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    Uterine Fibroids

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    Shoaib Akhtar
    The document discusses uterine fibroids, including their definition, risk factors, classification, natural history, clinical features, investigations, and treatment options. Uterine fibroids are benign tumors that originate in the uterus and affect around 40% of women. Treatment options include conservative treatments to reduce size and bleeding, surgical procedures like myomectomy and hysterectomy, and radiological procedures.

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    Uterine Fibroids

    Uploaded by

    Shoaib Akhtar
    12 views25 pages
    The document discusses uterine fibroids, including their definition, risk factors, classification, natural history, clinical features, investigations, and treatment options. Uterine fibroids are benign tumors that originate in the uterus and affect around 40% of women. Treatment options include conservative treatments to reduce size and bleeding, surgical procedures like myomectomy and hysterectomy, and radiological procedures.

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    The document discusses uterine fibroids, including their definition, risk factors, classification, natural history, clinical features, investigations, and treatment options. Uterine fibroids are benign tumors that originate in the uterus and affect around 40% of women. Treatment options include conservative treatments to reduce size and bleeding, surgical procedures like myomectomy and hysterectomy, and radiological procedures.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    12 views25 pages

    Uterine Fibroids

    Uploaded by

    Shoaib Akhtar
    The document discusses uterine fibroids, including their definition, risk factors, classification, natural history, clinical features, investigations, and treatment options. Uterine fibroids are benign tumors that originate in the uterus and affect around 40% of women. Treatment options include conservative treatments to reduce size and bleeding, surgical procedures like myomectomy and hysterectomy, and radiological procedures.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 25

    AMMAR ALI

    ROLL No: 186

    TOPIC ASSIGNED:
    UTERINE FIBROIDS
    UTERINE FIBROIDS
    • Definition:
    Benign Tumor that originates from
    smooth muscle layer and accompanying connective
    tissue of uterus is called uterine fibroid.
    • INCIDENCE:
    40% of women.

    • RISK FACTORS:
     Family History
     Nulliparous
     Obesity
    • CLASSIFICATION:
    oFibroids commonly are

    i. Submucosal
    ii. Intramural
    iii. Sub serosal
    iv. Cervical

    oFibroids uncommonly arise from


    Broad ligament of uterus.
    NATURAL HISTORY :
    • Growth of fibroids:
     Uterine fibroids are estrogen dependent.

     With advancing reproductive age , size of fibroid


    increases.
    • Regression of fibroids:
    At menopause , estrogen level decreases . So, they
    undergo degenerative changes.
     Three forms of degenerative changes:
    1. Red: hemorrhagic and necrosis within fibroid.
    2. Hyaline : Asymptomatic softening and liquefaction
    of fibroid.
    3. Cystic : Asymptomatic cystic spaces in center.
    Clinical features:
    •Symptoms:
    1. Abnormal uterine bleeding.
    2. Reproductive failure.
    3. Subfertility.
    4. Recurrent miscarriages.
    5. Bulk effect on adjacent structures of pelvis.
    6. Pressure and pain.
    7. Bladder and bowl dysfunctioning.
    8. Abdominal distension.
    • Signs:
    General signs of anemia
     Abdominal examination : Palpable abdominal mass
    arising from pelvis.
     Pelvic Bimanual Examination : Enlarged , firm , smooth
    , non tender , uterus palpable.
    INVESTIGATIONS:
    1.Transvaginal ultrasound scan:
    A)Helps to detect and locate submucosal and
    intramural Fibroids.
    B) Helps to differentiate uterine fibroid from
    ovarian tumor.
    2. Transabdominal ultrasound scan:
    Helps to detect intramural and sub serosal fibroids.
    3.Saline infusion sonogram:
    to confirm location of submucosal fibroids.
    4. Hysteroscopy:
    A) to detect submucosal fibroids.
    B) to plan surgery
    C) surgical hysteroscopy removes polyps , adhesions ,
    submucosal fibroids.
    5. MRI:
    It demarcates morphology, size and location of uterine
    fibroid.
    TREATMENT:
    1. Conservative treatment:
    Aim of this is to;
    i. Decrease size of fibroid.
    ii. Blood loss.
    A) To decrease size of fibroid
    1.GnRH agonist: leuprolide
    2.Selective progesterone receptor modulator : Ulipristal
    acetate.
    3.Progesterone receptor antagonists: mifepristone.
    4. Aromatase inhibitor: letrozole.
    B)To decrease blood loss:
    1.Transexamic acid/ Mefenamic acid.
    2.Combined oral contraceptive pills.
    3. Levonorgestrel releasing intrauterine system.
    2.Surgical Therapy :
    A) Hysteroscopic myomectomy:
    only for small submucosal fibroids.
    B) Myomectomy.
    Advantages: it spares fertility and treat heavy
    mensturual bleeding.
    Disadvantage: 1% of cases there is risk of heavy bleed
    during surgery so there is possibility of unplanned
    hysterectomy .
    C) Hysterectomy:
    Advantage: prevents fibroids recurrence.
    Complications :
    1. Sepsis.
    2. Shock.
    3. DVT.
    4.bladder dysfunction.
    5. bowel dysfunction
    3.Radiological:
    A) Uterine artery embolization:
    B) Advanced techniques:
    1) MRI guided transcutaneous focused ultrasound .
    2) Trans cervical intrauterine ultrasound guided
    radiofrequency ablation.

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