UTERINE FIBROIDS

 
Uterine fibroids are a very common tumour in women. In the majority of cases they can grow to a large size without causing concern. Most women do not feel them and they go undetected.

The location of the fibroid determines if they are felt or not.


Types of Fibroids according to location

Subserous - arise from surface of uterus
Intramural - arises from the deeper muscle layer
Broad ligament - grows into side of uterus close to the major blood vessels of the uterus
Submucous - grows within the uterine cavity or close to the endometrium


Subserous Fibroids

Subserous fibroids are those on the surface of the uterus and are the most common. These grow quite large without being felt. They are usually detected in the course of routine check ups.

Small Subserous Fibroids
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Subserous Fibroid
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When they grow large enough to be of concern, the main complaint is pressure. Fibroids on the anterior wall of the uterus press on bladders and cause women to go to the toilet frequently. One example is the one in the picture.

Subserous Fibroid - large and broad based
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Larger subserous fibroids can have a broad base, arising from muscle layers deep in the uterus and can be difficult to remove during surgery.

Pedunculated Fibroid
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Left ovary enlarge, cyst is about 2 cm. in diameter and there are adhesions to the uterus.

Broad Ligament Fibroid
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Sometimes the fibroids grow into the broad ligament. Removal is feasible but difficult as there are many blood vessels in that area.

Vaginal Fibroid
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Occasionally fibroids arise from unusual areas like the back of the vagina.


Submucous Fibroids

This group of fibroids tend to be the most often detected as they cause abnormal vaginal bleeding - periods can be prolonged, heavy or irregular in women with these fibroids. Fertility is another complaint. The presence of fibroids in the uterine cavity makes it difficult for the embryo to attach. This is described by a gynecologist (who happens to be a gardening enthusiast) as being similar to planting trees in a rock garden.

Submucous Fibroids - Multiple
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Submucous Fibroid - Single
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Intracavitary Fibroid
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Movement of hysteroscope through cervical canal to view an Intracavitary Fibroid.

Hysteroscopic Resection of Fibroid
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Adhesions
Cysts
Endometriosis
Endoscopy
Fibroids
Gynaecology
Hysteroscopy
Infertility
Keyhole Surgery
Laparoscopic Surgery
- For Ovarian Cyst
Laparotomy for Uterine Fibroids

  DR YAP LIP KEE
Gynaecologist,
GYNAE CONSULTANCY PTE LTD
Mount Elizabeth Medical Center Visiting Doctor
(Formerly Head and Senior Doctor)
Minimally Invasive Surgery Unit,
KK Women's and Children's Hospital
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