1.
UTERINE FIBROIDS

2.
DEFINITION
• Uterine fibroid is a leiomyoma (benign (non-
cancerous) tumor from smooth muscle tissue)
that originates from the smooth muscle layer
(myometrium) of the uterus

3.
CAUSES
• unknown.
• Family history
• Genetic alterations.
• Hormones.
• Other chemicals.

4.
RISK FACTORS
• Heredity.
• Race.
• Pregnancy and childbirth.
• Nulliparity Obesity
• Oral contraceptives.

5.
TYPES
• BODY OR
CORPOREAL
FIBROIDS
• Intramural or
interstitial fibroids
• Subserosal fibroids
• Submucosal fibroids

6.
• CERVICAL FIBROIDS 1-2 %

7.
SECONDARY CHANGES IN
FIBROID
• Degenerative changes
• Hyaline degeneration:
• Cystic degeneration:
• Calcification:
• Fatty degeneration:
• Red degeneration:
• Septic degeneration:

8.
• Infection
• Atropy
• Necrosis
• Vascular changes
• Sarcomatous changes

9.
CLINICAL FEATURES
• 75 % remains asymptomatic
• Menustrual abnormalities
– Menorrhagia (30%)
– Metrorrhagia or irregular bleeding

10.
• Dysmenorrhea
• Infertility(30%):
• Pain lower abdomen
• Abdominal swelling (lump)
• Pressure symptoms

11.
• Abdominal examination
• Feel is firm more towards hard may be cystic
in cystic degeneration.
• Margins are well defined except the lower
pole.
• nodular may be uniformly enlarged
• Mobility is restricted from above downwards
but can be moved from side to side.
• Percussion : swelling is dull

12.
• Pelvic examination
• Bimanual examination reveals uterus
irregularly enlarged
• Uterus is not felt separated from the swelling
and as such a groove is not felt between the
uterus and the mass.
• The cervix moves with the movement of the
tumour felt per abdomen.

13.
DIAGNOSIS
• An abdominal, transvaginal or pelvic
ultrasound
• An endometrial biopsy
• A hysteroscopy
• Hysterosalpingography
• Laparoscopy

14.
TREATMENT
• For symptomatic fibroids
• Medication to control symptoms
• Medication aimed at shrinking tumours
• Ultrasound fibroid destruction
• surgically aided methods to reduce blood
supply of fibroids
• Myomectomy or radio frequency ablation
• Hysterectomy
• Treatment for infection and anemia
• Embolization

15.
Medications
• Oral contraceptive pills
• GnRH agonists
• The antihormonal drug RU-486
(mifepristone)
• Danazol (Danocrine)
• Antifibrinolytics (tranexamic acid)
• Nonsteroidal anti-inflammatory agents
• Progesterone receptor modulator named
Ellaone

16.
SURGERY
• Myomectomy
• Hysterectomy

17.
• Uterine artery embolization,
• Uterine artery ligation
• Radio frequency ablation
• Endometrial ablation

18.
COMPLICATIONS
• Menorrhagia.
• Abdominal pains
• Premature birth, labor problems,
miscarriages
• Infertility

19.
• Leiomyosarcoma
• Twisting of the fibroid
• Anemia
• Urinary tract infections
• A c-section may be needed
• Some pregnant women with fibroids
have heavy bleeding immediately after
giving birth.

20.
NURSING DIAGNOSIS
• Acute pain related to post operative wound as
manifested by facial expression and pain scale
score
• Imbalanced nutrition less than body
requirements related to pain as manifested by
decreased food intake.

21.
• Impaired bowel elimination , constipation
related to decreased activity, pain on straining
• Disturbed sleep pattern related to pain and
hospitalization
• Risk for infection related to the surgery
• Low Self-Esteem related to changes in
femininity as evidenced by Withdrawal,
depression