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