Uterine leiomyoma

Definition

• Benign smooth-muscle tumour of the uterus

Epidemiology

• Most common pelvic tumour in reproductive-age women

Risk Factors

• Family history
• Early menarche

Clinical Presentation

• May be asymptomatic if small
• Larger fibroids may have obstructive symptoms
  • Constipation
  • Urinary frequency or retention
  • Back and pelvic pain
  • Impaired fertility
• Abnormal menstrual bleeding

Investigations

• Imaging:
  • Ultrasound is first-line and has high sensitivity

Management

• If asymptomatic: observation
• If symptomatic
  • Hormonal contraception
  • Embolization
  • Surgical excision