Fibroids

Question 1

Fibroids

Answer 1

1. non cancerous growths that develop in or around the uterus
2. Arise from the myometrium

Question 2

Submucous fibroids

Answer 2

Fibroids that develop in the muscle layer and grow into the cavity of the womb

Question 3

Intramural fibroids

Answer 3

located within the myometrium

Question 4

Subserosal fibroids

Answer 4

Develop outside the uterine wall and grow into the pelvis

Question 5

Menstruation symptoms of fibroids

Answer 5

1. Dysmenorrhea

2. Menorrhagia

Question 6

General symptoms of fibroids

Answer 6

1. Pressure symptoms - increase in urinary frequency and constipation
2. Pelvic pain
3. Pain during sex

Question 7

Diagnosis of fibroids

Answer 7

1. Clinical examination - hard, irregular uterine mass

2. Transvaginal/abdominal ultrasound

Question 8

Treatment for fibroids - conservative

Answer 8

GnRH analogues - shrinks fibroids, but should only be used for this purpose prior to surgery

Question 9

Surgical treatment for uterine fibroids

Answer 9

1. Myomectomy - open, laparoscopic or hysteroscopic depending upon location
2. Hysterectomy - women who have either completed their family

Question 10

What are fibroids dependant on?

Answer 10

Oestrogen

Question 11

Risk factors for fibroids

Answer 11

1. Nulliparity
2. Obesity
3. Family history

Question 12

Which type of fibroid causes menorrhagia?

Answer 12

1. Fibroid of submucous origin

2. Distorts the endometrial cavity by increasing the endometrial surface area

Question 13

Tx for fibroids

Answer 13

Fibroids are not removed unless they cause symptoms

Question 14

First line medical Mx for Fibroids

Answer 14

First line - symptomatic management with a levonorgestrel-releasing intrauterine system is recommended by CKS first-line

Question 15

Complication of fibroids

Answer 15

red degeneration - haemorrhage into tumour - commonly occurs during pregnancy

Question 16

Medical therapies for fibroids - 2nd line

Answer 16

other options include tranexamic acid, combined oral contraceptive pill etc