Fibroids: Clinical information.
1. Fibroids are the most common Benign uterine abnormality encounter in women these days.
2. Women often experience menstrual problems such as abnormal periods and/or painful periods.
3. Depending on the location fibroids can cause pressure on the pelvis and the bladder causing urinary frequency.
4. Depending on the location they may cause infertility as well.
Fibroids are composed of smooth muscles and connective tissue.
2. They may contain calcifications.
3. During pregnancy, fibroids might grow rapidly due to increased blood flow on the uterus.
4. A rapid fibroid growth might lead to infarction and degeneration causing significant pain.
Fibroids are classified by the location.
Subserous Fibroids: These project to the uterine serosa which is the outer layer of the uterus. They are problematic when they are large and indenting surrounding organs.
Pedunculated or exophytic Fibroids: This is the type of fibroid that is located entirely outside the uterus. They must be connected to the uterus by a stalk-like growth called peduncle.
Intramural Fibroids: Those fibroids are predominantly located within the Myometrium ( uterine muscle ). They rarely lead to significant clinical problems unless they are large >5cm.
Submucosal or Submucous Fibroids: These are the most clinically important fibroids, which account for only 5% of all uterine fibroids. Small and Medium Submucosal fibroids cause classic symptoms like Abnormal and Painful periods and more importantly, these are the fibroids that can cause Infertility. Submucosal fibroids can be removed from the cavity with a Procedure called Hysteroscopy.
Classification System used by hysteroscopic surgeons for submucous fibroids.
Type 0: Entirely within the cavity.
Type 1: Mostly within the cavity ( >50% of fibroid within the endometrial cavity.
Type 2: Mostly outside the cavity ( <50% of fibroid located outside the cavity within the myometrium.
Type 2 of submucosal fibroids are NOT considered for hysteroscopy resection.
If the Fibroids cannot be Removed with a Hysteroscopy then a Myomectomy will be necessary.
Retroverted Uterus / Subserosal Fibroid / Transvaginal scan.
Anteverted Uterus / Pedunculated Fibroid / Transabdominal scan.
Anteverted uterus / Intramural fibroid / Transabdominal scan.
Anteverted Uterus / Submucosal fibroid / Transabdominal scan.
The last image represents the various degree of Submucosal Fibroids.
Well this resumes the most important aspects of fibroids, on my next post I will be talking about Abnormalities of the endometrium ( cavity), thank you for staying until the end.
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