Fibroids Flashcards
Define fibroids.
Benign tumor (leiomyoma) arising from myometrium.
Explain the aetiology of fibroids.
Hormone dependentL contain large numbers of oestrogen and progesterone receptors, Enlarge in pregnancy (high OES) and shrink in menopause (low OES).
What are the risk factors for fibroids?
Nuliparity, FHx, obese.
Reduced risk with smoking and hormonal contraception.
What are the different classifications of fibroids?
Can be submucosal, intramural or subserosal.
Rounds of smooth muscle and connective tissue.
What are the secondary changes fibroids can undergo?
Hyaline degeneration (mucopolysaccharides deposit around fibres)
Calcification (postmenopausal)
Red degeneration (coagulative necrosis, pregnancy)
Cystic change (liquefaction)
Summarise the epidemiology of fibroids.
30% women reproductive age
Recognise the presenting symptoms of fibroids.
Menhorragia
Dysmenhorrea
Abdominal swelling
Pressure symptoms
Dyspareunia
Miscarriage
Infertility
Often asymptomatic
Recognise the signs of fibroids on physical examination.
Abdomen: May be palpable
Vaginal: Uterine enlargement
Identify appropriate investigations for fibroids and interpret the results.
Blood: FBC for anaemia
USS: TVS to diagnose.
Other: Hysetroscopy – can see submucosal ones.
Generate a management plan for fibroids.
No treatment if asymptomatic.
Medical: Tranaxemic acid and mefenamic acid. COCP, IUS, GnRH analogues.
Surgical: Endometrial ablation, transcervical resection of fibroid, uterine artery embolisation, myomectomy, hysterectomy.
Identify the possible complications of fibroids and its management.
Anaemia (menhorragia)
Miscarriage
Infertility
Malignant change (leiomyosarcoma).
Summarise the prognosis for patients with fibroids.
10y recurrence after removal 15%.
