the most common benign uterine tumour, a simple approach to understand fibroid, pathology, diagnosis, modes of treatment

1. Fibroid

2. Definition :

3. Etiology :

4. Risk factors are:

6. Histogenesis

9. Pathology ... ... N ...... SSSS ...... CCC ...... M ...

10.  type II

15. Secondary (Pathological) changes :

18. (B) Vascular

20. (3) Inflammatory

21. (4) Malignant(Sarcomatous change)

22. Clinical Picture :

26. 6) Pressure symptoms
Frequency, retensionof urine, incontinence,constipation(even obstipation? =IO), rarely
hydronephrosis if compressing ureter ( in Cx fibroid). Large tumors may cause palpitation,
orthopnia, dyspepsis.
7) Pregnancycomplications
reccurent abortion in submucus ( space occupying ) in 40 % and after removal 20 %...

28. • - Bimanual examination

29. Complications of fibrold :
1.Pathological (2ry) changesof fibroid.
2.Pregnancy complications.
3.Ruptureof surface vein causinginternalhge.
4.Impaction (incarceration): with cervical or posterior wall fibroid.
5.Pressure effects.(onbladder→...., urethra→......,ureter→.....rectum→....)

30. 6.Prolapse, chronicinversion, cervical elongation & obstruction.
7.Infertility (1⁄3 cases) & anemia.
8.Pseudo-meig's syndrome and polycythemia .
9.Elongation and stretch of thetube in broad ligament fibroid.
10.Anemia incase of bleeding.
11.Tortion uterus :very rare, in case of very large fundal subserous fibroid.

31. Differential diagnosis :

32. Investigations :

34. Treatment of Fibroids ....... Depends on :

35. (1) Expectant ttt ( observation) :

36. (2) Medical ttt : ...creats a state of hyperestrogenemia
deprive the tumor from stimulus

39. (3) Surgical ttt : mainstay treatment or standard line

42. Hysterectomy

43. Hysterectomy

44. (4) Uterine Artery Embolization (UAE).

47.  Relative
Coagulopathy
Renalimpairment
Desire for futurefertility
Uterine size >20–24 weeks
Prior salpingectomy or salpingo-oophorectomy
Prior pelvic radiation
Concurrent GnRH agonistuse
Pedunculated:subserosal or submucousleiomyoma Large hydrosalpinx
Severe contrast allergy