Uterine fibroids are benign tumors that develop in the uterus. They are composed of smooth muscle and connective tissue and are the most common tumors found in females. The highest prevalence occurs in women between ages 35-45. While the exact cause is unclear, genetic and hormonal factors likely play a role. Fibroids can be asymptomatic but may cause heavy periods, pelvic pain, infertility, or pregnancy complications. Diagnosis involves ultrasound, MRI, or other imaging. Treatment options include medication, myomectomy (surgical removal of fibroids), hysterectomy (removal of the uterus), or embolization (blocking the blood supply).

1. UTERINE FIBROID
Dr. Yashika

2. Fibroid
 Commonest benign tumour in females.
 Histologically composed of Smooth
muscles fibres and fibrous connective
tissues.
 Aka lieomyoma, myoma and
fibromyoma.

3. Incidence
 Higher incidence in dark coloured females.
 More common in nulliparous or child bearing
age.
 Prevalence is higher in 35 – 45 years.

4. Aetiology
 Aetiology is unclear at present.
 Hypothesis
Chromosomal abnormality:
Rearrangement or deletion at chromosome 6
or 7.
Somatic mutations in myometrial cells.
Role of polypeptide growth factors :
Epidermal GF, Insulin-like GF Transforming
GF stimulate the growth.

5. UTERINE
FIBROIDS
Body
Interstitial /
Intramural
Subserous
Subserous
Pseudo
Parasitic
Submucous
Sessile
Peduncalate
d
Cervical
Anterior
Posterior
Central
Lateral

6. Types of Uterine Fibroids

7. Pathology
 Naked eye appearance:
Enlarged uterus, distorted shape.
Firm appearance on touch.
Cut section :
Smooth, whitish, whorled and trabeculation.
False capsule formation.
Periphery is more vascular.

8. Cut section of Uterine Fibroid

9. Secondary changes in fibroids:
 Degeneration
 Atrophy
 Necrosis
 Infection
 Vascular changes
 Sarcomatous changes

10. Clinical features
 Asymptomatic
 Menstrual abnormalities menorrhagia,
metrorhhagia
 Dysmenorrhoea
 Dyspareunia
 Infertility
 Recurrent pregnancy loss
 Abdominal enlargement
 Pelvic pain

11. Investigations
 USG
Pelvis, TVS
 MRI
 HSG
 Hysteroscopy
 Uterine curettage

12. Management of Uterine
Fibroids
Symptomatic
Medical Surgery
Myomectomy
Hysterectomy
Myolysis
Embolothera
py
Asymptomati
c
Regular
supervision
Surgery

13. Medical Management
Objectives :
 To improve menorrhagia
 To correct anaemia
 To reduce vascularity and size of tumour
 To postpone surgery

14. Drug Therapy
 Antiprogesterones (Mifeprestone)
 Danazol
 GnRH analogues
 LNG-IUS
 Prostaglandin synthetase inhibitors.

15. Surgical Management of Uterine
Fibroids
 Myomectomy
 Embolotherapy
 Hysterectomy

16. Cervical Fibroids
Symptoms :
 Anterior Cervical Fibroids
 Posterior Cervical Fibroids
 Lateral Cervical Fibroids
 Central Cervical Fibroids

17. Treatment
 Supravaginal cervix : Myomectomy
 Infravaginal cervix :
a. Sessile tumour : Myomectomy
b. Pedunculated tumour :
Polypectomy