Uterine fibroids are benign tumors that develop in the uterus. They affect around 40% of women by age 40. Risk factors include obesity, family history, never giving birth, and early menarche. Symptoms include heavy bleeding, pelvic pain, and pressure. Diagnosis involves pelvic exam, ultrasound, and other imaging tests. Treatment options include medication to shrink fibroids, surgical procedures like hysterectomy or myomectomy, and minimally invasive procedures such as uterine artery embolization.

1. UTERINE FIBROID
Presented by:
Suvetha.G
Tutor
VMCON

2. DEFINITION:
 Uterine fibroids (also reffered to as uterine
leiomyoma or uterine myomas) are abnormal
growths, or benign tumors that originate in the
tissue of the uterus.
 Uterine fibroids are made up of fibrous connective
tissue.
 These are common and occur in about 40% of
women by the age of 40.

3.  It is a usually slow growing up, irregularly shaped
and benign (non cancerous) tumours.
 Uterine fibroids can vary considerably in size,
they may be very small or larger than a grapefruit
and can occur as a single growth or as a cluster of
growths

4.  Fibroids can develop in different types of uterine
tissues
 The most common type develops within the muscular
wall of the uterus
 Other types can develop in uterine lining,on the
outside of the uterus or can grow into the uterine
cavity.

6. CAUSES AND RISK FACTORS :
The following factors have bdeen associated with the
growth of fibroids :
 Being overweight, obesity
 Hereditary
 Never having given birth to a child
 Onset of menstural period prior to age 10
 Alterations in growth factor (proteins formed in the
body that direct the rate and extent of cell
proliferation expression)
 Tissue injuries

7.  Abnormalities in vascular (blood vessels) system
 Fibroids are stimulated by the harmone estrogen,
produced naturally in the body. These growths can
show up early as age 20 and shrink after menopause
when your body stops producing large amounts of
estrogen.
 Age is a risk factor for uterine fibroids
 Women who are of childbearing age(between puberty
and menopause) are at increased risk for developing
fibroids.

8. CLINICAL MANIFESTATION :
 Uterine fibroids often are asymptomatic i.e do not
cause symptoms, especially in women younger than
30years of age
 When symptoms do occur they usually depend on the
location of fibroids
 When the growth located in the bladder regions it
may cause uterine symptoms
 Those that affect the lining of the uterus
(endometrium) may cause problems with mensuration

9. Signs and symptoms includes :
 Abdominal or pelvic pain
 Bowel problems ( Painfull bowel movements)
 Infertility
 Feeling of fullness in the lower abdomen
 Low back pain
 Bleeding between periods
 Painful periods (Dysmenorrhea)

10.  Heavy menstural bleeding (menorrhagia)
 Pain during intercourse
 Pregnancy complications (misscariage, early
labor)
 Urinary symptoms (frequency in urination,
painful urination (dysuria).

11. DIAGNOSTIC EVALUATION :
 Pelvic examination
 Pelvic ultrasound
It is the simplest, cheapest and the best
technique for imaging the pelvis.
 An endomerial biopsy
Performed by taking a tissue sample from the
uterus.
 Hysteroscopy
Performed to look the uterus by passing a small
fiber optic camera through the opening of the
cervix.

12.  Hysterosalpingogram(HSG)
In this procedure,an ultrasound exam is done
while contrast fluid is injected into the uterus from
cervix
The fluid is visualized in the endomerial cavity
and thus outlines any masses that are inside, such as
submucosal fibroids.
 CT and MRI scans
 Complete blood count (CBC) is done to determine
if patient have iron deficiency anemia because of
chronic blood loss.

15. MANAGEMENT :
 Medical therapy and surgical procedures can shrink
or remove fibroids if patient have discomfort or
troublesome symptoms.
 Rarely fibroids can require emergency treatment if
they cause sudden, sharp pelvic pain or profuse
menstural bleeding.

16. MEDICAL MANAGEMENT :
 Medications for uterine fibroids target harmones
that regulate menstural cycle, treating
symptoms such as heavy menstural bleeding and
pelvic pressure.
 They don’t eliminate fibroids,but may shrink the
fibroids by as much as 50%.
 These medications are given to three to six
months.

17.  Mild pain may be treated using the prescription
of pain reliever non steroidal anti-inflammatory
drugs like ibuprofen and acteaminophen
 In some cases harmone treatment can be used
to reduce the size of the uterine fibroids.
For eg. Leuteninzing harmone-releasing
harmone(LHRH),Gonadotropin-releasing
harmone(GnRH)agonist,oral contraceptives or
progestins, Danazol(Danocrine) and anti-harmone
drugs (mifepristone).

18.  Mifepristone( RU-486) is an antiprogestin drug that
cam shrink fibroids to an extent comparable to
treatment with GnRH analogs.
 Low doses of this drug may reduce the size of
fibroids in preparation for surgery to remove them.
 Treatment with mifepristone also reduced the
bleeding associated with fibroids
 This drug is sometimes known as the morning after
pill is also used to terminate early pregnancy.

19. SURGICAL MANAGEMENT :
 Uterine fibroids that cause moderate to severe
symptoms may require surgery.
 A number of surgical procedures are available to
treat this condition
 The method used depends on several factors, such
as the patients age amd whether she may want to
become pregnant and the size and location of the
fibroids.

20. 1.Hysterectomy:
 It is the surgical removal of the uterus,it may be
performed vaginally or through an incision in the
abdomen.
 This treatment may be used in women with severe
uterine fibroids who do not wish to havr children.
 Hysterectomy may also include removing other
partsof the female reproductive system such as
cervix, ovaries and fallopian tubes.

21. 2.Myomectomy:
 In this procedure uterine fibroids are removed
without damaging Helathy tissue.
 This surgical procedure ,which usually does not
affect fertility, often is performed through small
incisions using instruments passed through a
laproscope or hysteroscope.

23. 3.Myolysis:
 Myolysis involves using electrical current passed
through a needle to destroy blood vessels that supply
the uterine fibroids that allows them to grow.
 This procedure which usually is performed through a
small incision in the abdomen.
 This procedure may affect fertility.

24. 4.Endometrial ablation:
 Endometrial ablation involves destroying the lining of
the uterus (endomerium) and the surface layer of
smooth muscle (myometrium) using a laser or thermal
ballon(fulid filled balloon inserted into the uterus and
heated to destroy tissue)
 Following thus procedure women are unable to become
pregnant.

26. 5.Uterine artery embolization:
 Embolic agents injected into the arteries supplying
the uterus to cut off the blood flow to fibroids,
causing them to shrink
 Advantages over surgery include no incision and a
shorter recovery time.
 Complications may occur if the blood supply to
ovaries or other organs is compromised.