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Uterine Fibroids

Obstetrics and GynaecologyReproductive Medicine

Uterine Fibroids, also known as Uterine Leiomyomas, are non-cancerous tumours of the female reproductive organ. They typically develop in the muscular layer of the uterus and are considered benign tumours. Uterine fibroids are a common gynaecological issue, especially among women of reproductive age.

Classification of Uterine Fibroids

Uterine fibroids can be classified based on their location and uterine growth characteristics. Here are some common types of uterine fibroids:

Pedunculated Fibroids:
Pedunculated fibroids are a type of uterine fibroid with a stalk or pedicle, allowing it to protrude or attach to the surface of the uterus. It may affect its movement and position.
Intramural Fibroids:
Intramural fibroids grow within the muscular wall of the uterus. It is the most common type of uterine fibroid and typically directly influences the shape and size of the uterus.
Submucosal Fibroids:
Submucosal fibroids grow on the inner wall of the uterine cavity and may protrude into the uterine cavity. It can lead to abnormal menstrual patterns and other related symptoms.
Intraligamentous Fibroids:
Intraligamentous fibroids grow within the uterine ligaments, which are structural connecting tissues. It may affect surrounding structures.
Subserosal Fibroids:
Subserosal fibroids grow on the outer surface of the uterine muscle layer and may protrude onto the surface of the uterus. It can exert pressure on adjacent organs.

These classifications are primarily based on uterine fibroids' location and growth characteristics. Different types of uterine fibroids may have varying effects on symptoms and treatment. Therefore, doctors may consider the specific kind of fibroid during the diagnosis and treatment process.

Symptoms

Most uterine fibroid patients do not have apparent symptoms, and among those with symptoms, their manifestations are influenced by the location, size, and quantity of uterine fibroids.

Menstrual Irregularities: This includes excessive menstrual flow, shortened menstrual cycles, and other abnormalities.
Pelvic Pain: Pelvic discomfort or a sensation of pain may accompany the presence of uterine fibroids.
Frequent Urination: The pressure from uterine fibroids may lead to increased frequency of urination.
Difficulty Urinating: Larger uterine fibroids could exert pressure on the bladder, causing difficulty in urination.
Abdominal Bloating: The enlargement of uterine fibroids may result in a feeling of abdominal bloating.
Pain or Pressure Sensation: Pain or pressure may be felt in the pelvic region.

It's important to note that each patient's symptoms may vary, and some individuals may experience no noticeable symptoms. If there is suspicion of uterine fibroids or the presence of related symptoms, seeking professional medical advice and examination is recommended.

Factors

The exact cause of uterine fibroids is not clear, but it may be related to female hormone levels, genetic factors, and other physiological factors.

Age: Uterine fibroids are more common in women of reproductive age.
Race: African-American women are more prone to uterine fibroids than women of other races.
Family History: Women with a family history of uterine fibroids have a higher risk.
Hormone Levels: Changes in hormone levels may influence the development of uterine fibroids.

Diagnosis and Treaments

Diagnostic methods

Medical history inquiry: Including menstrual conditions and symptoms.
Physical examination: The doctor may perform a pelvic exam.
Ultrasound examination: Using ultrasound imaging to examine the location, size, and number of uterine fibroids.
Other imaging tests: such as MRI or CT scans, are needed for a more detailed understanding of the characteristics of uterine fibroids.

Treatment methods

Medication: Hormone therapy or non-steroidal anti-inflammatory drugs relieve symptoms.
Laparoscopic Surgery: Utilizes laparoscopic assistance for procedures including hysterectomy (removal of the uterus) or myomectomy (removal of uterine fibroids).
Uterine Artery Embolization: Blocks the blood supply to uterine fibroids, reducing their size and preserving the uterus and its function.
HIFU (High-Intensity Focused Ultrasound) Treatment: Involves using focused ultrasound technology to remove uterine fibroids. This procedure leaves no incisions, minimizes damage to surrounding tissues, and preserves the uterus and its function.

FAQ

Uterine Fibroids are typically non-cancerous tumours and are usually benign. They grow in the uterus's muscular layer, not the uterine lining. While Uterine Fibroids themselves are not cancerous, in sporadic cases, they may develop into a rare form of cancer known as "Leiomyosarcoma."

Uterine Fibroids originate from the muscular layer of the uterus, while adenomyosis involves the uterine lining (Endometrium). Uterine Fibroids and adenomyosis differ in their causes and symptoms.

Yes, pregnant women can also have uterine fibroids. During pregnancy, the growth of uterine fibroids may be influenced by hormone levels, but in most cases, it does not significantly impact pregnancy.

Yes, medication is a viable treatment option for managing symptoms of uterine fibroids. Hormonal medications or non-steroidal anti-inflammatory drugs (NSAIDs) can be used to alleviate associated discomfort.

Recovery time varies depending on the nature of the surgery and individual patient conditions. Generally, more minor surgeries may have shorter recovery periods, while more extensive procedures like total hysterectomy may require a longer recovery.

There is a possibility of uterine fibroid recurrence, especially for those who have not undergone a total hysterectomy. Regular follow-up appointments and monitoring are crucial to ensure the early detection and management of any recurrence.