UTERINE FIBROIDS

a.k.a. Leiomyoma

“Leio” means ‘smooth’, ”myo” means ‘muscle’, and ”oma” means ‘tumor’.

• Smooth muscle tumor/growth → malignant counter part = Sarcoma

Symptoms:

1. Heavy uterine bleeding → AUB - Abnormal Uterine Bleeding, Menorrhagia
2. Dysmenorrhea
3. Pressure and bulk symptoms → Stress Incontinence
4. Infertility

Diagnosis:

• Physical exam
• Ultrasound
• MRI

Management:

• Expectant: Monitor fibroid shrinkage postpartum or with menopause
  • BW
  • US
• Medical Therapy: → if become symptomatic or affect QoL, symptomatic management of AUB - Abnormal Uterine Bleeding
  • NSAID
  • TXA - Tranexamic acid
  • Hormonal treatments
    • OCP
    • Progesterone-related drugs
    • LNG-IUD
    • GnRH agonists
• Interventional Radiology:
  • UAE if not interested in fertility
  • MRI-guided HiFU
• Surgery:
  • Considerations
  • Laparoscopic Removal
  • Hysterectomy/Myomectomy