Fibroids Flashcards
Fibroids
Benign smooth muscle tumours of the uterus
Associations
More common in Afro-Caribbean women
Features
May be asymptomatic
Menorrhagia
Bulk-related symptoms
- lower abdo pain
- bloating
- urinary symptoms
Subfertility
Polycythaemia secondary to autonomous production of erythropoetin
Diagnosis
Transvaginal ultrasound
Management asymptomatic
No treatment
Periodic review to monitor size and growth
Management of menorrhagia secondary to fibroids
IUS (cannot be used if distortion of the uterine cavity)
NSAIDs (mefenamic acid)
Tranexamic acid
COCP
Oral progesterone
Injectable progesterone
Medical treatment to shrink/ remove
GnRH agonists
Ulipristal acetate (serious liver toxicity)
Surgery
Myoemectomy
Hysteroscopic endometrial ablation
Hysterectomy
Complications
Subfertility
Iron deficient anaemia
Red degeneration
