fibroids

Question 1

what are fibroids

Answer 1

benign smooth muscle tumours of the uterus (leiomyomas)

Question 2

are fibroids oestrogen dependent

Answer 2

yes- enlarge in pregnancy, on COC and atrophy after menopause

Question 3

what happens if they degenerate gradually or suddenly

Answer 3

red degeneration

Question 4

presentation

Answer 4

menorrhagia, fertility problems (interfere with implantation), pain (torsion, red degeneration), mass (if large may be felt abdominally)

Question 5

treatment

Answer 5

in many no treatment is needed. myomectomy. embolising fibroids (shrinks them)

Question 6

presentation red degeneration

Answer 6

abdominal pain +- vomiting and low grade fever, localised peritoneal tenderness. analgesia

Question 7

complications myomectomy

Answer 7

torrential bleeding requiring hysterectomy, post op adhesions

Question 8

what does torsion resemble

Answer 8

acute abdomen. required urgent surgery

Question 9

fibroids in pregnancy

Answer 9

most arise from body of uterus so don’t obstruct labour, but if large pelvic masses of fibroids- C section