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MYOMA ( FIBROID)
MAGDY ABDELRAHMAN MOHAMED2015
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Nomenclature Fibroid--------Fibroids
Myoma--------Myomata
Fibromyoma—Fibromyomata
Leiomyoma---Leiomyomata
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• 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.
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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.
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Types• Subserosal:
protrudes out of serosal surface.• Cervical: located in the cervix, rather than uterine corpus.
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Clinical picture
•Symptoms• Bleeding.• Infertility.• Vaginal discharge.• Pain.• Abdominal enlargement.• Pressure symptoms.
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Clinical picture
• Signs.• Pelvi-abdominal mass.• Bimanual examination.
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Investigations • Abdominal & vaginal u/s.• Saline infusion sonohysterography.• Hysteroscopy.• Routine pre-operative investigation.
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Complications
• Tortion.• Infection.• Red degeneration.• Malignancy (leiomyosarcoma), Very rare.
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Treatment
• Factors affecting treatment.• Age.• Parity.• Number of fibroid.
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Treatment
• No symptoms…… no treatment.• Medical:
• GnRH agonist.• Correction of anemia
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Treatment
• Myomectomy.• Safe, possible & needed.
• Hysterectomy.• Recent options.
• Uterine artery embolization.• Focused U/S.
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Fibroid during pregnancy.• Increase incidence:
• Abortion• Preterm labour.• Pain• Malpresentation.• CS.• Post partum He.
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Fibroid during pregnancy.• Myomectomy during CS.
• Contraindicated.• Done only in rare situations.
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