Leiomyoma, or uterine fibroids, are benign tumors of the uterine smooth muscle that are common among women over 30 years old. Risk factors include early menarche, nulliparity, family history, and increased BMI. Protective factors include childbearing, use of oral contraceptives, Depo-provera, and LNG-IUS. Fibroids are classified based on their location as submucosal, intramural, or subserosal. Common symptoms include heavy menstrual bleeding, intermenstrual bleeding, pressure symptoms, pain, and subfertility. Complications can include anemia, torsion, degeneration, calcification, and rare sarcomatous change.

1. LEIOMYOMA
Dr. Sana Javed
Post-Graduate Resident
Gynae Dept. SZH RahimYarKhan

2. • Benign tumor of uterine smooth muscle
• Gross morphology – Whorled pattern of smooth muscles

3. EPIDEMIOLOGY
• Incidence : 20% in women over 30 yrs of age.
• Age Distribution: 4th – 5th decade of life
• Parity : Higher incidence in Nulliparous & low fertility.
Child bearing has a protective effect.
• Race : Less common in Caucasians ,
2-3 times higher incidence in African – Black races
& at younger age.
• Hereditary Factor : Seen more in patients with a family history of fibroid.

4. • Risks
Early menarche, nulliparity, family history, Increased BMI
• Protective Factors :
Childbearing, Prolonged use of OCPs, Depo-provera and LNG-IUS.

5. AEITIOLOGY
• Unicellular in origin
• Ovarian Hormone dependant tumor.
• EGF , Vascular EDF , TGF-β
• Over- expression of Estrogen and Progesterone receptors .

6. CLASSIFICATION
• Uterine Corpus Fibroids
Sub- mucosal
Intra mural
Sub- serosal
• Cervical Fibroids 1-2%
Intra mural
Sub serosal
• Intra-Ligamentary Fibroids
Broad Ligament - Embryonal remanents.

7. SYMPTOMATOLOGY
• Heavy Menstrual Bleeding – submucosal
• Intermenstrual Bleeding , Vaginal discharge
• Pressure Symptoms
• Lower abdominal pain
• Sub fertility - large fibroid obstructing cornual ends

8. COMPLICATIONS
• Heavy Menstrual Bleeding – anemia
• Sub-serosal pedunculated – torsion
• Degeneration - Cystic , Hyaline , Red
• Calcification
• Sarcomatous Change 0.1%