Uterine Fibroid

📚INTRODUCTION

Uterine fibroids are the most common benign tumors of the female reproductive system, arising from the smooth muscle layer (myometrium) of the uterus.

They are estrogen-dependent tumors, commonly seen in women of reproductive age (30–50 years) and tend to regress after menopause.

♦️DEFINITION

A uterine fibroid is a benign (non-cancerous) growth of smooth muscle and fibrous tissue in the uterus.

🔷ETIOLOGY / CAUSES

• (Exact cause unknown, but associated factors include)

• Hormonal factors (↑ estrogen & progesterone)

• Genetic predisposition

• Growth factors (IGF, EGF)

• Increased local estrogen production

• Abnormal response of myometrial cells

⭕RISK FACTORS

• Age (30–50 years)

• Early menarche

• Nulliparity (no childbirth)

• Obesity

• Family history

• High estrogen exposure

• PCOS

• Hypertension

• Diet high in red meat

  
  

🧮CLASSIFICATION / TYPES

🔷CLINICAL MANIFESTATIONS

(Depends on size, number, and location)

Menstrual Symptoms

• Menorrhagia (heavy bleeding)

• Prolonged menstruation

• Intermenstrual bleeding

Pain Symptoms

• Pelvic pain

• Dysmenorrhoea

• Backache

Pressure Symptoms

• Frequent urination (bladder pressure)

• Constipation (rectal pressure)

• Abdominal distension

Reproductive Issues

• Infertility

• Recurrent abortions

General Symptoms

• Fatigue

• Weakness (due to anemia)

🧪DIAGNOSIS

Clinical Evaluation

• Detailed menstrual history

• Pelvic examination → enlarged, irregular uterus

Investigations

• Ultrasound (USG) → first-line, confirms fibroid

• MRI → detailed size & location

• Hysteroscopy → visualize uterine cavity

• Endometrial biopsy → rule out malignancy

• Blood tests → Hb (anemia)

🧫COMPLICATIONS

• Severe anemia (due to heavy bleeding)

• Infertility

• Recurrent pregnancy loss

• Degeneration (red degeneration causing acute pain)

• Torsion (in pedunculated fibroid)

• Pressure effects on bladder/bowel

• Rare malignant transformation (leiomyosarcoma)

👨🏻‍⚕️MANAGEMENT

1. Conservative / Medical Management

• Observation (if small & asymptomatic)

• NSAIDs → pain relief

• Tranexamic acid → reduce bleeding

• Hormonal therapy:

• Oral contraceptive pills (OCPs)

• Progesterone

• GnRH agonists (shrink fibroid)

• Iron supplements → treat anemia

2. Surgical Management

• Myomectomy → removal of fibroid (fertility preserved)

• Hysterectomy → removal of uterus (definitive treatment)

• Uterine artery embolization (UAE) → cuts blood supply

• Endometrial ablation → reduces bleeding

🏥NURSING MANAGEMENT

Assessment

• Monitor menstrual bleeding pattern

• Check vital signs

• Assess pain level

Nursing Interventions

• Provide pain relief measures

• Administer prescribed medications

• Maintain fluid and electrolyte balance

• Monitor Hb levels

• Prepare patient for surgery

• Provide post-operative care (infection prevention, wound care)

HEALTH EDUCATION

• Explain disease and treatment options

• Encourage iron-rich diet (green leafy vegetables)

• Maintain menstrual hygiene

• Importance of follow-up

• Avoid self-medication

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🚀Here’s a short “exam trick” version for Uterine fibroids — super quick points you can remember:

Introduction: Common benign tumor of uterus in reproductive age

Definition: Non-cancerous growth of uterine smooth muscle

Causes: Hormonal (↑ estrogen & progesterone), genetic factors

Risk factors: Age 30–50, obesity, nulliparity, early menarche

Types: Intramural (wall), Submucosal (cavity), Subserosal (outside), Pedunculated (stalk)

Clinical manifestations: Heavy bleeding, pain, pressure symptoms, infertility

Diagnosis: Pelvic exam, USG (most common), MRI, hysteroscopy

Complications: Anemia, infertility, abortion, pressure effects, degeneration

Management: Medical (NSAIDs, hormones, iron) + Surgical (myomectomy, hysterectomy)

Nursing management: Monitor bleeding, pain, Hb, give drugs, patient education.

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🚀Here’s a set of 07 MCQs on Uterine Fibroid for practice:

1. Uterine fibroid is:

a) Malignant tumor

b) Benign tumor of uterus ✅

c) Infectious disease

d) Hormonal disorder

2. Most common type of fibroid is:

a) Submucosal

b) Subserosal

c) Intramural ✅

d) Pedunculated

3. Fibroid is most commonly seen in:

a) Children

b) Postmenopausal women

c) Reproductive age women (30–50 yrs) ✅

d) Neonates

4. Most common symptom of uterine fibroid:

a) Amenorrhea

b) Menorrhagia (heavy bleeding) ✅

c) Weight loss

d) Fever

5. Investigation of choice for fibroid:

a) X-ray

b) Ultrasound (USG) ✅

c) ECG

d) CT scan

6. Drug used to reduce bleeding in fibroid:

a) Antibiotics

b) Antivirals

c) Tranexamic acid ✅

d) Antifungals

7. Definitive treatment of uterine fibroid is:

a) Iron therapy

b) NSAIDs

c) Hysterectomy ✅

d) Bed rest