myoma

MYOMA ( FIBROID)

MAGDY ABDELRAHMAN MOHAMED2015

Nomenclature Fibroid--------Fibroids

Myoma--------Myomata

Fibromyoma—Fibromyomata

Leiomyoma---Leiomyomata

• Fibroids (leiomyomas) are benign smooth muscle cell tumors of the uterus.

• Incidence:• Commonest tumour in female genital

system.• More common in low parity, black races.

Types

• Described based on location in the uterus:• Interstitial: develop from within uterine

wall, do not distort uterine cavity.• Submucosal: develop from myometrial

cells just below endometrium, often protrude into and distort uterine cavity.

Types• Subserosal:

protrudes out of serosal surface.• Cervical: located in the cervix, rather than uterine corpus.

Clinical picture

•Symptoms• Bleeding.• Infertility.• Vaginal discharge.• Pain.• Abdominal enlargement.• Pressure symptoms.

Clinical picture

• Signs.• Pelvi-abdominal mass.• Bimanual examination.

Investigations • Abdominal & vaginal u/s.• Saline infusion sonohysterography.• Hysteroscopy.• Routine pre-operative investigation.

Complications

• Tortion.• Infection.• Red degeneration.• Malignancy (leiomyosarcoma), Very rare.

Treatment

• Factors affecting treatment.• Age.• Parity.• Number of fibroid.

Treatment

• No symptoms…… no treatment.• Medical:

• GnRH agonist.• Correction of anemia

Treatment

• Myomectomy.• Safe, possible & needed.

• Hysterectomy.• Recent options.

• Uterine artery embolization.• Focused U/S.

Fibroid during pregnancy.• Increase incidence:

• Abortion• Preterm labour.• Pain• Malpresentation.• CS.• Post partum He.

Fibroid during pregnancy.• Myomectomy during CS.

• Contraindicated.• Done only in rare situations.