Types of fibroids
- Submucosal: just beneath the lining, growing into the cavity; even small ones are linked to bleeding and infertility.
- Intramural: within the uterine wall; symptoms depend on size.
- Subserosal: on the outer surface; usually cause pressure symptoms.
- Pedunculated: attached by a stalk; rarely twist and cause pain.
Symptoms
- Heavy, prolonged periods and anaemia
- Pelvic pain, painful periods, pain during sex
- Pressure symptoms such as frequent urination or constipation
- Abdominal swelling or a palpable mass
Do fibroids affect fertility?
Submucosal fibroids that distort the cavity lower pregnancy rates and increase miscarriage risk, so hysteroscopic removal is recommended. The effect of intramural fibroids depends on size and position. Subserosal fibroids that do not affect the cavity usually have no effect. Assessing fibroids before IVF is an important part of planning.
Diagnosis
Usually by transvaginal ultrasound; saline sonohysterography or hysteroscopy assesses the cavity, and MRI is used in complex cases.
Treatment options
- Observation for fibroids without symptoms.
- Medication: treatments that reduce bleeding, a hormonal IUD or pre-operative shrinking.
- Hysteroscopic myomectomy: cavity fibroids removed through the vagina without incisions.
- Laparoscopic myomectomy: suitable fibroids removed by keyhole surgery with faster recovery.
- Open myomectomy: for many or very large fibroids.
- Hysterectomy: for women who do not want children and have not benefited from other treatments.
After uterus-sparing surgery, pregnancy timing and mode of birth are planned according to the extent of the operation.
Frequently Asked Questions
Can fibroids become cancer?
Fibroids are benign and malignant change is extremely rare. Rapid growth or growth after menopause is assessed separately.
Can I get pregnant with fibroids?
Yes, many women with fibroids have healthy pregnancies. Fibroids affecting the cavity should be treated beforehand.
Sources
- ACOG Practice Bulletin No. 228: Management of Symptomatic Uterine Leiomyomas, 2021.
- Totally inverted cervix due to a huge prolapsed cervical myoma simulating chronic non-puerperal uterine inversion. International Journal of Surgery Case Reports, 2014.
The information on this website is for general information only and does not replace a medical consultation.