Fibroid


 

Fibroid is a non-cancerous disorder. It can be found in the uterus or the cervix. The medical terminology of fibroid is leiomyoma. It is an estrogen dependent tumour. There are 3 types of uterine myoma: submucous, intramural and subserosal.

It may be totally asymptomatic. The signs and symptoms may be variable depending on the type of the tumour.

Menorrhagia: It presents on submucosal variety. It may be increased quantity or duration. This is because the tumour is hypervascular. Subserosal and cervical fibroids are not associated with menstrual symptoms.

Anemia: may be a direct consequence of menorrhagia. The haemoglobin levels fall frequently to 7 to 8 g/dl.

Symptoms of compression: Seen in sub serosal fibroid. It presents as discomfort or pain in pelvis or urinary frequency or constipation.

Infertility: Pregnancy related problems like abortion, preterm labour and intrauterine growth retardation chances are high.

Tests:

The history of the patient , clinical examination. The abdomen and uterus is palpated by the physician.
USG ( to differentiate from ovarian mass or pregnancy)
Hysterosalpingography (for submucosal fibroid).

Complications of fibroid:

Haemorrhage
infection, can lead to peritonitis or septicaemia
Torsion,
Necrosis and
Cancer(Sarcoma)

Treatment:

Treatment is surgical. Hysterectomy ( Removal of uterus) and myomectomy. Myomectomy has chance of recurrence or persistence. Hystererectomy can be total or partial and can be done by laparatomy (abdominal surgery) or laparoscopic ( through laparoscopy).

Medical treatment is supportive. Antifibrinolytics to decrease blood loss.
Antiprogesterones decrease size of the tumour and decrease bleeding.

Wandering fibroid or Parasitic fibroid

If a fibroid outside the wall of the uterus attaches to other organs, especially the omentum, they derive their blood supply from these structures and the uterine stalk either disappears completely or becomes devoid of blood supply. It is known as parasitic or ectopic fibroid. It is rare and its unusual places and symptoms can confuse us with the test results and require a histopathology on microscopy for confirmation of the diagnosis.


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