Definition of "Uterine fibroid"

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Uterine fibroid (aka fibroleiomyoma) is a leiomyoma (i.e. benign tumor from smooth muscle tissue) of the myometrium (i.e. smooth muscle layer) of the uterus. Fibroids are often multiple. Diffuse uterine leiomyomatosis is where the uterus contains too many to count.

Patient information

What is a fibroid, and how does it differ from adenomyosis? I know they're both non-cancer growths, but... what is the difference?
Uterine fibroids are growths arising from the smooth muscle of the womb. Adenomyosis is probably the most easily to get confused with a fibroid. Adenomyosis is where tissue usually found in the endometrium (which lines the womb), makes it's way into the smooth muscle of the uterus. So the difference is whereas "fibroid" is growth of tissue from the same location, "adenomyosis" is tissue from elsewhere that's made it's way there.

How about polyp or cyst?
On the other hand, polyps are growths arising from the endometrial lining of the uterus. So whereas "fibroid" is made of muscle tissue, "polyps" is made of endometrial tissue. Now as for ovarian cysts... they are in a totally different class! They are fluid-filled cavities within the ovary. So whereas cysts are filled with fluid, and fibroids have dense tissue.

Sx
  • Most are asymptomatic
  • If they grow, they can cause:
    • Bleeding, specifically, menorrhagia (heavy mensturation) and dysmenorrhea (painful menstruation)
    • Pelvic pain
    • Dyspareunia (painful sex)
    • Urinary frequency
    • Urgency
    • Painful defecation

Patient information

What happens if you have growth arising from smooth muscle of the womb?
Usually, nothing happens. But if it grows, it can cause bleeding. Pelvic pain. Pain during sex. It can also cause problems with other nearby systems, including both number 1's and 2's. So having to pee a lot. Having sudden urges to pee. And pain with pooping.

Tx
  • Most fibroids do NOT require Tx unless they are causing Sx
  • Drugs, including:
  • Uterine artery embolization, a noninvasive procedure that blocks blood flow to fibroids
  • Myomectomy, surgery to remove 1+ fibroids. It is recommended when more conservative Tx fail for women who want fertility preserving surgery, or who want to retain the uterus. It can be done hysteroscopic, laparoscopic, or laparotomic
  • Hysterectomy (surgical removal of the uterus), the classical method to Tx fibroids, but now recommended only as last option
  • Endometrial ablation, is used if the fibroids are only within the uterus, and not intramural and relatively small
  • RF ablation, is minimally invasive Tx for fibroids, where it is shrunk by inserting a needle like device into the fibroid through the abdomen, and heating it with RF electrical energy to cause necrosis of cells

Patient information

What can you do about a growth arising from smooth muscle of the womb?
You don't usually need to do anything unless it's causing problems. If there's pain, you can give NSAID's. OCP's and IUD's can help address period pain or cramping. Iron for low RBC's. You can also do surgeries.

What surgeries can you do?
You can block blood flow to the fibroids, thus killing them. You can surgically remove the fibroid. You can remove the womb. If the fibroid is just found on the inside of the womb and not deep, you can destroy the womb lining.

Prognosis
  • After menopause, fibroids shrink
  • The cancerous version of a fibroid is a leiomyosarcoma, and is extremely uncommon
  • Some fibroids may interfere with pregnancy, although this appears to be uncommon
Epidemiology
  • Most common benign tumors in females
  • Typically found during the middle and later reproductive years

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Definition of Uterine fibroid | Autoprac


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