Fibroids (also called myomas or leiomyomas) are benign growths that arise from the muscle layer of the uterus. They are usually discrete masses distinct from the surrounding uterus and they rarely become malignant. Fibroid tumors occur in about 50% of the female population. Uterine fibroids are the most common indication for hysterectomy and account for 33% of gynecologic hospital admissions.
Fibroid size can increase or remain the same during the reproductive years. They can occur as a single mass or mulitple growths in a variety of locations on the uterus. After menopause, however, growth usually ceases, and fibroids can actually shrink, as their growth is dependent on estrogen. Unfortunately, fibroids can recur following both medical and surgical therapy. For that reason consultation with an experienced gynecologic surgeon and fertility specialist is of utmost importance.
Submucous fibroids are located just under the inner lining of the uterus and can protrude into the uterine cavity.
Intramural fibroids are located within the muscle wall of the uterus.
Subserosal fibroids are located just under the outer covering of the uterus.
Pedunculated fibroids are attached to the uterus by a thin stalk.
Intraligamentous fibroids originate from the uterus but are located in the ligaments that support the uterus.
More than 50% of women with fibroids are asymptomatic. Symptoms depend on fibroid location and size and include: abnormal uterine bleeding, pelvic pressure, pelvic or back pain, constipation, urinary symptoms, infertility, and pregnancy complications.
Treatment of Fibroids
After a full evaluation, a treatment plan is made and tailored according to the patient's wishes, severity of symptoms, lifestyle, general health status, and desire for future childbearing. Options include observation, medical therapy (results are temporary), abdominal or laparoscopic surgery (including myomectomy, hysterectomy, and myolysis), hysteroscopic surgery, and embolization.
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