removal of fibroids

Question 13

What is uterine artery embolization?

Answer 13

Cutting off blood supply via the uterine artery to reduce flow

The uterus still gets blood via the anastamosis with the ovarian artery