Fibroids

Question 1

Fibroids Definition

Answer 1

• Benign monoclonal tumours of the smooth muscle cells, large amount of extracellular matrix with disordered collagen
• Classified according to their position; submucosal, intramural, subserosal

Question 2

Fibroids Epidemiology

Answer 2

• 77% of women
• In 40s
• Black ethnicity
• Hypertension

Question 3

Fibroids Presentation

Answer 3

• Up to half have no symptoms
• Usually present between 30 and 50
• Pain, menorrhagia, pressure symptoms
• Infertility is possible but rare and resolves with removal
• Examination: irregular mass on bi-manual

Question 4

Fibroids Differentials

Answer 4

Dysfunctional uterine bleeding, polyps, cancer, endometriosis, pregnancy

Question 5

Fibroids Ix

Answer 5

• Pregnancy test may be indicated
• FBC (anaemia), iron studies
• USS
• Endometrial sampling for abnormal bleeding

Question 6

Fibroids Management

Answer 6

Pharmacological
-NSAIDS
-Tranexamic acid
Surgical when
-Excessive enlargement
-Pressure symptoms
-Medical management failed
-Fibroid is submucous and fertility is desired
-Myomectomy (if fertility desired), hysterectomy (if fertility not desired)

Question 7

Fibroids Complications

Answer 7

-Iron deficiency anaemia, frequency, constipation, infertility

Question 8

Fibroids Prognosis

Answer 8

Typically regress with the menopause and symptoms resolve