uterine fibroids

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Author:
mariyage
ID:
123127
Filename:
uterine fibroids
Updated:
2011-12-12 16:11:59
Tags:
fibroids
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Description:
fibroids
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  1. fibroid, aka
    leiomyoma, uterine myoma
  2. define leiomyoma
    • benign SM tumor
    • MC solid pelvic tumor
    • #1 cause of hysterectomies
  3. locations of leiomyoma
    • 1. submucosal - beneath endometrium - most symptomatic
    • 2. intramural
    • 3. subserosal
  4. symptoms of leiomyoma
    • 1. asxs (MC) -> monitor
    • 2. bleeding - menorrhagia (MC symptom)
    • 3. pain - pressure, low back pain, urinary frequency
    • 4. infertility - compression of fallopian tubes
  5. define menorrhagia
    • menses lasting >= 7 days
    • anemia
    • changes quality of life
  6. PE of leiomyoma
    • non-tender pelvic mass moves contiguously w cervix
    • (if fixed or fluctuant >> not fibroid)
  7. Dx leiomyoma
    • pathological
    • US - best test uterus and ovaries
    • PE
    • hysteroscopy
    • sonohysterogram
    • HSG (histerosalpingogram)- XR
  8. if bleeding, must r/o
    • uterine CA
    • endometrial polyp
    • anovulation - MCC
    • thinning lining
  9. treatment of leiomyoma
    • NSAIDs - pain
    • Progesterin - control bleeding
    • GnRH agonists - shrink fibroids - max effect 3 months - enlarge again when stop tx
    • Sx
  10. Tx of fibroids for F desiring future pregnancies
    • myomectomy - removal fibroid
    • uterine a. embolization
    • endometrial ablation - control bleeding
    • myolysis - coagulates fibroid w electricity
  11. Tx of fibroids for F who doesNOT desire future pregnancy
    hysterectomy

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